title: Profile of blood cells and inflammatory mediators in periodic fever, aphthous stomatitis, pharyngitis and adenitis (PFAPA) syndrome.
abstract: BACKGROUND
  This study aimed to profile levels of blood cells and serum cytokines during afebrile and febrile phases of periodic fever, aphthous stomatitis, pharyngitis and adenitis (PFAPA) syndrome to advance pathophysiological understanding of this pediatric disease.
  
  
  METHODS
  A cohort of patients with a median age of 4.9 years experiencing 'typical PFAPA' episodes participated in this study. Blood cells and serum cytokines were analyzed by CBC analysis and multiplex ELISA.
  
  
  RESULTS
  Oscillations in the concentration of blood cells during the afebrile and febrile phases of typical PFAPA syndrome were observed; novel findings include increased monocytes and decreased eosinophils during a febrile episode and increased thrombocytes in the afebrile interval. Relatively modest levels of pro-inflammatory cytokines were present in sera. IFNγ-induced cytokine IP10/CXCL10 was increased after the onset of fever while T cell-associated cytokines IL7 and IL17 were suppressed during afebrile and febrile periods.
  
  
  CONCLUSIONS
  Identification of dysregulated blood cells and serum cytokines is an initial step towards the identification of biomarkers of PFAPA disease and/or players in disease pathogenesis. Future investigations are required to conclusively discern which mediators are associated specifically with PFAPA syndrome.
authors.affiliation: Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden. kelly.brown@gu.se
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Brown
authors.forename: Per
authors.initials: P
authors.lastname: Wekell
authors.forename: Veronica
authors.initials: V
authors.lastname: Osla
authors.forename: Martina
authors.initials: M
authors.lastname: Sundqvist
authors.forename: Karin
authors.initials: K
authors.lastname: Sävman
authors.forename: Anders
authors.initials: A
authors.lastname: Fasth
authors.forename: Anna
authors.initials: A
authors.lastname: Karlsson
authors.forename: Stefan
authors.initials: S
authors.lastname: Berg
mesh_terms: D001772:Blood Cell Count; D001773:Blood Cells / Q000166:cytology*; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D010505:Familial Mediterranean Fever / Q000097:blood* / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008199:Lymphadenitis / Q000097:blood* / Q000150:complications; D008297:Male; D010612:Pharyngitis / Q000097:blood* / Q000150:complications; D012720:Severity of Illness Index; D013281:Stomatitis, Aphthous / Q000097:blood* / Q000150:complications; D013577:Syndrome
chemical_list: D016207:Cytokines
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