{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T04:07:51Z","timestamp":1788840471622,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) is the most common autoinflammatory syndrome of childhood. Although immune dysregulation is central to its pathogenesis, the broader burden of allergic and autoimmune comorbidities in PFAPA remains incompletely characterized. We aimed to evaluate the prevalence of allergic and autoimmune diseases in children with PFAPA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a nationwide matched case\u2013control study using electronic health records from Leumit Health Services in Israel between 2000 and 2024. Children with PFAPA were identified using a dedicated ICD\u20109 code and matched 1:20 with controls by age, sex, socioeconomic status, ethnicity, and year of first record. Allergic and autoimmune diagnoses were identified using predefined ICD\u20109 codes. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, with false discovery rate correction for multiple testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort included 1641 PFAPA patients and 32,820 matched controls with a mean follow\u2010up of 8.6\u2009years. PFAPA patients had increased prevalence of asthma (49.6% vs. 37.5%; OR 1.64), allergic rhinitis (15.7% vs. 9.8%; OR 1.71), atopic dermatitis (23.0% vs. 19.9%; OR 1.21), urticaria (18.8% vs. 15.0%; OR 1.32), drug allergy (1.22% vs. 0.57%; OR 2.15), and anaphylaxis (0.55% vs. 0.20%; OR 2.78). In contrast, autoimmune diseases were uncommon and showed no consistent enrichment. Similar associations were observed for diagnoses recorded before PFAPA diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PFAPA is associated with a broad atopic comorbidity profile but not with classical autoimmune disease. These findings suggest that PFAPA may represent a distinct immune phenotype in which episodic autoinflammation coexists with atopic susceptibility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pai.70423","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T05:54:04Z","timestamp":1784094844000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Allergic but not autoimmune comorbidities in children with PFAPA: A nationwide matched case\u2013control cohort study"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9823-4750","authenticated-orcid":false,"given":"Yackov","family":"Berkun","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Hadassah\u2010Hebrew University Medical Center, Mount Scopus, Faculty of Medicine Hebrew University  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7713-423X","authenticated-orcid":false,"given":"Eli","family":"Magen","sequence":"additional","affiliation":[{"name":"Leumit Health Services  Tel Aviv\u2010Yafo Israel"},{"name":"Medicine A Department, Assuta Ashdod University Hospital, Faculty of Health Sciences Ben\u2010Gurion University of the Negev  Beer\u2010Sheba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5469-0236","authenticated-orcid":false,"given":"Eugene","family":"Merzon","sequence":"additional","affiliation":[{"name":"Leumit Health Services  Tel Aviv\u2010Yafo Israel"},{"name":"Adelson School of Medicine Ariel University  Ariel Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9435-7152","authenticated-orcid":false,"given":"Ilan","family":"Green","sequence":"additional","affiliation":[{"name":"Leumit Health Services  Tel Aviv\u2010Yafo Israel"},{"name":"Department of Family Medicine, Gray Faculty of Medical &amp; Health Sciences Tel\u2010Aviv University  Tel Aviv\u2010Yafo Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2406-6402","authenticated-orcid":false,"given":"Avivit","family":"Golan\u2010Cohen","sequence":"additional","affiliation":[{"name":"Leumit Health Services  Tel Aviv\u2010Yafo Israel"},{"name":"Department of Family Medicine, Gray Faculty of Medical &amp; Health Sciences Tel\u2010Aviv University  Tel Aviv\u2010Yafo Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9804-7103","authenticated-orcid":false,"given":"Shlomo","family":"Vinker","sequence":"additional","affiliation":[{"name":"Leumit Health Services  Tel Aviv\u2010Yafo Israel"},{"name":"Department of Family Medicine, Gray Faculty of Medical &amp; Health Sciences Tel\u2010Aviv University  Tel Aviv\u2010Yafo Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4389-8896","authenticated-orcid":false,"given":"Ariel","family":"Israel","sequence":"additional","affiliation":[{"name":"Leumit Health Services  Tel Aviv\u2010Yafo Israel"},{"name":"Department of Epidemiology and Preventive Medicine, School of Public Health, Gray Faculty of Medical &amp; Health Sciences Tel Aviv University  Ramat Aviv, Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"e_1_2_10_2_1","article-title":"Periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome: an update","volume":"12","author":"Michailou M","year":"2025","journal-title":"Children 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