Diagnostic performance of routine blood parameters in periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome

• Published in: Journal of clinical laboratory analysis Vol. 37; no. 11-12; pp. e24934 - n/a
• Main Authors: Onur, Hakan, Onur, Arzu Rahmanali
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.06.2023; John Wiley and Sons Inc
• Subjects: Adenitis; Antigens; Aphthous stomatitis; Biomarkers; Blood; Cell number; C‐reactive protein; Fever; Hospitals; Inflammation; Inflammatory diseases; Laboratories; laboratory parameters; Leukocytes; Leukocytes (neutrophilic); Lymphocytes; mean platelet volume; Monte Carlo simulation; Neutrophils; neutrophil‐lymphocyte ratio; Patients; Pediatrics; PFAPA syndrome; Pharyngitis; Sepsis; Tonsillitis; neutrophil-lymphocyte ratio; C-reactive protein; PFAPA syndrome; laboratory parameters; mean platelet volume
• ISSN: 0887-8013; 1098-2825
• DOI: 10.1002/jcla.24934

Background We aimed to investigate the difference between PFAPA and streptococcal tonsillitis (Strep Pharyngitis) by using blood parameters. We want to evaluate the relationship between periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrome, and tonsillitis by using NLR. Methods The data of 141 pediatric patients who had applied to our clinic between October 2016 and March 2019 and were diagnosed with PFAPA syndrome and tonsillitis were reviewed from hospital records. The demographic data of the study group were recorded, as were their WBC, neutrophil, and lymphocyte counts, NLR, and MPV values, which are obtained by proportioning these two counts. Results CRP and ESR values were significantly higher in the PFAPA group (p = 0.026 and p < 0.001, respectively). No significant difference was determined between the groups in terms of platelet count or lymphocyte count. Receiver operating curve analyses were calculated. The AUC was 0.713 ± 0.04 according to age, and the CRP was 0.607 ± 0.04 (95% confidence interval). Using a cutoff point of >49 months for age, the sensitivity was 0.71 and the specificity was 0.67. Conclusion With simple laboratory parameters, PFAPA syndrome can be differentiated from a diagnosis of tonsillitis. This may reduce the costs associated with unnecessary antibiotic use. However, these findings still need to be confirmed by other future studies. Use of CRP and ESR in the model used to differentiate PFAPA and tonsillitis groups with blood markers.