Vitamin D linked to PFAPA syndrome

Objective: the etiology and pathogenesis of PFAPA is still unknown, the rapid response to corticosteroids treatment suggested an immune mechanism. The role of vitamin D in the development of immune mediated diseases is widely investigated. In this study we aimed to look for possible association between serum 25-hydroxy vitamin D levels and PFAPA syndrome. Method: Twenty-two patients diagnosed with PFAPA followed up at our private clinics between June 2010 and May 2012 were enrolled in the study in addition to 20 patients' age and gender-matched control group. All subjects had complete work-up medical examination and laboratory tests. Laboratory tests included complete blood count, C-reactive protein (CRP), throat culture, and vitamin D levels. Results: mean WBC and CRP values were significantly higher in the PFAPA group (WBC = 13.9 +/- 2.3 x 10(3)/mm(2) versus 5.8 +/- 3.4 x 10(3)/mm(2) in the control group (P < 0.05) and CRP 37.9 +/- 25.7 mg/dl versus0.7 +/- 1.23 mg/dl in the control group (P < 0.05)). Vitamin D levels were significantly decreased in PFAPA group as compared with the control (12.27 +/- 11.02 ng/ml in the PFAPA group versus 2034 +/- 12.64 ng/ml in the control group (P < 0.05)). Multivariate analysis showed that CRP (odd ratio (OR) = 3.0, 95% confidence interval (CI) = 2.6-4.2, P = 0.01 and serum vitamin D levels <30 ng/ml OR = 2.6, 95% CI = 2.4-3.2, P = 0.02 were associated with PFAPA. Conclusion: we found a significant correlation between PFAPA and vitamin D deficiency. Vitamin D deficiency can be significant risk factor for PFAPA occurrence. (C) 2012 Elsevier Ireland Ltd. All rights reserved.