Original ArticleEffectiveness of Adenotonsillectomy in PFAPA Syndrome: A Randomized Study
Section snippets
Methods
Between February 2003 and December 2006, all children affected by PFAPA referred to the Department of Otorhinolaryngology of the University of Milano-Bicocca were offered participation in a randomized study. Children were eligible if they met the following diagnostic criteria for PFAPA syndrome2, 4: (1) onset of disease in early childhood (before age 5 years); (2) regularly recurring, abrupt episodes of fever lasting approximately 5 days associated with constitutional symptoms and at least 1 of
Results
A total of 41 patients were eligible; 2 parents declined to participate. Thirty-nine patients were randomized. Nineteen patients underwent surgery, and 20 patients were allocated to expectant management. All randomized patients completed the study. Baseline clinical characteristics of the recruited children according to treatment allocation are given in Table I.
No major surgical complication was reported in the surgery group. Pathological diagnoses were reactive lymphoid hyperplasia in 14
Discussion
Adenoidectomy and tonsillectomy is a highly effective treatment strategy for children with PFAPA syndrome. In our study, the majority of patients experienced complete resolution immediately after surgery. Noteworthy benefit also was documented in those without resolution. Indeed, none of them had more than 3 episodes during the study period, complete resolution was achieved in all cases within 1 year, and episodes that occurred after surgery were less severe.
Our trial was not blinded and we did
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2020, International Journal of Pediatric OtorhinolaryngologyCitation Excerpt :These results seem to be consistent with the findings of other studies. Two randomised controlled studies involving surgery for PFAPA reported significant decreases in the numbers of periodic fever episodes following intervention [14,34]. Similarly, Erdoğan et al. also observed significant decreases in the numbers of periodic fever episodes and hospitalisation requirements following surgical intervention in cases of PFAPA [13].
The authors declare no conflicts of interest.