A 78-year-old female was admitted to our hospital four times between July and October 2000 because of periodic fevers associated with aphthous stomatitis, pharyngitis and cervical adenitis. Episodes continued for about one week and recurred every three to four weeks. She was healthy until these episodes. Body temperature was elevated to a maximum of 37.8°C. The number of leukocytes did not exceed 9000/mm3, but shifts of the nuclei to the left were seen in each attack. C-reactive protein (CRP) was markedly elevated to more than 9.4mg/dl, serum IgE was slightly elevated to 770IU/ml, and other laboratory studies were within normal limits. Her pathogenesis was compatible with PFAPA (periodic fever, aphthous stomatitis, pharyngitis, adenitis) syndrome except for advanced age, so cimetidine therapy (200mg four times daily) was chosen after the fourth episode and continued for two and half months. The patient has been asymptomatic for more than two years since cimetidine therapy.
