Cochrane · systematic review · CD008669
Tonsillectomy for periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis syndrome (PFAPA)
Burton, MJ, Pollard, AJ, Ramsden, JD, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
7
current version
GRADE rated
4
No studies
3
Included studies
NR
No studies 3 · 42.9%Ungraded 0 · 0%Very low 0 · 0%Low 1 · 14.3%Moderate 3 · 42.9%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlySurgery (tonsillectomy with or without adenoidectomy) for children with periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome
Population: children with PFAPA
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete resolution of symptoms (proportion of patients with 'immediate and persistent resolution of symptoms' from the point of surgery/randomisation up to end of study | RR 4.38 [0.64, 30.11] | 2 studies · 65 participants | Moderate |
Complications of surgery (haemorrhage and days with pain) | no estimate extracted | NR | No studies |
Number of episodes of fever and associated symptoms (episodes per person per month) | Rate ratio 0.08 [0.05, 0.13] | 2 studies · 65 participants | Moderate |
Severity of episodes (number of days with fever and the associated symptoms (per episode)) | Mean difference 1.8 | 1 study · 39 participants | Moderate |
Use of corticosteroids (proportion of patients using corticosteroids) | RR 0.58 [0.37, 0.92] | 1 study · 39 participants | Low Downgraded: indirectness |
Absence or time off school | no estimate extracted | NR | No studies |
Quality of life | no estimate extracted | NR | No studies |
Surgery (tonsillectomy +/‐ adenoidectomy) for children with periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis syndrome (PFAPA)
Population: children with PFAPA
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete resolution of symptoms (proportion of patients with 'immediate and persistent resolution of symptoms' from the point of surgery/randomisation up to end of study | RR 4.38 [0.64, 30.11] | 2 studies · 65 participants | Moderate |
Complications of surgery (haemorrhage and days with pain) | no estimate extracted | NR | No studies |
Number of episodes of fever and associated symptoms (episodes per person per month) | Rate ratio 0.08 [0.05, 0.13] | 2 studies · 65 participants | Moderate |
Severity of episodes (number of days with fever and the associated symptoms (per episode)) | Mean difference 1.8 | 1 study · 39 participants | Moderate |
Use of corticosteroids (proportion of patients using corticosteroids) | RR 0.58 [0.37, 0.92] | 1 study · 39 participants | Low Downgraded: indirectness |
Absence or time off school | no estimate extracted | NR | No studies |
Quality of life | no estimate extracted | NR | No studies |
Surgery (tonsillectomy +/‐ adenoidectomy) for children with periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis syndrome (PFAPA)
Population: patients with children with periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis syndrome (PFAPA)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete resolution of symptoms | RR 3.25 [1.78, 5.92] | 2 studies · 65 participants | Moderate |
Number of PFAPA episodes over 18 months | no estimate extracted | 1 study · 39 participants | High |
Number of episodes per person month | no estimate extracted | 2 studies · 65 participants | High |