C-reactive protein in the periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome

Abstract

Aims: To evaluate levels of C-reactive protein (CRP) during febrile episodes in children with periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis syndrome (PFAPA).

Methods: All CRP values during typical episodes of fever in children diagnosed with PFAPA during a 3 years period were retrospectively registered.

Results: In 16 children with PFAPA, a total of 87 CRP values were registered during 38 episodes of fever. The mean of the maximum CRP during each episode was 185 mg/L (SD: 69.4, range: 45-322). Values of CRP were elevated throughout the whole period of fever, with higher values on days 2-4 compared to day 1.

Conclusion: Levels of CRP are substantially increased during febrile episodes in children with PFAPA. High levels of CRP may suggest a role for immunological mechanisms in PFAPA, and may raise the suspicion of PFAPA when measured in children with periodic fever of unknown origin.