Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Adenitis Syndrome and Syndrome of Unexplained Recurrent Fevers in Children and Adults

J Allergy Clin Immunol Pract. 2023 Jun;11(6):1676-1687. doi: 10.1016/j.jaip.2023.03.014. Epub 2023 Mar 21.

Abstract

Children and adults with autoinflammatory disorders, who often experience recurrent fevers, rashes, cold-induced symptoms, conjunctivitis, lymphadenopathy, recurrent infections, aphthous stomatitis, and abnormal blood cell counts, may present to the allergist/immunologist because the symptoms mimic allergies and disorders of immunity. In recent years, there has been increased recognition of non-monogenic autoinflammatory disorders, including periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome and syndrome of undifferentiated recurrent fevers. For many clinical practitioners, the natural history, diagnostic criteria, differential diagnoses, and preferred therapies remain challenging because of the presumed rarity of patients and the evolving field of autoinflammation. Here, we aim to provide a practical framework for the clinical allergist/immunologist to evaluate and treat this patient population.

Keywords: Autoinflammation; PFAPA; Recurrent fever; SURF; undifferentiated fever.

MeSH terms

  • Adult
  • Child
  • Fever / diagnosis
  • Humans
  • Lymphadenitis* / diagnosis
  • Lymphadenopathy*
  • Nasopharyngitis*
  • Pharyngitis* / diagnosis
  • Pharyngitis* / therapy
  • Stomatitis, Aphthous* / diagnosis
  • Stomatitis, Aphthous* / therapy
  • Syndrome