Paediatria Croatica, Vol. 59 No. 1, 2015.
Professional paper
https://doi.org/10.13112/PC.2015.7
Marshall syndrome – a challenge in medical practice
Cecilia Lazea
; Emergency Pediatric Hospital
Rodica Manasia
Călin Lazăr
Abstract
Marshall syndrome (periodic fever, adenitis, pharyngitis, aphthae, PFAPA syndrome) is characterized by recurrent episodes of fever
associated with aphthous stomatitis, cervical adenitis or pharyngitis. Although it is the most common cause of recurrent fever in
children, the diagnosis is rarely established. The aim of this study was to describe a group of Romanian children with Marshall
syndrome. In seven children with PFAPA, the following methods were used: patient history, clinical examination, and determination
of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and tumor necrosis factor α (TNF-α). The treatment consisted in
prednisone at a dose of 1 mg/kg. The age at onset was 2.2 years and at diagnosis 4.8 years. The mean interval between episodes was
3.1 weeks and the duration per febrile episode was 3.7 days. The patients presented with pharyngitis (100%), adenitis (100%) and
aphthous lesions (57.1%). The mean ESR value was 31 mm/h, CRP 7.8 mg/dL and leukocytes 17700/mm3
. TNF-α remained elevated
between febrile episodes. Six patients treated with prednisone had favorable evolution. In conclusion, PFAPA should be suspected in
children with periodic fever associated with pharyngitis, cervical adenitis and aphthous stomatitis.
Keywords
Hrčak ID:
142405
URI
Publication date:
26.3.2015.
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