Late Relapse of Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Adenitis (PFAPA) Syndrome: A Case Report
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ID: 311572
2025
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Abstract
PFAPA syndrome (periodic fever, aphthous stomatitis, pharyngitis, and adenitis) is the most common periodic fever disorder in childhood, typically resolving by early adolescence. Relapse after a prolonged symptom-free interval is rare and has been reported following tonsillectomyrelated remission. We describe a 13-year-old girl with intact tonsils who experienced recurrence of PFAPA a decade after initial remission. She presented with a 6-day history of high-grade fever, aphthous ulcers, pharyngitis, and cervical adenitis unresponsive to antibiotics. Investigations showed elevated inflammatory markers, a negative infectious workup, and significant cervical lymphadenopathy on ultrasound. A single dose of prednisolone led to the rapid resolution of symptoms followed by sustained remission on follow-up. This case highlights the diagnostic challenges of late PFAPA relapse and underscores the importance of clinical recognition, exclusion of mimicking conditions, and corticosteroid responsiveness in guiding management.
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| Authors | Ahmad Ibrahim Zaal, Amad Radwan Jamal Eddin, Maryam Mohanad Al Ansari, Manar Husam Hussein, Ikram Hamoud, Rabih R. Andari, David Aman Eddin, Manaf Shaker Alkassab, Maher Mohamad Najm |
| Journal | Yemen Journal of Medicine |
| Year | 2025 |
| DOI |
10.63475/yjm.v4i1.0202
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| URL | |
| Keywords | Keywords not found |
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