What is the age range for Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Adenitis (PFAPA) syndrome?

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Last updated: February 8, 2025View editorial policy

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From the Research

Age Range for PFAPA Syndrome

The age range for Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Adenitis (PFAPA) syndrome is typically characterized by:

  • Onset usually before the age of 5 years 1, 2, 3, 4
  • Most cases resolve spontaneously before age 10 1
  • However, there are reports of PFAPA syndrome in adults, with a study describing 15 adult patients diagnosed with the syndrome, with episodes of fever occurring at 4.6 +/- 1.3 week intervals, beginning at the age of 20.9 +/- 7.5 1
  • A review of the literature suggests that typical PFAPA syndrome is not associated with significant long-term sequelae and has a good response to steroids, with the age of onset typically less than 5 years 2
  • Another study found that the median age at onset was 1.58 years, and the median age at diagnosis was 2.97 years, with a higher frequency of febrile attacks in children with an age at diagnosis under 1 year 5

Key Characteristics

Some key characteristics of PFAPA syndrome include:

  • Periodic fever, aphthous stomatitis, pharyngitis, and adenitis typically before age 5 3
  • Elevated C-reactive protein in the absence of elevated procalcitonin, vitamin D, CD64, mean corpuscular volume, and other nonspecific inflammatory mediators in the absence of an infectious explanation for fever 3
  • Effective treatment includes steroids, tonsillectomy/adenoidectomy, and cimetidine 2
  • Tonsillectomy remains the only permanent treatment modality 3

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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