The Role of Serum Zinc, Iron, Magnesium, and Selenium Levels in the Pathogenesis of PFAPA Syndrome

Objective: To investigate the potential role of zinc, iron, magnesium, and selenium in the pathogenesis of Periodic Fever, Aphthous Stomatitis, Pharyngitis, Adenitis (PFAPA) syndrome.Methods: A retrospective analysis was conducted of 26 children diagnosed with PFAPA and 31 age-and sex-matched healthy controls.Serum levels of zinc, iron, magnesium, and selenium were retrieved from hospital records and compared between the groups.Results: Magnesium levels were 2.03 ± 0.14 mg/dL in the PFAPA group and 1.99 ± 0.13 mg/dL in the control group.The difference was not statistically significant (P = 0.308).Median iron levels (25 th -75 th percentiles) were 52.5 µg/dL (22.0-81.5) in the PFAPA group and 61.1 µg/dL (42.5-89.0) in the control group; the difference was not significant (P = 0.226).Zinc levels were similar: 86.24 ± 11.18 mcg/L in the PFAPA group and 87.26 ± 10.06 mcg/L in the control group (P = 0.720).However, median selenium levels differed significantly: 38.9 mcg/L (34.2-50.0) in the PFAPA group versus 48.0 mcg/L (43.0-55.5) in the control group (P = 0.002).Each one-unit increase in selenium levels increased the odds of disease by approximately 8.6%, and this association was statistically significant (odds ratio = 1.086, 95% confidence interval: 1.019-1.157,P = 0.011). Conclusion:In conclusion, this study demonstrates that low selenium levels are associated with PFAPA syndrome in children.No significant relationships were observed between zinc, iron, or magnesium levels and the disease.Given the effects of selenium on the immune system and inflammation, we hypothesize that selenium deficiency may contribute to the pathogenesis of PFAPA.