Children with periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) -syndrome diagnosis will be randomised either to tonsillotomy (partial tonsillectomy) or 3 months follow up.~In both groups the symptoms are monitored with symptom diaries. At follow up visit 3 months after randomisation the children from either groups with ongoing symptoms will be sent to tonsillectomy (total remove of palatine tonsil).~The design is sequential trial. From the previous trials we know that the effect of tonsillectomy is about 90% and that during follow up for six months as much as 50% of the patients will recover. Because the syndrome is rare and because the rescue operations of the tonsils (tonsillectomy in a person who has gone through tonsillotomy), the sample size has to be as low as possible. That is the reason why we chose sequential design, with assessments after every 8 patient.~Randomization is made in blocks of four. In sequential design we use the following assumptions:~We are looking for a 40% absolute difference in cure rate between tonsillotomy (90%) and follow up (50%) groups.~Two sided Whitehead design~Maximum likelihood estimation (MLE)~Five assessments (sample size 4+4, 8+8. 12+12, 16+16 and 19+19)~type 1 error 5 % and power 80%~The sample size will be from 8 to 38 patients depending on when the trial can be stopped along assessments.
Children with periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) -syndrome diagnosis will be randomised either to tonsillotomy (partial tonsillectomy) or 3 months follow up. At follow up visit 3 months after randomisation the children from either groups with ongoing symptoms will be sent to tonsillectomy.