PFAPA Sendromunda Kolşisin ve Streptococcus salivarius K12 Tedavilerinin Etkinliğinin Değerlendirilmesi

Öz

Bu çalışmada, PFAPA sendromlu çocuklarda profilaktik tedavide kullanılan kolşisin ile Streptococcus salivarius K12'nin kısa dönem klinik etkinliğinin karşılaştırılması amaçlandı. Sincan Eğitim ve Araştırma Hastanesi Çocuk Romatolojisi Kliniği'nde yürütülen bu tek merkezli retrospektif çalışmaya, Eurofever/PRINTO kriterlerine göre PFAPA tanısı alan ve profilaktik tedavi sonrası yaklaşık 3 aylık takip verileri bulunan 64 çocuk dahil edildi. Hastaların 33'ü kolşisin, 31'i Streptococcus salivarius K12 tedavisi aldı. Demografik özellikler ile tedavi öncesi ve sonrası atak sırasında ölçülen en yüksek vücut sıcaklığı, atak süresi ve son üç aydaki atak sıklığı değerlendirildi. Gruplar arasında cinsiyet dağılımı, hastalık başlangıç yaşı, tedavi başlangıç yaşı ve tedavi öncesi klinik özellikler açısından anlamlı fark saptanmadı. Kolşisin grubunda tedavi sonrası en yüksek ateş ve atak süresi anlamlı olarak azalırken (her ikisi için p≤0,003), atak sıklığında sınırda anlamlı değişiklik gözlendi (p=0,035). Benzer şekilde Streptococcus salivarius K12 grubunda da en yüksek ateş ve atak süresi anlamlı düzeyde azalırken (her ikisi için p≤0,003), atak sıklığında anlamlı iyileşme izlenmedi (p=0,121). Kolşisin ve Streptococcus salivarius K12, PFAPA'da kısa dönemde benzer klinik etkinlik göstermiştir. Her iki tedavi de özellikle atak şiddetini yansıtan ateş yüksekliği ve atak süresini azaltırken, atak sıklığı üzerinde anlamlı etki göstermemiştir. Bulgular, Streptococcus salivarius K12'nin seçilmiş hastalarda alternatif bir profilaktik seçenek olabileceğini düşündürmektedir. Daha büyük örneklemli, çok merkezli ve randomize kontrollü çalışmalara ihtiyaç vardır

Anahtar Kelimeler

• Kolşisin
• pfapa
• probiyotik

Evaluation of the Efficacy of Colchicine and Streptococcus salivarius K12 Therapy in PFAPA Syndrome

Öz

To compare the short-term prophylactic efficacy of colchicine and Streptococcus salivarius K12 in children with Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis (PFAPA) syndrome. This single-center retrospective study included 64 children diagnosed with PFAPA according to the Eurofever/PRINTO classification criteria who had approximately 3 months of follow-up after initiation of prophylactic therapy. Thirty-three patients received colchicine and 31 received Streptococcus salivarius K12. Demographic characteristics and changes in peak body temperature during attacks, attack duration, and attack frequency over the preceding three months were evaluated before and after treatment. Baseline demographic and clinical characteristics were comparable between the treatment groups. In the colchicine group, both peak body temperature during attacks and attack duration decreased significantly after treatment (both p≤0.003), whereas attack frequency did not change significantly (p=0.071). Similarly, patients receiving Streptococcus salivarius K12 showed significant reductions in peak body temperature and attack duration (both p≤0.003), without a significant reduction in attack frequency (p=0.143). Colchicine and Streptococcus salivarius K12 demonstrated comparable short-term clinical efficacy in children with PFAPA. Both treatments significantly improved attack severity, reflected by reduced fever and shorter attack duration, but neither significantly decreased attack frequency. These findings suggest that Streptococcus salivarius K12 may represent a promising prophylactic alternative for selected patients. Larger prospective, multicenter, randomized controlled studies with longer follow-up are needed.

Anahtar Kelimeler

• Colchicine
• PFAPA
• Probiotics

Kaynakça

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