Dipasquale RF

Magna Graecia University

ORCID Profile OpenAlex Profile
2
Publications
2
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(9 citations, 4 total works)

Research Topics

Autoimmune and Inflammatory Disorders Research (3) Rheumatoid Arthritis Research and Therapies (1) Vaccine Coverage and Hesitancy (1) Inflammasome and immune disorders (1) Virology and Viral Diseases (1)

PFAPA Syndrome Publications

Oral aphthosis in children: baseline clinical features associated with diagnostic categories in a single-centre retrospective cohort.

Dipasquale RF, Sinopoli P, Adessi S, Pascuzzo A, Gallizzi R
European journal of pediatrics •

We examined associations between clinical features at first paediatric rheumatology assessment and eventual benign/self-limited (Group 1) versus systemic/chronic (Group 2) diagnostic categories in children referred for recurrent oral aphthosis. We retrospectively studied 404 children evaluated from 2010 to 2024. Baseline clinical variables were documented at the first rheumatology visit before final diagnosis; follow-up assessments were performed every 3-6 months. Eight prespecified clinical features entered multivariable logistic regression. Firth and diagnosis-exclusion sensitivity analyses addressed sparse data and diagnostic-composition bias. CRP/ESR and HLA-B51 were analysed separately. The cohort included 198 males (49.0%) and 206 females (51.0%); age at symptom onset ranged from 2 months to 15 years. Group 1 included 267 patients, and Group 2 included 137. Recurrent fever (aOR, 0.25; 95% CI, 0.12-0.49) and tonsillitis/pharyngitis (aOR, 0.17; 95% CI, 0.09-0.32) were associated with lower odds of Group 2, whereas genital aphthosis was associated with higher odds (aOR, 13.08; 95% CI, 3.04-56.32). After simultaneous exclusion of PFAPA and Behçet disease spectrum diagnoses, the fever/pharyngitis associations were attenuated, and the genital aphthosis estimate became uninformative because of sparse data, while arthralgia/arthritis remained positively associated. Elevated CRP/ESR was not independently associated with Group 2; HLA-B51 positivity was more frequent in Group 2 among selectively tested patients.  In children referred for recurrent oral aphthosis, recurrent fever and pharyngitis were mainly associated with benign/self-limited diagnoses, whereas genital aphthosis was mainly associated with systemic/chronic diagnoses. These associations were largely driven by PFAPA and Behçet spectrum disease, respectively. Articular involvement showed the most consistent positive association across sensitivity analyses. These findings are descriptive, not a validated diagnostic prediction tool. • Oral aphthae are common and non-specific in childhood. • Associated symptoms guide diagnostic work-up and follow-up. • PFAPA-characteristic features clustered with benign/self-limited diagnoses; genital aphthosis with systemic/chronic diagnoses. • After PFAPA/Behçet spectrum exclusion, these signals attenuated; articular involvement was the most consistent positive association.

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Colchicine prophylaxis in pediatric PFAPA: a systematic review.

Dipasquale RF, Sinopoli P, Mendicino A, Gallizzi R
European journal of pediatrics •

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) is the most common periodic fever syndrome in children. On-demand corticosteroids stop attacks but may shorten fever-free intervals. This systematic review assessed the effectiveness of daily colchicine prophylaxis in pediatric PFAPA. Furthermore, MEFV status association with colchicine efficacy has been explored. PubMed, Scopus, and Web of Science were systematically searched from inception to 6 November 2025 to identify trials and observational studies presenting participants with a diagnosis of PFAPA, colchicine prophylaxis as interventions, and attack frequency/attack-free interval as outcomes. All eligible records identified up to that date were screened. Colchicine reduced attack frequency, lengthened attack-free intervals, and lowered steroid use, with benefits often within 1 month. A short randomized comparison showed similar 3-month efficacy to cimetidine. Adverse events were mostly mild gastrointestinal; discontinuations were uncommon. MEFV variants as predictors of response remain uncertain. Current evidence supports colchicine as an efficacy and generally well-tolerated preventive option. • PFAPA is the most common periodic fever in children. On-demand corticosteroids stop attacks but may shorten symptom-free intervals; preventive options include cimetidine, selective tonsillectomy, and biologics. • Colchicine modulates innate immunity and it is effective in familial Mediterranean fever; MEFV variants occur in a subset of PFAPA, supporting interest in repurposing. • Continuous colchicine reduced attack frequency, prolonged attack-free intervals, and lowered steroid use; adverse events were mostly mild gastrointestinal, with few treatment discontinuations. • Clinical improvement often appeared by about 1 month and stabilized by 3 months; this supports early reassessment to adjust dose or change therapy. MEFV is not clearly associated.

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