Guidelines for the management and treatment of periodic fever syndromes: periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome

Guidelines for the management and treatment of periodic fever syndromes: periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome

Title: Guidelines for the management and treatment of periodic fever syndromes: periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome;
Diretrizes de conduta e tratamento de síndromes febris periódicas: síndrome de febre periódica, estomatite aftosa, faringite e adenite
Author Terreri, Maria Teresa R. A. Autor UNIFESP Google Scholar
Bernardo, Wanderley Marques Google Scholar
Len, Claudio Arnaldo Autor UNIFESP Google Scholar
Almeida da Silva, Clovis Artur Google Scholar
Ribeiro de Magalhaes, Cristina Medeiros Google Scholar
Sacchetti, Silvana B. Google Scholar
Leme Ferriani, Virginia Paes Google Scholar
Petry Piotto, Daniela Gerent Autor UNIFESP Google Scholar
Cavalcanti, Andre de Souza Google Scholar
Pantoja de Moraes, Ana Julia Google Scholar
Sztajnbok, Flavio Roberto Google Scholar
Feitosa de Oliveira, Sheila Knupp Google Scholar
Arruda Campos, Lucia Maria Google Scholar
Bandeira, Marcia Google Scholar
Sena Teixeira Santos, Flavia Patricia Google Scholar
Magalhaes, Claudia Saad Google Scholar
Abstract Objective: To establish guidelines based on scientific evidence for the management of periodic fever, aphthous stomatitis, pharyngitis and adenitis (PFAPA) syndrome. Description of the evidence collection method: The Guideline was prepared from 5 clinical questions that were structured through PICO (Patient, Intervention or indicator, Comparison and Outcome), to search in key primary scientific information databases. After defining the potential studies to support the recommendations, these were graduated considering their strength of evidence and grade of recommendation. Results: 806 articles were retrieved and evaluated by title and abstract

from these, 32 articles were selected to support the recommendations. Recommendations: 1. PFAPA is a diagnosis of exclusion established on clinical grounds, and one must suspect of this problem in children with recurrent and periodic febrile episodes of unknown origin, or with recurrent tonsillitis interspersed with asymptomatic periods, especially in children in good general condition and with preservation of weight and height development

2. Laboratory findings are nonspecific. Additional tests do not reveal pathognomonic changes

3. The evidence supporting an indication for surgical treatment (tonsillectomy with or without adenoidectomy), is based on two non-blinded randomized clinical trials with small numbers of patients

4. The use of prednisone at the onset of fever in patients with PFAPA proved to be an effective strategy. There is still need for more qualified evidence to support its use in patients with PFAPA

5. Despite promising results obtained in studies with IL-1 beta inhibitors, such studies are limited to a few case reports. (C) 2015 Elsevier Editora Ltda. All rights reserved.
Keywords Syndrome Of Periodic Fever, Aphthous Stomatitis, Pharyngitis, And Cervical Adenitis
Guidelines
Childhood
Fever
Autoinflammatory SyndromesPfapa Syndrome
Cervical Adenitis
Clinical Characteristics
Tonsillectomy
Children
Adenotonsillectomy
Outcomes
Language Portuguese
Date 2016
Published in Revista Brasileira De Reumatologia. New york, v. 56, n. 1, p. 52-57, 2016.
ISSN 0482-5004 (Sherpa/Romeo, impact factor)
Publisher Elsevier science inc
Extent 52-57
Origin http://dx.doi.org/10.1016/j.rbr.2015.08.005
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000374895300009
SciELO ID S0482-50042016000100052 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/49532

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