Recurrent tonsillitis and tonsillectomy in juvenile idiopathic arthritis.

Abstract:

OBJECTIVES:To compare the clinical and bacteriological features of recurrent tonsillitis between patients with and without juvenile idiopathic arthritis (JIA). METHODS:A total of 122 participants, aged 2-18 years, were consecutively recruited into four groups: (i) JIA and recurrent tonsillitis; (ii) JIA; (iii) recurrent tonsillitis; and (iv) healthy. All the patients with recurrent tonsillitis underwent tonsillectomy. Swabs from tonsillar surface crypts of all children and samples from tonsillar core tissue in case of tonsillectomy were processed for culturing. Mycoplasma pneumoniae was determined by polymerase chain reaction (PCR). RESULTS:Significantly lower rates of recurrences but more frequent tonsillar detritus, paratonsillar scars, and more intensive bleeding during tonsillectomy were found in patients with JIA and recurrent tonsillitis, versus patients with recurrent tonsillitis without arthritis. In JIA patients with recurrent tonsillitis, Staphylococcus aureus was cultured from the tonsillar surface in 36%, and from the core tissue in 92% of cases (p = 0.0000). In patients suffering from recurrent tonsillitis alone, this pathogen was cultured from the core in 55.9% of cases (p = 0.0066 compared to JIA patients with recurrent tonsillitis). No M. pneumoniae was revealed by PCR in samples from the tonsillar surface and the core tissue. CONCLUSIONS:The increased rate of S. aureus in the core tissue of tonsils, the higher frequency of tonsillar detritus, the more pronounced paratonsillar scarring, and more intensive bleeding during tonsillectomy, associated with the lower frequency of tonsillitis recurrences, are characteristic for recurrent tonsillitis in JIA as compared to recurrent tonsillitis without arthritis.

journal_name

Scand J Rheumatol

authors

Astrauskiene D,Bernotiene E,Bytautiene J,Sakalinskas V,Panaviene V,Venaliene J,Lesinskas E

doi

10.1080/03009740902911664

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

349-52

issue

5

eissn

0300-9742

issn

1502-7732

pii

912918411

journal_volume

38

pub_type

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