Growth and development in children with periodic fever, aphthous stomatitis, pharyngitis, lymphadenitis syndrome: a...

Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome is the most common cause of recurrent fever in childhood. Although normal growth and development are included in the diagnostic criteria, this assumption has not been systematically evaluated in controlled studies. This study aimed to compare growth patterns and developmental screening outcomes between children with PFAPA and healthy controls.

A total of 138 children were enrolled, including 69 patients diagnosed with PFAPA according to the modified Marshall criteria and 69 age- and sex-matched healthy controls. The PFAPA group consisted of 26 females (37.7%) and 43 males (62.3%), while the control group included 26 females (37.7%) and 43 males (62.3%). The mean age was 52.1 ± 13.86 months in the PFAPA group and 50.28 ± 13.70 months in the control group. Growth was assessed using anthropometric parameters, including height, weight, body mass index (BMI), weight-for-height, and mid-upper arm circumference. The primary outcome was overall growth pattern, assessed by anthropometric measures, with particular attention to BMI. Developmental screening was performed using the Denver II Developmental Screening Test.

Mean anthropometric measures, including height, weight, and BMI, were comparable between patients with PFAPA and controls. However, overweight/obesity was more prevalent in the PFAPA group than in controls (18.8% vs. 5.8%; odds ratio [OR] 3.77, 95% confidence interval [CI] 1.16-12.24, p=0.020). Patients with PFAPA who were overweight/obese had received a higher number of corticosteroid treatments (p=0.046). Developmental screening outcomes did not differ significantly between groups.

In this case-control study, children with PFAPA demonstrated overall growth patterns and developmental screening results similar to those of healthy peers, although a higher prevalence of overweight/obesity was observed. These findings support, but do not definitively establish, the assumption of preserved growth and development in PFAPA and underscore the need for further longitudinal studies.