Comparison of conventional and low dose steroid in the treatment of PFAPA syndrome: preliminary study.

BACKGROUND Steroids have been widely used to relief symptoms in the patients with PFAPA syndrome. OBJECTIVES This study was constructed to show the effectiveness of low-dose steroid therapy in patients diagnosed with PFAPA syndrome. METHODS 41 patients (86 febrile attacks) who were diagnosed using the criteria suggested by Thomas et al. were involved in the study. The cases were classified into two groups and the selection of patients in groups was made randomly. Twenty patients received prednisolone at a dose of 2 mg/kg/day (first group: 40 attacks) and 21 patients received a dose of 0.5 mg/kg/day (second group: 46 attacks). The effectiveness of the treatment was especially determined by the time needed to reduce the fever and the effect on the duration between the two attacks. The patients were re-examined 24 hours later, after a steroid treatment. RESULTS The patients who were in the first group received 2mg/kg/day dose of prednisolone and their fever was dramatically decreased in 6-8 hours (7.6 ± 0.9 hours). The second group received 0.5mg/kg/day dose and 19 of these patients' fever was decreased in 8-12 hours. Two patients whose temperature did not decrease, received another dose of prednisolone 24 hours after the first dose and their fever was reduced 12 hours after the second dose (11.3 ± 6.4 hours). A comparison of the rate of fever reduction and the interval between the attacks (Group I: 5.11 ± 1.01 week and Group II: 5.2 ± 1.13 week) in the two groups did not show any statistical significance (p=0.104). CONCLUSION Low-dose steroid treatment is as effective as normal dose in PFAPA syndrome but there is need to study with a larger group.