title: Vitamin D linked to PFAPA syndrome.
abstract: OBJECTIVE
  the etiology and pathogenesis of PFAPA is still unknown, the rapid response to corticosteroids treatment suggested an immune mechanism. The role of vitamin D in the development of immune mediated diseases is widely investigated. In this study we aimed to look for possible association between serum 25-hydroxy vitamin D levels and PFAPA syndrome.
  
  
  METHODS
  Twenty-two patients diagnosed with PFAPA followed up at our private clinics between June 2010 and May 2012 were enrolled in the study in addition to 20 patients' age and gender-matched control group. All subjects had complete work-up medical examination and laboratory tests. Laboratory tests included complete blood count, C-reactive protein (CRP), throat culture, and vitamin D levels.
  
  
  RESULTS
  mean WBC and CRP values were significantly higher in the PFAPA group (WBC=13.9±2.3×10(3) /mm(2) versus 5.8±3.4×10(3) /mm(2) in the control group (P<0.05) and CRP 37.9±25.7mg/dl versus0.7±1.23mg/dl in the control group (P<0.05)). Vitamin D levels were significantly decreased in PFAPA group as compared with the control (12.27±11.02ng/ml in the PFAPA group versus 20.34±12.64ng/ml in the control group (P<0.05)). Multivariate analysis showed that CRP (odd ratio (OR)=3.0, 95% confidence interval (CI)=2.6-4.2, P=0.01 and serum vitamin D levels <30ng/ml OR=2.6, 95% CI=2.4-3.2, P=0.02 were associated with PFAPA.
  
  
  CONCLUSIONS
  we found a significant correlation between PFAPA and vitamin D deficiency. Vitamin D deficiency can be significant risk factor for PFAPA occurrence.
authors.affiliation: Department of Internal Medicine, Holy Family Hospital, Nazareth, Israel. mahmudmahamid@yahoo.com
authors.forename: Mahmud
authors.initials: M
authors.lastname: Mahamid
authors.forename: Khaled
authors.initials: K
authors.lastname: Agbaria
authors.forename: Ammad
authors.initials: A
authors.lastname: Mahamid
authors.forename: William
authors.initials: W
authors.lastname: Nseir
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000097:blood / Q000150:complications*; D006801:Humans; D008199:Lymphadenitis / Q000097:blood / Q000150:complications*; D008297:Male; D010612:Pharyngitis / Q000097:blood / Q000150:complications*; D011446:Prospective Studies; D013281:Stomatitis, Aphthous / Q000097:blood / Q000150:complications*; D013577:Syndrome; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood* / Q000150:complications
chemical_list: D014807:Vitamin D