Long-term follow-up of tonsillectomy efficacy in children with PFAPA syndrome

Aktas, Ozturk; Aytuluk, Hande Gurbuz; Caliskan, Sebla Kumas; Erdur, Omer; Cirik, Ahmet Adnan

doi:10.1016/j.bjorl.2017.10.012

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Brazilian Journal of Otorhinolaryngology

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Original articles • Braz. j. otorhinolaryngol. 85 (1) • Jan-Feb 2019 • https://doi.org/10.1016/j.bjorl.2017.10.012 copy

Long-term follow-up of tonsillectomy efficacy in children with PFAPA syndrome^☆ ☆ Please cite this article as: Aktas O, Aytuluk HG, Caliskan SK, Erdur O, Cirik AA. Long-term follow-up of tonsillectomy efficacy in children with PFAPA syndrome. Braz J Otorhinolaryngol. 2019;85:78-82.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction:

The role of tonsillectomy in the periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome, is controversial. Although some studies reported high success rates with tonsillectomy, further investigations are needed with larger numbers of patients.

Objective:

To seek the long-term outcomes of tonsillectomy in periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome.

Methods:

Case series; multi-center study. The study comprised 23 patients with periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome who underwent surgery (tonsillectomy with or without adenoidectomy) between January 2009 and November 2014.

Results:

21 (91%) of 23 patients had complete resolution immediately after surgery. One patient had an attack 24 h after surgery, but has had no further attacks. One patient had three attacks with various intervals, and complete remission was observed after 3 months.

Conclusions:

Tonsillectomy is a good option for the treatment of periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome.

KEYWORDS
Fever; Lymphadenitis; Stomatitis aphthous; Pharyngitis; Tonsillectomy

Characteristic	PFAPA patients (n = 23)
Male; n (%)	14 (61%)
Female; n (%)	9 (39%)
Age at onset; mean (range), months	27 (12-36)
Recurrence of episodes; mean (range), weeks	3.9 (3-8)
Duration of fever; mean (range), days	3.7 (3-5)
Pharyngitis; n (%)	18 (78%)
Cervical adenitis; n (%)	14 (61%)
Aphthous stomatitis; n (%)	10 (43%)
Age at surgery; mean (range), months	50 (36-84)

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br

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[1] * Corresponding author. E-mail:handegrbz@gmail.com (H.G. Aytuluk).

Case no.	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	19	20	21	22	23
Male/female	M	F	M	M	M	M	M	F	M	F	F	M	F	M	M	M	F	F	F	M	M	M	F
Age onset, months	12	12	13	14	14	18	22	24	24	28	28	32	32	32	33	34	34	35	36	36	36	36	36
Recurrence of episodes, weeks	3	8	3	3	3	6	3	4	3	4	4	4	3	5	3	3	4	3	3	4	3	6	4
Duration of fever, days	3	3	4	3	3	5	5	3	4	3	3	5	3	3	5	3	5	3	3	3	5	5	3
Pharyngitis	-	+	-	-	+	+	+	-	+	+	+	+	+	+	+	-	+	+	+	+	+	+	+
Aphthous stomatitis	+	+	+	+	-	-	-	-	+	+	-	-	+	-	-	-	+	+	-	-	-	+	-
Cervical adenitis	-	-	-	+	-	+	+	-	-	+	+	-	+	-	+	+	-	+	+	+	+	+	+
AT/T	AT	AT	AT	AT	AT	AT	AT	AT	AT	AT	AT	AT	T	AT	AT	AT	AT	AT	AT	T	AT	AT	AT
Age at surgery, months	48	40	55	44	36	36	39	36	36	41	37	38	52	84	72	50	40	80	42	60	68	70	46

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Long-term follow-up of tonsillectomy efficacy in children with PFAPA syndrome☆ ☆ Please cite this article as: Aktas O, Aytuluk HG, Caliskan SK, Erdur O, Cirik AA. Long-term follow-up of tonsillectomy efficacy in children with PFAPA syndrome. Braz J Otorhinolaryngol. 2019;85:78-82.

Abstract

Introduction:

Objective:

Methods:

Results:

Conclusions:

Long-term follow-up of tonsillectomy efficacy in children with PFAPA syndrome^☆ ☆ Please cite this article as: Aktas O, Aytuluk HG, Caliskan SK, Erdur O, Cirik AA. Long-term follow-up of tonsillectomy efficacy in children with PFAPA syndrome. Braz J Otorhinolaryngol. 2019;85:78-82.