Tonsillectomy for periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis syndrome (PFAPA)

Burton, Martin J; Pollard, Andrew J.; Ramsden, James D.; Chong, Lee Yee; Venekamp, Roderick P

doi:10.1002/14651858.cd008669.pub3

Cited by 35 publications

(27 citation statements)

References 28 publications

(12 reference statements)

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“…Tonsillectomy has been reported to prevent recurrences and while this may be effective for patients with PFAPA, it is not without risk [26][27][28]. Although two small randomized control trials [26,27] suggested that patients with PFAPA have less fever and less severe episodes after tonsillectomy compared to those receiving no surgery, a Cochrane review [28] concluded that this evidence is of moderate quality (meaning that further research is likely to have an important impact on our confidence in the estimate of effect) due to the small numbers of patients in the studies and concerns about the generalizability of the results. Moreover, the number of patients randomly allocated to surgery was too small to detect potentially important complications.…”

Section: Discussionmentioning

confidence: 99%

Consensus treatment plans for periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome (PFAPA): a framework to evaluate treatment responses from the childhood arthritis and rheumatology research alliance (CARRA) PFAPA work group

Amarilyo

Rothman²,

Manthiram

et al. 2020

Pediatr Rheumatol

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Background: Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is the most common periodic fever syndrome in children. There is considerable heterogeneity in management strategies and a lack of evidence-based treatment guidelines. Consensus treatment plans (CTPs) are standardized treatment regimens that are derived based upon best available evidence and current treatment practices that are a way to enable comparative effectiveness studies to identify optimal therapy and are less costly to execute than randomized, double blind placebo controlled trials. The purpose of this project was to develop CTPs and response criteria for PFAPA.

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Section: Discussionmentioning

confidence: 99%

Consensus treatment plans for periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome (PFAPA): a framework to evaluate treatment responses from the childhood arthritis and rheumatology research alliance (CARRA) PFAPA work group

Amarilyo

Rothman²,

Manthiram

et al. 2020

Pediatr Rheumatol

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“…85,86 In 2014, a Cochrane review compared these articles, being the only 2 randomly controlled trials applicable, and found a significant beneficial effect of tonsillectomy versus no surgery on both immediate and complete symptom resolution (number needed to treat to benefit = 2) and a substantial reduction in the frequency and severity (length of episode) of any further symptoms experienced. 87 Tonsillectomy may be considered per the frequency of illness, the severity of infection, and the child’s response to medical management.…”

Section: Guideline Key Action Statementsmentioning

confidence: 99%

Clinical Practice Guideline: Tonsillectomy in Children (Update)

Mitchell

Archer

Ishman

et al. 2019

Otolaryngol.--head neck surg.

391

470

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Objective. This update of a 2011 guideline developed by the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations on the pre-, intra-, and postoperative care and management of children 1 to 18 years of age under consideration for tonsillectomy. Tonsillectomy is defined as a surgical procedure performed with or without adenoidectomy that completely removes the tonsil, including its capsule, by dissecting the peritonsillar space between the tonsil capsule and the muscular wall. Tonsillectomy is one of the most common surgical procedures in the United States, with 289,000 ambulatory procedures performed annually in children \15 years of age based on the most recent published data. This guideline is intended for all clinicians in any setting who interact with children who may be candidates for tonsillectomy. KAS 14 (Postoperative codeine), and KAS 15a (Outcome assessment for bleeding). (6) Addition of an algorithm outlining KASs. (7) Enhanced emphasis on patient and/or caregiver education and shared decision making.

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“…Its association with some systemic diseases such as Behçet's disease, cyclic neutropenia, celiac disease, periodic fever, adenitis, pharyngitis and aphthae (PFA-PA) syndrome, oral and genital ulcers with inflamed cartilage (MAGIC) syndrome, Sweet's syndrome, Reiter's disease or some immunodeficiencies should be taken into account. [21][22][23] RAS is of unknown origin, and specific treatment is therefore not available; therapeutic measures are basically aimed at minimizing symptoms and preventing recurrences. The choice of topical or systemic treatment depends on symptom severity, lesion size and number and on the frequency of recurrent episodes.…”

Section: Introductionmentioning

confidence: 99%

Clinical study of 200 patients with recurrent aphthous stomatitis

Rodríguez-Archilla¹,

Raissouni²

2023

GMM

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Introduction: Recurrent aphthous stomatitis (RAS) affects approximately 20% of the general population. Its etiology is still unknown. Objective: To analyze this entity's clinical features. Method: Data such as age, gender, family history of RAS, age at first episode onset, prodromal symptoms, number, size, morphology and localization of lesions, RAS clinical form, annual rate of recurrence, predisposing factors, symptoms and time for symptoms and lesions disappearance were assessed in 200 patients with RAS. Results: Patients had RAS minor forms. Main clinical characteristics were family history of RAS ( 89%), first episode at ≥ 10 years of age (69%), prodromal symptoms (66%), one lesion per episode (63%), < 0.5 cm lesions (64%), rounded morphology (55%), localization at the tongue (27%), 3 recurrent episodes per year (36%), stress as predisposing factor (34%), symptom disappearance in 2 days (54%) and healing of lesions in 8 days (40%). Conclusion: Even when RAS is a common disorder of the oral mucosa, there is no curative treatment available. Therapeutic measures seek to reduce the pain and size of lesions, accelerate the time of recovery and decrease the rate of relapses.

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Tonsillectomy for periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis syndrome (PFAPA)

Cited by 35 publications

References 28 publications

Consensus treatment plans for periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome (PFAPA): a framework to evaluate treatment responses from the childhood arthritis and rheumatology research alliance (CARRA) PFAPA work group

Consensus treatment plans for periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome (PFAPA): a framework to evaluate treatment responses from the childhood arthritis and rheumatology research alliance (CARRA) PFAPA work group

Clinical Practice Guideline: Tonsillectomy in Children (Update)

Clinical study of 200 patients with recurrent aphthous stomatitis

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