PFAPA(PERIODIC FEVER, APHTHOUS STOMATITIS,
PHARYNGITIS, CERVICAL ADENITIS ) SYNDROME
Charoniti I,
Bitsori M, Giannousi E, Aggelaki M, Psillakis D, Kokori H
Pediatric
Department, Venizelio and University Hospital of Iraklio, Crete, Greece
PFAPA is a newly defined syndrome applying to young
children Diagnosis is mainly based on clinical criteria. Aim of the study
was to detect PFAPA in two pediatric groups. Group 1 was consisted of 123
children have had tonsillectomy done last 3 years. Group 2 was consisted of
51 children admitted with pharyngitis and high fever in last year. Medical
chatrs were retrospectively reviewed regarding periodic recurrence of fever
and other related symptoms. Additionally telephone contact was made to
confirm the periodical recurence of the symptoms. From group1, 43/123
children had tonsillectomy done due to recurrent tonsillitis. 15(34.8%)
children met the criteria of PFAPA as shown on table1. From group 2 after
the contact 12(23.7%) children met PFAPA criteria as shown on table 2.
Table 1
|
|
Male Patients
|
Female Patients
|
|
Criteria
|
1
|
2
|
3
|
4
|
5
|
6
|
7
|
8
|
9
|
10
|
11
|
12
|
13
|
14
|
15
|
|
Periodic Fever
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
|
Pharyngitis
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
|
Stomatitis
|
+
|
+
|
-
|
-
|
-
|
-
|
-
|
-
|
+
|
+
|
-
|
-
|
-
|
-
|
-
|
|
Adenitis
|
+
|
+
|
+
|
+
|
+
|
+
|
-
|
+
|
-
|
+
|
+
|
+
|
+
|
+
|
-
|
Table 2
|
|
Male Patients
|
Female Patients
|
|
Criteria
|
1
|
2
|
3
|
4
|
5
|
6
|
7
|
8
|
9
|
10
|
11
|
12
|
|
Periodic Fever
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
|
Pharyngitis
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
|
Stomatitis
|
-
|
-
|
-
|
-
|
+
|
-
|
-
|
+
|
+
|
+
|
+
|
-
|
|
Adenitis
|
-
|
+
|
-
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
All the patients met the PFAPA criteria had had normal
development. One patient was treated with methyl prednisone and improved as
well as all patients have had tonsillectomy done. In conclusion PFAPA
syndrome is a frequent cause of recurrent fever in young children and
pediatricians have to take it in serious consideration.