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Reduced Number of CD 8+ Cells in Tonsillar Germinal Centres in Children with the Periodic Fever, Aphthous Stomatitis, Pharyngitis and Cervical Adenitis Syndrome
Author(s) -
Førsvoll J.,
Janssen E. A. M.,
Møller I.,
Wathne N.,
Skaland I.,
Klos J.,
Kristoffersen E. K.,
Øymar K.
Publication year - 2015
Publication title -
scandinavian journal of immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.934
H-Index - 88
eISSN - 1365-3083
pISSN - 0300-9475
DOI - 10.1111/sji.12303
Subject(s) - pharyngitis , tonsil , medicine , palatine tonsil , tonsillectomy , germinal center , stomatitis , recurrent aphthous stomatitis , pathology , follicular hyperplasia , immunology , lymphoid hyperplasia , b cell , hyperplasia , antibody , lymphoma
The syndrome of periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis ( PFAPA ) is an autoinflammatory disorder of unknown aetiology. Tonsillectomy may cause a prompt resolution of the syndrome. The aim was to study the histologic and immunological aspects of the palatine tonsils in PFAPA , to help understand the pathophysiology of the syndrome. Tonsils from children with PFAPA ( n = 11) and children with tonsillar hypertrophy ( n = 16) were evaluated histologically after haematoxylin and eosin staining. The number of different cell types was identified immunohistochemically by cluster of differentiation ( CD ) markers: CD 3 (T cells), CD 4 (T helper cells), CD 8 (cytotoxic T cells), CD 15 (neutrophils), CD 20 (B cells), CD 45 (all leucocytes), CD 57 ( NK cells) and CD 163 (monocytes and macrophages). Tonsils from children with PFAPA showed reactive lymphoid hyperplasia dominated by well‐developed germinal centres with many tingible body macrophages. The histologic findings were unspecific, and a similar morphologic appearance was also found in the tonsils from controls. The number of CD 8+ cells in germinal centres differed between children with PFAPA [median 9 cells (quartiles: 5, 15)] and controls [18 cells (12, 33) ( P = 0.001)] and between children with PFAPA with (median 14 cells; 9, 16) and without (4 cells; 3, 8) aphthous stomatitis ( P = 0.015). For the other cell types, no differences in germinal centres were found between children with PFAPA and controls. In conclusion, a lower number of CD 8+ cells were found in germinal centres of tonsils in children with PFAPA compared to controls, which may be a feature linked to the aetiology of the syndrome.