If your child has a fever every two weeks to 8 weeks, the fever can last for more than three days, it barely goes below 38 despite the medications given, and if the mother senses that the child will have a fever on those days based on the child's behavior and behavior, YOU MAY HAVE PFAPA. In fact, PFAPA does not include antibiotics in its treatment and is unnecessary for children. It is a condition that usually resolves spontaneously around the age of 9, when antibiotics are given instead.
Periodic fever (fever every 2-6 weeks), aphthous stomatitis (aphtha in the mouth), pharyngitis (throat redness, inflamed tonsils) and cervical adenitis. I would like to draw attention to this entity, which is known for its symptoms (swelling in the neck lymph nodes).
PFAPA syndrome is mostly seen in children under 5 years of age. The syndrome is generally more common in boys than girls. The most important finding of PFAPA syndrome is fever, which recurs at regular intervals between 21-28 days and usually rises to 40.0-40.6ºC. The fever lasts for an average of 4 days and subsides spontaneously. The mother senses from a different attitude that the child will have a fever that day, for example, she eats too much today. He waits for the fever after a situation such as "he ate, he was very angry".
Along with the fever, there are pharyngitis (throat redness, inflamed tonsils) and cervical adenitis (swelling in the neck lymph nodes) and aphthous stomatitis (sore sores in the mouth). They heal within 5-10 days without leaving a scar. While non-exudative erythema can usually be seen in the tonsils, crypts and membranes can also be seen. Throat culture taken during the patients' attacks is detected as normal throat flora.
Cervical lymphadenitis is usually bilateral, painless, mobile lymphadenopathies with diameters not exceeding 5 cm. There is no enlargement of the lymph nodes outside the cervical region. There are no laboratory findings specific to PFAPA syndrome. During attacks, leukocytosis and an increase in erythrocyte sedimentation rate are observed. Between attacks, clinical and laboratory findings return completely to normal.
Although the cause of PFAPA syndrome is unknown, viral and autoimmune mechanisms are emphasized. It is possible for physicians who encounter a child with recurrent fever attacks to make a diagnosis by using some clues specific to these diseases. (PFAPA). ) syndrome is one of the rare diseases. The disease-specific laboratory finding of this syndrome is The absence of this disease makes the diagnosis of the disease difficult.
Although PFAPA syndrome is rare, symptoms such as fever, aphthous stomatitis, pharyngitis and cervical lymphadenitis that constitute the syndrome can be overlooked because they are common examination findings in children. The physician may say that the tonsils are inflamed because pharyngitis is indeed present, but the recurrence of fever should not be overlooked. In cases where the fever returns to normal after 5-6 days despite the use of antibiotics and antipyretics, no mutation is detected in the DNA analysis for familial Mediterranean fever (FMF) in the patient who is examined in detail due to recurrent fever. It is important.
.Attacks in PFAPA syndrome can last for years. Families should be informed that there will be no sequelae in the child, their development will not be affected and the disease will heal on its own.
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