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MINERVA PEDIATRICA

A Journal on Pediatrics, Neonatology, Adolescent Medicine,
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Minerva Pediatrica 2015 June;67(3):219-26

Copyright © 2015 EDIZIONI MINERVA MEDICA

language: Italian

Effectiveness of pidotimod in combination with bacterial lysates in the treatment of the PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) syndrome

Buongiorno A. 1, Pierossi N. 2

1 Dipartimento di Otorinolaringologia, Università di Firenze, Firenze, Italia; 2 Unità di Otorinolaringologia Pediatrica, Dipartimento di Neuroscienze AUO A. Meyer, Firenze, Italia


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AIM: PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) syndrome is the most common autoinflammatory syndrome in pediatrics, accepted as an hyperimmune condition. Pidotimod is a molecule with immunomodulatory activity on both innate and adaptive immune responses; it also has the capacity to modulate the function of the respiratory epithelial cells through the activation of a NK-KB pathway which would involve the host-virus interaction. Moreover, the proven beneficial effect of Pidotimod in enhancing the immune response during vaccination, and its benefits in the prevention of respiratory tract infections, should be noted.
METHODS: A joint combination of Pidotimod and bacterial lysates was used to treat 37 children with a clinical diagnosis of PFAPA; within the end of the first year of therapy, the healing rate of PFAPA symptoms was 67.5% (25 children), with a 10.8% (4 cases) still in complete remission within the end of the second year of follow-up.
RESULTS: It is important to highlight that 29 children (78.3%) had benefitted from this therapy, in terms of healing, with a marked decrease in the incidence of fever from a total of 360 to 106 episodes, and episodes of periodic fever occurring almost 4 times less frequently. The use of Pidotimod determined a significant reduction of surgical tonsillectomy’s treatment.
CONCLUSION: This approach had a strong impact on the children’s quality of life; a significant decrement in the use of antipyretic drugs, as well as a lower rate of antibiotic prescription, were also noted. It also had a dramatic impact on families’ lives, because the treatment lowers the number of absences of family members from work or school/kindergarten.

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Cite this article as

Buongiorno A, Pierossi N. Effectiveness of pidotimod in combination with bacterial lysates in the treatment of the PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) syndrome. Minerva Pediatr 2015 June;67(3):219-26. 

Corresponding author e-mail

n.pierossi@gmail.com