Clinical Usefulness of Acute-Phase Markers in Distinguishing between PFAPA and Other Exudative Tonsillitis Causes: A Methodological Study. (7th January 2021)

• Record Type: Journal Article
• Authors: Kanik, Ali; Eliacik, Kayı; Kanik, Esra Toprak; Tekindal, Mustafa Agah
• Is Part Of: Journal of tropical pediatrics. Volume 67:Number 1(2021)
• Publication Date: 2021-01-07
• Subjects: PFAPA -- exudative tonsillitis -- children -- laboratory markers; Pediatrics -- Periodicals; Tropical medicine -- Periodicals; Pediatrics -- Periodicals; Tropical Medicine -- Periodicals; Environmental Health -- Periodicals; Infant; Child; 618.929883
• DOI: 10.1093/tropej/fmaa124
• Languages: English
• ISSNs: 0142-6338

Abstract

Abstract: Background: We investigated the practical use of procalcitonin (PCT), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and complete blood count (CBC) parameters in distinguishing periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis syndrome (PFAPA) attacks from exudative tonsillitis associated with group A streptococcus (GAS) and Epstein–Barre virus (EBV). Methods: The study population consisted of cases with exudative tonsillitis who had been subsequently diagnosed as PFAPA, EBV, and GAS tonsillitis through a period of 6 years. We retrieved the CBC, ESR, CRP and PCT data from patients' medical records. Results: Of the patients, 47 (35.6%) had PFAPA, 36 (27.3%) had GAS and 49 (37.1%) had EBV tonsillitis. Median CRP, ESR and PCT values of patients with PFAPA were 78 (17–92) mg/dl, 44 (11–83) mm/h, 0.16 (0.01–1.45) ng/ml, respectively. The CRP and ESR levels were significantly higher in PFAPA and GAS groups compared with the EBV group ( p = 0.001). There was no significant difference between the groups regarding the PCT levels. Conclusion: The study indicated no benefit of PCT in distinguishing PFAPA from the others. However, we found that CRP, ESR, and CBC parameters could be useful in identifying PFAPA and GAS than EBV tonsillitis.