Abstract
The tonsillar provocation test was performed in patients with suspected tonsillar focal infection, in order to examine the relation between the primary focus and secondary disease. In this study, we performed the tonsillar provocation test in 78 cases with suspected tonsillar focal infection. Twenty- eight patients were diagnosed as having IgA nephropathy (IgA group), and 50 patients as having pustulosis palmaris et plantaris (PPP group). Tonsillectomy was performed in 28 patients who underwent the tonsillar provocation test. Eighteen of the 28 cases were diagnosed as having IgA nephropathy and 10 as having pustulosis palmaris et plantaris. We investigated the improvement rate of the tonsillar focal infection, and the relation between the effect of tonsillectomy and the result of the tonsillar provocation test. The percentage of patients with a positive reaction in the tonsillar provocation test was 29%. The percent with a positive reaction in the IgA group was 39%, while that in the PPP group was 24%. Increase of the white blood cell count and urinary protein excretion, and the skin condition were used as the criteria for a positive reaction. Although the postoperative follow-up period was short, the number of red blood cells in the urine and the urinary protein excretion decreased in 80% of the patients of the IgA group. All the patients in the PPP group showed improvement of the skin condition. The relation between the treatment effect and the provocation test result in the IgA nephropathy patients was not clear. In the PPP group, 67% of patients who showed a positive reaction in the provocation test underwent tonsillectomy. All patients showed improvement of their skin condition.
