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18-09-2022 | Stomatitis Aphthosa | Observational research

Long-term efficacy of tonsillectomy/adenotonsillectomy in patients with periodic fever aphthous stomatitis pharyngitis adenitis syndrome with special emphasis on co-existence of familial Mediterranean fever

Authors: E. Deniz Gozen, Mehmet Yildiz, Sinem Kara, Firat Tevetoglu, Fatih Haslak, Amra Adrovic, Sezgin Sahin, Kenan Barut, İpek Ulkersoy, Neslihan Gücüyener, Aybuke Gunalp, H. Murat Yener, Mehmet Ada, Ozgur Kasapcopur

Published in: Rheumatology International | Issue 1/2023

Abstract

Periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrome is one of the most common autoinflammatory fever disorders in the childhood which may co-exists with familial Mediterranean fever (FMF) causing treatment complexity. As the role of surgery in PFAPA syndrome is still controversial, in this paper, our aim is to present our results of tonsillectomy/adenotonsillectomy in the treatment of PFAPA syndrome. Archives of a tertiary care hospital were investigated for patients who underwent tonsillectomy or adenotonsillectomy due to PFAPA Syndrome between 2010 and 2020. 344 patients were found but only 281 of them were accessible. Through phone call interview and chart review methods, preoperative and postoperative the number and severity of the attacks and general satisfaction after the operation were recorded and analyzed. Also, patients with concomitant FMF were analyzed separately. A total of 281 patients were included in the study. There was no improvement in 10 (3.55%) patients. Eight (2.84%) patients showed mild improvement, 29 (10.32%) patients had moderate improvement and 234 (83.27%) patients had full recovery after tonsillectomy. There were 266 PFAPA patients without FMF. No improvement, mild improvement, moderate improvement, and full recovery in this patient group were 5 (1.9%), 6 (2.3%), 25 (9.4%) and 230 (86.5%), respectively. FMF was present in 5.33% (15/281) of the patients. In PFAPA + FMF group 5 patients had no improvement (33.3%), 2 had mild improvement (13.3%), 4 had moderate improvement (26.7%) and 4 had full recovery (26.7%). Benefit of tonsillectomy was significantly lower in the patients with concomitant FMF when compared to the patients who did not have FMF (p < 0.001). Age of diagnosis, age of operation, severity of the disease, type of operation, and gender were found to have no significant relationship with the benefit from surgery (p < 0.05). According to the findings of this study, tonsillectomy is an effective long-term treatment for PFAPA syndrome with success rate of 83.27%. Also, preoperatively FMF should be considered in these patients, which dramatically reduces surgical efficacy.

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Title: Long-term efficacy of tonsillectomy/adenotonsillectomy in patients with periodic fever aphthous stomatitis pharyngitis adenitis syndrome with special emphasis on co-existence of familial Mediterranean fever
Authors: E. Deniz Gozen
Mehmet Yildiz
Sinem Kara
Firat Tevetoglu
Fatih Haslak
Amra Adrovic
Sezgin Sahin
Kenan Barut
İpek Ulkersoy
Neslihan Gücüyener
Aybuke Gunalp
H. Murat Yener
Mehmet Ada
Ozgur Kasapcopur
Publication date: 18-09-2022
Publisher: Springer Berlin Heidelberg
Keywords: Stomatitis Aphthosa
Pharyngitis
Tonsillectomy
Familial Mediterranean Fever
Pharyngitis
Published in: Rheumatology International / Issue 1/2023
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI: https://doi.org/10.1007/s00296-022-05210-4

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