Aim. Although PFAPA syndrome is the most common cause of recurrent fever in children, the diagnosis is rarely established and it is a diagnosis of exclusion because there are no specific diagnostic tests. The aim of this study was to assess the value of procalcitonin, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in diagnosis of febrile attacks in PFAPA syndrome. Material and methods. C-reactive protein, erythrocyte sedimentation rate and procalcitonin were measured in 16 children with PFAPA syndrome during febrile attacks and in 12 children with bacterial pneumonia (control group A) and 18 children with bacterial tonsillitis (control group B). Results. No significantly statistic differences were recorded for CRP and ESR between the PFAPA group and control groups. Procalcitonin was undetectable in all children with PFAPA syndrome. Conclusion. Procalcitonin can be a useful marker for differential diagnosis between febrile attacks of PFAPA syndrome and acute bacterial infection in children.

Marshall syndrome (periodic fever, adenitis, pharyngitis, aphthae, PFAPA syndrome