Nakano Seiichi, Kondo Eiji, Iwasaki Hidetaka, Akizuki Hironori, Matsuda Kazunori, Azuma Takahiro, Sato Go, Kitamura Yoshiaki, Abe Koji, Takeda Noriaki
Department of Otolaryngology, Kochi National Hospital, Kochi 780-8077, Japan.
Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima 770-8503, Japan.
J Med Invest. 2021;68(1.2):38-41. doi: 10.2152/jmi.68.38.
Objective : An attempt was made to identify characteristic cytokine profiles to distinguish periodic fever with aphthous stomatitis, pharyngitis and cervical adenitis syndrome (PFAPAS) from recurrent tonsillitis, of which clinical manifestations are similar to those of PFAPAS in children. Methods : Serum concentrations of IL-6, IL-4 and IFN-γ were measured during febrile episodes in pediatric patients. Results : The levels of IL-6 during febrile episodes were markedly increased above the upper limit of normal ranges in patients with both PFAPAS and recurrent tonsillitis, but there were no significant differences between groups. The levels of IL-4 during febrile episodes in PFAPAS patients were significantly lower than those in recurrent tonsillitis patients. The levels of IFN-γ during febrile episodes in PFAPAS patients were significantly higher than those in recurrent tonsillitis patients. Conclusion : In pediatric patients with PFAPAS, despite an increase of IL-6, IL-4 was suppressed with a marked increase of IFN-γ during febrile episodes. On the contrary, in febrile pediatric patients with recurrent tonsillitis, both IL-6 and IL-4, but not IFN-γ were increased. The characteristic cytokine profiles of IL-6, IL-4 and IFN-γ can be used for differential diagnosis of PFAPAS from recurrent tonsillitis in children in clinical ear, nose and throat (ENT) settings. J. Med. Invest. 68 : 38-41, February, 2021.
试图确定特征性细胞因子谱，以区分儿童周期性发热伴口疮性口炎、咽炎和颈淋巴结炎综合征（PFAPAS）与复发性扁桃体炎，后者临床表现与儿童PFAPAS相似。方法：在儿科患者发热期测量血清白细胞介素-6（IL-6）、白细胞介素-4（IL-4）和干扰素-γ（IFN-γ）浓度。结果：PFAPAS患者和复发性扁桃体炎患者发热期IL-6水平均明显高于正常范围上限，但两组间无显著差异。PFAPAS患者发热期IL-4水平显著低于复发性扁桃体炎患者。PFAPAS患者发热期IFN-γ水平显著高于复发性扁桃体炎患者。结论：在患有PFAPAS的儿科患者中，尽管发热期IL-6升高，但IL-4受到抑制，IFN-γ显著升高。相反，在发热的复发性扁桃体炎儿科患者中，IL-6和IL-4均升高，而IFN-γ未升高。IL-6、IL-4和IFN-γ的特征性细胞因子谱可用于临床耳鼻喉（ENT）环境中儿童PFAPAS与复发性扁桃体炎的鉴别诊断。《医学调查杂志》68：38 - 41，2021年2月。
