Immunology

We had a follow up with Dr Baxi today at Children's. He has been so awesome for us. The appointment went well. We updated him with all the craziness that has been going on. He is really hoping that the tonsils/adenoids come out, and that we can avoid all the antibiotics that we used over the winter again. He has actually been doing some research regarding some syndrome type thing related to recurrent fevers. He is wondering if Sam could possibly have this syndrome and that that could be the cause of the intermittent fevers which he seems to get on a seemingly regular basis. In the past we had thought it was related to his IVIG but now Dr Baxi is wondering if it could be this PFAPA syndrome. Below is some info that I have found about this syndrome. The weird thing about this syndrome is that typically it resolves once the tonsils are out. It seems like it kind of fits...


The following is from www.merck.com/mmpe/sec19/ch297/ch297g.html
The Merck Manual Minute



PFAPA (periodic fevers with aphthous stomatitis, pharyngitis, and adenitis) syndrome is a periodic fever syndrome that typically manifests between ages 2 and 5 yr; it is characterized by febrile episodes lasting 3 to 6 days, pharyngitis, aphthous ulcers, and adenopathy. Etiology and pathophysiology are undefined.

PFAPA syndrome is a relatively common periodic fever in children. Although genetic causes have not been determined, this syndrome tends to be grouped with hereditary fever syndromes. It typically starts in early childhood (between ages 2 and 5 yr) and tends to be more common among males.

Febrile episodes last 3 to 6 days and recur about every 28 days. The syndrome causes fatigue, chills, and occasionally abdominal pain and headache, as well as fever, pharyngitis, aphthous ulcers, and lymphadenopathy. Patients are healthy between episodes, and growth is normal."