Periodisches Fieber, aphthöse Stomatitis, Pharyngitis und Lymphadenitis (PFAPA-Syndrom) im Erwachsenenalter

Ce, Onderka; Gj, Ridder

doi:10.1055/s-0031-1298919

Cited by 6 publications

(5 citation statements)

References 32 publications

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“…Since the disease is not common, mostly series of case reports have been published in which the effect of surgery has been difficult to demonstrate. However, with randomization and meta-analysis, a positive effect of tonsillectomy has recently been clearly shown [28,29,30]. Of course, tonsillotomy is not suitable for a disease that is probably autoimmune, and the question is whether an adenotonsillectomy is always required to solve the patient's problem.…”

Section: Paradigm Shiftmentioning

confidence: 99%

Factors Influencing the Indication for Tonsillectomy: A Historical Overview and Current Concepts

Hultcrantz

Ericsson²

2013

ORL

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Tonsil surgery has been performed for more than 3,000 years. During the 19th century when anesthesia became available, techniques were refined and the number of procedures performed increased. Repeated throat infections often causing big tonsils was the reason why parents asked for the procedure. During the preantibiotic era, scarlet fever was feared since potential heart or kidney complications were life-threatening. The technique used before 1900 was tonsillotomy since neither a fingernail, snare nor the later ʼguillotineʼ were used extracapsularly. Bleeding was small and the surgery ambulatory. Extracapsular tonsillectomy developed around the turn of the 20th century with the purpose of avoiding remnants - the ‘focal infection theory' was prevailing. The whole tonsil was now extirpated with good visibility of the tonsillar area in a deeply anesthetized patient. During the first half of the 20th century, the two methods competed, but by 1950, total tonsillectomy had become the only ‘correct' tonsil surgery. The indication was still recurrent infections. The risk for serious bleeding increased; therefore large clinics arose where patients remained for at least a week after tonsillectomy. When oral penicillin for children became available during the 1960s, the threat of throat infection decreased and the number of tonsillectomies declined. The awareness of obstructive problems in children rose at the same time when obstructive sleep apnea syndrome became a disease for adults (1970s). Tonsillotomy was revived during the 1990s and is today used increasingly in many countries. The indication is mainly obstructive sleep apnea syndromeor sleep-disordered breathing, especially in small children. Total tonsillectomy is still preferred for recurrent infections, which include periodic fever/adenitis/pharyngitis/aphthous ulcer syndrome and recurrent peritonsillitis.

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Section: Paradigm Shiftmentioning

confidence: 99%

Factors Influencing the Indication for Tonsillectomy: A Historical Overview and Current Concepts

Hultcrantz

Ericsson²

2013

ORL

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“…It usually starts before the age of 5 and resolves spontaneously in adolescence. In addition to this classical knowledge, some studies which conducted long-term follow-up of patients diagnosed with PFAPA syndrome in childhood reported that the disease continued for a long time in a small percentage of patients [23,24]. Since the first adult patient with this disease was reported in 2008, many cases of PFAPA syndrome from not only the pediatric age group, but also from the adult age group, have been reported [14,16,[25][26][27][28].…”

Section: Adults Pfapamentioning

confidence: 99%

Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis Syndrome (PFAPA Syndrome)

Kaya¹,

Gürbüz²,

Bedrosian³

2021

Pediatric ENT Infections

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“…Between febrile episodes, the patients are asymptomatic . The symptoms usually resolve spontaneously before adolescence, but in recent years the syndrome has been described also among adults . The cumulative incidence of PFAPA has been calculated to be about two per 10 000 children up to 5 years of age , making PFAPA the most common periodic childhood febrile syndrome.…”

mentioning

confidence: 99%

Microbes of the tonsils in PFAPA (Periodic Fever, Aphtous stomatitis, Pharyngitis and Adenitis) syndrome - a possible trigger of febrile episodes

Lantto

Koivunen

Tapiainen

et al. 2015

APMIS

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Periodic Fever, Aphtous stomatitis, Pharyngitis, and Adenitis (PFAPA) is a childhood febrile syndrome that is often cured by tonsillectomy (TE). We hypothesized that microbes present in the tonsils may act as a trigger for the activation of inflammasomes and investigated the microbiology of the tonsils in PFAPA patients and controls. We recruited 31 consecutive children who underwent TE due to PFAPA; 24 children who underwent TE due to other reasons served as controls. We cultured all the samples for bacteria, mycobacteria, yeasts, and viruses and used PCR for 15 viruses. Also biofilm formation and histologic findings were identified. The samples of the patients yielded Candida albicans more often than did the controls (16 vs 0%, p = 0.003). Staphylococcus aureus occurred in only 10% of the patients, but in 38% of the controls (p = 0.01). Varicella zoster and Herpes simplex viruses occurred less often in patients than in controls. Biofilm was present in 55% of PFAPA tonsils, but in only 24% of the controls (p = 0.03). The microbes found in the tonsils of PFAPA patients showed significant differences from those of controls. This may in part explain the efficacy of TE in PFAPA.

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Periodisches Fieber, aphthöse Stomatitis, Pharyngitis und Lymphadenitis (PFAPA-Syndrom) im Erwachsenenalter

Cited by 6 publications

References 32 publications

Factors Influencing the Indication for Tonsillectomy: A Historical Overview and Current Concepts

Factors Influencing the Indication for Tonsillectomy: A Historical Overview and Current Concepts

Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis Syndrome (PFAPA Syndrome)

Microbes of the tonsils in PFAPA (Periodic Fever, Aphtous stomatitis, Pharyngitis and Adenitis) syndrome - a possible trigger of febrile episodes

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