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Garavello W, Romagnoli M, Gaini RM. Effectiveness of adenotonsillectomy in PFAPA syndrome: a randomized study. J Pediatr. 2009 Aug;155(2):250-3. Epub 2009 May 21. (Original) PMID: 19464029
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Clinical Evidence Topics: TonsillitisAphthous ulcers (recurrent) Sore throat
DISCIPLINE	RELEVANCE TO PRACTICE	IS THIS NEWS?
Pediatric Hospital Medicine
Pediatrics (General)
Surgery - Ear Nose Throat

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Abstract
OBJECTIVE: To evaluate whether adenotonsillectomy leads to complete resolution in children with PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) syndrome. STUDY DESIGN: 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.

Abstract

OBJECTIVE: To evaluate whether adenotonsillectomy leads to complete resolution in children with PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) syndrome. STUDY DESIGN: 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.

Comments from Clinical Raters
Pediatric Hospital Medicine This is a well done study of treatment for a rare condition that is not usually cared for on inpatient services.

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