Abstract

Objective: PFAPA (Periodic fever, apthous stomatitis, pharyngitis and cervical adenitis) is characterized by recurrent periodic  fever, pharnygitis,  stomatitis  and  classified  under  the  hereditary  fever  syndromes.  Diagnosis  is  based  on exclusion of diseases as bacterial and viral pharngitis commonly seen during childhood. There is no specific laboratory test during attacks. In this study, we recruited patients with complaints of recurrent fever and pharngitis and evaluated their final diagnosis. Also we aimed to compare the laboratory findings of PFAPA patients with bacterial and viral tonsillits

Material and Methods: Sixty-nine patients with recurrent fever and pharngitis were included in this study. All patients were evaluated by the same physician. Patients who had regular fever attacks and characteristic physical findings were diagnosed as PFAPA syndrome. Others who do not have regular fever were diagnosed as recurrrent tonsillopharngitis. Leucocyte and acute phase reactant (erytrocyte sedimentation rate, C reactive protein, procalcitonin) levels of patients with recurrent fever were compared with patients with group A streptococcus tonsillitis (n=9) and viral tonsillitis (n=15). 

Results: On follow-up 46 patients were diagnosed as PFAPA syndrome and 23 patients were diagnosed as recurrent tonsillopharngitis. Among patients with recurrent tonsillopharngitis, two patients were diagnosed as familial Mediterrenean fever (FMF), one was diagnosed as gastroesophageal reflux (GER) on follow-up. Remaining 20 patients had neither fever on follow-up or had irregular fever. When we compared patients with PFAPA syndrome and recurrent tonsillipharngitis, patients with PFAPA syndrome had statistically higher percent of family member with familiy history of recurrent tonsillitis (%60.9) (p=0.041) and were younger at disease onset (p=0.022). The procalcitonin levels of PFAPA patients were indifferent compared to bacterial tonsillitis patients (p=0.053).

Conclusion: Patients who admitted for recurrent fever and tonsillitis before 5 years of age should be followed for attack characteristics for correct diagnosis of PFAPA syndrome. Family history should be questioned for recurrent tonsillitis and familial mediterrenean fever. Procalcitonin levels were indifferent between PFAPA patients and bacterial tonsillitis during attacks.

Keywords: PFAPA syndrome, recurrent tonsillopharngitis

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Copyright and license

Copyright © 2019 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Kara Eroğlu F. DISTINGUISHING CLINICAL AND LABORATORY FEATURES OF PATIENTS WITH PFAPA SYNDROME, RECURRENT TONSILLOPHARNGITIS AND INFECTIOUS TONSILLITIS. Turk J Pediatr Dis [Internet]. 2019 Mar. 26 [cited 2025 Aug. 23];13(2):107-11. Available from: https://turkjpediatrdis.org/article/view/629