Effectiveness of adenotonsillectomy in PFAPA syndrome: a randomized study.
OBJECTIVE
To evaluate whether adenotonsillectomy leads to complete resolution in children with PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) syndrome.


METHODS
Thirty-nine children with PFAPA syndrome were randomized to either adenotonsillectomy (surgery group; n = 19) or expectant management (control group; n = 20). All patients were then invited prospectively to record all PFAPA episodes, and were evaluated clinically every 3 months for 18 months after randomization.


RESULTS
The proportion of patients experiencing complete resolution was 63% in the surgery group and 5% in the control group (P < .001). The mean (+/- standard deviation) number of episodes recorded during the study period was 0.7 +/- 1.2 in the surgery group and 8.1 +/- 3.9 in the control group (P < .001). The episodes were less severe in the surgery group.


CONCLUSIONS
Adenotonsillectomy is an effective treatment strategy for children with PFAPA syndrome.
Garavello
Werner
W
Department of Otorhinolaryngology-Head and Neck Surgery, Ospedale San Gerardo, University of Milano-Bicocca, DNTB Monza, Italy. werner.garavello@unimib.it
Romagnoli
Marco
M
Gaini
Renato Maria
RM
D000233:Adenoidectomy; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005335:Fever of Unknown Origin / Q000601:surgery*; D006801:Humans; D008199:Lymphadenitis / Q000601:surgery*; D008297:Male; D010612:Pharyngitis / Q000601:surgery*; D011446:Prospective Studies; D012720:Severity of Illness Index; D013281:Stomatitis, Aphthous / Q000601:surgery*; D013577:Syndrome; D014068:Tonsillectomy; D016896:Treatment Outcome