Preview

Allergology and Immunology in Paediatrics

Advanced search

Marshall’s Syndrome in pediatric practice (challenges in diagnosis)

https://doi.org/10.53529/2500-1175-2026-2-54-60

Abstract

Relevance. According to some authors, the prevalence of Marshall syndrome in the pediatric population is unknown. The patients with PFAFA syndrome can be mistakenly follow up within the group of frequently ill children. The diagnosis is largely based on the knowledge of the main clinical symptoms of the disease, described by G. S. Marshall et al. (1987).
In the last time, hereditary autoinflammatory diseases are in the focus of research and practical interests of clinicians. The nature of the PFAFA syndrome is associated with cytokine dysfunction and dysregulation of the inflammasome, with allow it to be, classified as an autoinflammatory syndrome the disease is triggered by genetically determined dysregulation of congenital immunity associated with excessive production of inflammation mediators (IL-1, TNFα, IL-6, IL-12, etc.)
Material and methods. An analysis of the scientific medical literature on PFAFA syndrome (Marshall syndrome) and clinical case, of child with Marshall syndrome is presented.
Results. Our clinical example illustrates the problem of late diagnosis of PFAFA syndrome. In now time diagnosis of the disease is based on clinical criteria (periodiс fever, aphthous stomatitis, pharyngitis and cervical lymphadenitis) and new criteria are the necessary. The etiology and pathogenesis of the disease have not been definitive established

About the Authors

B. A. Molotilov
Penza Institute for Further Training of Physicians — Branch Campus of the Federal State Budgetary Educational Institution of Further Professional Education «Russian Medical Academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation
Russian Federation

Boris Aleksandrovich Molotilov — Dr. Sci., professor

8A, Stasova Str., Penza, 440060



A. I. Kozina
Penza Institute for Further Training of Physicians — Branch Campus of the Federal State Budgetary Educational Institution of Further Professional Education «Russian Medical Academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation
Russian Federation

Alla Ildarovna Kozina — Cand. Sci., associate professor

8A, Stasova Str., Penza, 440060



References

1. Marshall G.S., Edwards K.M., Butler j., Lawton A.R. Syndrome of periodic fever, pharyngitis, and aphthous stomatitis. J. Pediatr. 1987; 110 (1): 43–46. https://doi.org/10.1016/s0022-3476(87)80285-8.

2. Frsvoll J., Kristoffersenn E.K., Ymar K. Incidence clinical characteristics and outcome in Norwegian children with periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis syndrome; a population-based study. Acta Pediatrica. 2013; 102: 187–192. https://doi.org/10.1111/apa.12069.

3. Gattorno M., Hoffer M., Federici S. et al. Classification critereia for autoinflammatory recurrent fevers. Annals of the Rheumatic Diseases. 2019; 78: 1025–1032. https://doi.org/10.1136/annrheumdis-2019-215048.

4. Amarilyo G., Rothman D., Manthiram K. et al. Consensus treatment plans for periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome (PFAPA): a framework to evaluate treatment responses from the childhood arthritis and rheumatology research alliance (CARRA) PFAPA work group. Pediatr Rheumatol Online J. 2020; 18 (1): 31. https://doi.org/10.1186/s12969-020-00424-x.

5. Zhdanova L.V., Bimbayev A.B.-Zh. Clinical and Laboratory Characteristics of Children with Marshall Syndrome. Bulletin of the Buryat State University. Medicine and Pharmacy. 2017; 4: 33–37. https://cyberleninka.ru/article/n/kliniko-laboratornayaharakteristika- detei-s-sindromom-marshalla (in Russ.).

6. Maidannik V.G. Modern aspects of periodic fever syndrome with aphthous stomatitis, pharyngitis and cervical lymphadenitis (Marshall syndrome) in children. Mezhdunarodnyi Zhurnal Pediatrii, Akusherstva I Ginekologii. 2013; 3 (3): 63–74. (In Russ.).

7. Babachenko I.V., Tyan N.S., Sharipova E.V., Orlova E.D. Marshall’s syndrome in children with recurrent respiratory infections. Clinical case. Modern medicine. 2021; 4 (23): 6–10. (In Russ.) http://infocompany-sovmed.ru/wp-content/uploads/2021/12/6-10.pdf.

8. Hayem F. Les fievres periodique. Arch Pediatr. 2002; 9 (6): 638–643. https://doi.10.1016/s0929-693x(01)00936-8.

9. Rydenman K., Sparud-Lundin C., Karlsson-Bengtsson A. et al. Tonsillectomy reduces the family impact of periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome and improves health-related quality of life in affected children. Orphanet J Rare Dis. 2023; 18 (1): 153. https://doi.org/10.1186/s13023-023-02773-8.

10. Renko M., Salo E., Putto-Laurila A. et al. A randomized, controlied trial of tonsillectomy in periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome. J. Pediatr. 2007; 151: 289–292. https://doi.org/10.1016/j.jpeds.2007.03.015.

11. Garavello W., Romagnoli M., Gaini R.M. Effectiveness of adenotonsillectomy in PFAPA syndrome: a randoimized study. J. Pediatr. 2009; 155: 250–253. https://doi.org/10.1016/j.jpeds.2009.02.038.

12. Kuznetsova M.A., Zryachkin N.I., Tsareva Yu.A. et al. The PFAPA syndrome: current paradigm and a clinical case description. Almanac of Clinical Medicine. 2018; 46: 184–193. (In Russ.) https://doi.org/10.18786/2072-0505-2018-46-2-184-193.

13. Kuzmenko N.B., Shcherbina A.Yu. Classification of primary immunodeficiencies as a reflection of modern ideas about their pathogenesis and therapeutic approaches. Russian Journal of Pediatric Hematology and Oncology. 2017; 4 (3): 51–57. (In Russ.) https://doi.org/10.17650/2311-1267-2017-4-3-51-57.

14. Burlutskaya A.V., Statova A.V., Tril V.E., Zenkina O.Yu.et al. Marshall’s Syndrome: A Clinical Case. Kuban Scientific Medical Bulletin. 2024; 31 (1): 88–98. (In Russ.) https://doi.org/10.25207/1608-6228-2024-31-1-88-98.

15. De Jesus A.A., Canna S.W., Liu Y., Goldbach-Mansky R. Molecular mechanisms in genetically defined autoinflammatory diseases: disorders of amplified danger signaling. Annu Rev Immunol. 2015; 33: 823–874. https://doi.org/10.1146/annurevimmunol-032414-112227.

16. Masters S.L., Simon A., Aksentijevich I., Kastner D.L. Horror autoinflammaticus: the molecular pathophysiology of autoinflammatory disease. Annu Rev immunol. 2009; 27: 621–668. https://doi.org/10.1146/annurev.immunol.25.022106.141627.

17. Lutfullin I.Ya., Salugina S.O., Daminova M.A., Gazizov I.M. A current view of PFAPA syndrome (Marshall syndrome) in children (clinical observation). The Bulletin of Contemporary Clinical Medicine. 2021; 14 (4): 78–84. (In Russ.) https://doi.org/10.20969/VSKM.2021.

18. Dagan E., Gershoni-Baruch R., Khatib I. et al. MEFV, TNF IrA, CARD15 and NLRP3 mutation analysis in PFAPA. Rheumatol Int. 2010; 30 (5): 633–636. https://doi.org/10.1007/s00296-009-1037-x.


Review

For citations:


Molotilov B.A., Kozina A.I. Marshall’s Syndrome in pediatric practice (challenges in diagnosis). Allergology and Immunology in Paediatrics. 2026;(2):54-60. (In Russ.) https://doi.org/10.53529/2500-1175-2026-2-54-60

Views: 199

JATS XML

ISSN 2500-1175 (Print)
ISSN 2712-7958 (Online)