Tonsillitis

Summary

Tonsillitis (MONDO:0001039) is a disease with 39 GWAS associations across 12 studies and 90 clinical trials. Top therapeutic interventions include dexmedetomidine, penicillin g, and azithromycin. A subtype of upper respiratory tract disorder — broader associated-gene and molecular evidence is on the parent page (see Disease family below).

At a glance

• GWAS associations: 39
• Clinical trials: 90

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

Field	Value
Canonical name	tonsillitis
Mondo ID	MONDO:0001039
MeSH	D014069
DOID	DOID:10456
ICD-10-CM	J35.01
NCIT	C116006
SNOMED CT	90979004
UMLS	C0740402
MedGen	1781351
Is cancer (heuristic)	no

Also known as: chronic tonsillitis · inflammation of tonsil · tonsil inflammation · tonsilitis

Data availability: 39 GWAS associations (12 studies).

Disease family

This is a subtype of upper respiratory tract disorder. Genetic, therapeutic, and trial evidence is largely curated at the broader-term level — see the parent page for the associated-gene cohort and molecular evidence.

Classification path: disease › human disease › disease by body system or component › respiratory system disorder › upper respiratory tract disorder › tonsillitis

Related subtypes (9): uvulitis, adenoid hypertrophy, acute laryngopharyngitis, nasal cavity disorder, pharyngitis, tracheal disorder, laryngeal disorder, nasopharyngeal disorder, epiglottitis

Subtypes (2): adenoiditis, acute tonsillitis

Genetics & variants

GWAS landscape

39 GWAS associations across 12 studies. Top hits map to 20 distinct genes (as reported by GWAS).

Top associations by p-value

rsID	p-value	Gene	Risk allele	Odds ratio
rs573841223	8e-26	TNFRSF13B	?	1.42
rs72553883	4e-21	TNFRSF13B	?	1.09
rs189411872	1e-20	ADAM23	?	1.53
rs713875	2e-20	HORMAD2 - LIF-AS1	?	1.09
rs10849448	4e-19	LTBR	?	1.11
rs1045267	3e-16	MIR4435-2HG	?	1.09
rs714027	2e-13	HORMAD2 - LIF-AS1	?	1.02
rs5860793	2e-12	RNU6-351P - TET2	?	0.93
rs4648052	2e-11	NFKB1	?	0.94
rs186785612	2e-11	RNF217	C	1.69
rs1541374	4e-11	RNU6-351P - TET2	?	1.02
rs612169	6e-11	ABO	?	1.07
rs12128267	4e-10	LINC01705	?	1.1
rs1980080	9e-10	SLC12A8	?	0.98
rs3774964	1e-09	NFKB1	?	0.98
rs73631760	2e-09	SLC20A2	?	1.11
rs12082271	3e-09	LINC01714	?	0.94
rs74178437	4e-09	ZBTB7A	?	0.94
rs73181194	5e-09	PIM3 - IL17REL	?	1.07
rs9542155	6e-09	KLHL1	?	0.98
rs950529388	8e-09	ABO	?	0.98
rs78426131	1e-08	CCDC188 - LINC02891	?	0.92
rs35668054	2e-08	DYSF - RPS20P10	?	1.1
rs931555	2e-08	SPEF2	?	0.98
rs11204752	2e-08	ANXA9	?	1.02
rs199710977	2e-08	PLEKHH3	?	1.06
rs4838155	2e-08	NEK6	?	1.02
rs117556162	5e-08	CARMIL2	?	0.88
rs551502318	9e-08	ADSS1	?	2.01
rs1444289	9e-08	NFIL3 - ROR2	?

Top studies (by case count)

Study	Lead author	Year	Cases	Controls	Title
GCST90269775	Saarentaus EC	2023	29,135	199,208	Inflammatory and infectious upper respiratory diseases associate with 41 genomic loci and type 2 inflammation.
GCST90269792	Saarentaus EC	2023	29,135	199,208	Inflammatory and infectious upper respiratory diseases associate with 41 genomic loci and type 2 inflammation.
GCST90077955	Backman JD	2021	5,112	326,642	Exome sequencing and analysis of 454,787 UK Biobank participants.
GCST90081941	Backman JD	2021	5,112	326,642	Exome sequencing and analysis of 454,787 UK Biobank participants.
GCST90651814	Liu TY	2025	4,567	185,643	Diversity and longitudinal records: Genetic architecture of disease associations and polygenic risk in the Taiwanese Han population.
GCST90077956	Backman JD	2021	4,551	324,501	Exome sequencing and analysis of 454,787 UK Biobank participants.
GCST90081942	Backman JD	2021	4,551	324,501	Exome sequencing and analysis of 454,787 UK Biobank participants.
GCST90478097	Verma A	2024	2,617	444,070	Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program.
GCST90436201	Zhou W	2018	2,013	390,045	Efficiently controlling for case-control imbalance and sample relatedness in large-scale genetic association studies.
GCST90478096	Verma A	2024	1,475	117,961	Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program.

Variant details and genetic-evidence tiers

Tier distribution (top 50 variants)

Tier	Variants
Tier 1: coding	2
Tier 2: splice/UTR	3
Tier 3: regulatory	1
Tier 4: intronic/intergenic	25

MAF distribution

Bucket	Variants
common (>=0.05)	24
low_freq (0.01-0.05)	0
rare (<0.01)	1
unknown	6

Functional consequences

Consequence	Count
intron_variant	18
intergenic_variant	6
missense_variant	2
5_prime_UTR_variant	2
splice_polypyrimidine_tract_variant	1
non_coding_transcript_exon_variant	1
regulatory_region_variant	1

Top variants

rsID	Chr	Pos	Alleles	MAF	Consequence	Gene	p-value	Tier
rs573841223	17	16939881	C>G,T		intron_variant	TNFRSF13B	8e-26	Tier 4: intronic/intergenic
rs72553883	17	16940415	G>A,C,T		missense_variant	TNFRSF13B	4e-21	Tier 1: coding
rs189411872	2	206557414	A>G		splice_polypyrimidine_tract_variant	ADAM23	1e-20	Tier 2: splice/UTR
rs713875	22	30196498	C>A,G,T	0.05	intron_variant	HORMAD2 - LIF-AS1	2e-20	Tier 4: intronic/intergenic
rs10849448	12	6384185	A>G	0.05	5_prime_UTR_variant	LTBR	4e-19	Tier 2: splice/UTR
rs1045267	2	111429464	A>C,G,T	0.05	non_coding_transcript_exon_variant	MIR4435-2HG	3e-16	Tier 4: intronic/intergenic
rs714027	22	30181782	A>C,G,T	0.05	intergenic_variant	HORMAD2 - LIF-AS1	2e-13	Tier 4: intronic/intergenic
rs5860793	4	105129809	G>GC	0.05	intergenic_variant	RNU6-351P - TET2	2e-12	Tier 4: intronic/intergenic
rs4648052	4	102593898	G>A,C,T	0.05	intron_variant	NFKB1	2e-11	Tier 4: intronic/intergenic
rs186785612	6	125054737	C>T	0.001	intron_variant	RNF217	2e-11	Tier 4: intronic/intergenic
rs1541374	4	105127203	T>A,C,G	0.05	intergenic_variant	RNU6-351P - TET2	4e-11	Tier 4: intronic/intergenic
rs612169	9	133268030	G>A	0.05	intron_variant	ABO	6e-11	Tier 4: intronic/intergenic
rs12128267	1	221915660	A>G	0.05	intron_variant	LINC01705	4e-10	Tier 4: intronic/intergenic
rs1980080	3	125192997	C>A,T	0.05	intron_variant	SLC12A8	9e-10	Tier 4: intronic/intergenic
rs3774964	4	102598330	A>G	0.05	intron_variant	NFKB1	1e-09	Tier 4: intronic/intergenic
rs73631760	8	42424332	G>A,C,T	0.05	intron_variant	SLC20A2	2e-09	Tier 4: intronic/intergenic
rs12082271	1	8189495	G>A,C,T	0.05	intron_variant	LINC01714	3e-09	Tier 4: intronic/intergenic
rs74178437	19	4056862	G>A,C,T	0.05	5_prime_UTR_variant	ZBTB7A	4e-09	Tier 2: splice/UTR
rs73181194	22	49970241	G>A	0.05	intergenic_variant	PIM3 - IL17REL	5e-09	Tier 4: intronic/intergenic
rs9542155	13	70005395	T>C,G	0.05	intron_variant	KLHL1	6e-09	Tier 4: intronic/intergenic
rs950529388	9	133261662			intron_variant	ABO	8e-09	Tier 4: intronic/intergenic
rs78426131	22	20157273	G>A,C	0.05	regulatory_region_variant	CCDC188 - LINC02891	1e-08	Tier 3: regulatory
rs35668054	2	71827707	C>A,T	0.05	intergenic_variant	DYSF - RPS20P10	2e-08	Tier 4: intronic/intergenic
rs931555	5	35803475	C>A,G,T	0.05	intron_variant	SPEF2	2e-08	Tier 4: intronic/intergenic
rs11204752	1	150985657	T>C,G	0.05	intron_variant	ANXA9	2e-08	Tier 4: intronic/intergenic
rs199710977	17	42670964	T>C		intron_variant	PLEKHH3	2e-08	Tier 4: intronic/intergenic
rs4838155	9	124294914	A>G,T	0.05	intron_variant	NEK6	2e-08	Tier 4: intronic/intergenic
rs117556162	16	67646903	G>A,T	0.05	missense_variant	CARMIL2	5e-08	Tier 1: coding
rs551502318	14	104740994	G>A,T		intron_variant	ADSS1	9e-08	Tier 4: intronic/intergenic
rs1444289	9	91521103	G>A	0.05	intergenic_variant	NFIL3 - ROR2	9e-08	Tier 4: intronic/intergenic

Genes & proteins

No associated-gene cohort resolved for this disease. Atlas builds the molecular and therapeutic sections — associated genes, protein families, druggability, pathways, interactions, and drug associations — by aggregating over a disease’s associated genes (resolved via GWAS / GenCC / ClinVar / CIViC), and none resolved here. This is expected for antibody-mediated, autoimmune, or otherwise non-gene-defined conditions; the curated evidence for this disease is its clinical features, GWAS susceptibility, and clinical trials (above).

Function

No pathway enrichment — requires an associated-gene cohort.

Therapeutics

Drugs indicated for this disease

8 approved, 2 in late-stage (phase 3) trials. Disease-direct ChEMBL indications, not inferred from the associated-gene cohort below.

Drug	Development status
Amoxicillin	Approved (phase 4)
Azithromycin	Approved (phase 4)
Cefdinir	Approved (phase 4)
Cefditoren Pivoxil	Approved (phase 4)
Cefixime	Approved (phase 4)
Cefuroxime Axetil	Approved (phase 4)
Clarithromycin	Approved (phase 4)
Telithromycin	Approved (phase 4)
Mikamycin	Phase 3 (in late-stage trials)
Penicillin G	Phase 3 (in late-stage trials)

Earlier-phase candidates (phase 2, investigational — efficacy not yet established): Acetaminophen, Celecoxib, Dexamethasone, Fospropofol, Ketorolac, Midazolam, Morphine, Nitrous Oxide, Ondansetron, Oxygen, Propofol, Sevoflurane, Sodium Chloride.

Clinical trials & evidence

Clinical trials

Clinical trials: 90.

Phase distribution (across all retrieved trials)

Phase	Trials
Not specified	53
PHASE4	17
PHASE3	10
PHASE2	7
PHASE2/PHASE3	1
PHASE1/PHASE2	1
EARLY_PHASE1	1

Top trials by phase / activity

NCT	Phase	Status	Title
NCT03625011	PHASE4	RECRUITING	Gabapentin Premedication to Reduce Postoperative Pain for Pediatric Tonsillectomy
NCT04083417	PHASE4	RECRUITING	Sore Throat in Primary Care - a Comparison of Phenoxymethylpenicillin and No Antibiotic Treatment
NCT06576830	PHASE4	RECRUITING	Optimization of Pediatric Tonsillectomy to IMprove AnaLgesia
NCT00466544	PHASE4	UNKNOWN	Randomized Controlled Study of Plasmaknife Tonsillectomy Versus Monopolar Tonsillectomy
NCT00547391	PHASE4	COMPLETED	Recurrent Throat Infections and Tonsillectomy
NCT00643539	PHASE4	COMPLETED	Multicenter, Open, Randomized Comparative Trial To Compare The Efficacy Of Azithromycin Versus Amoxicillin In Children With Strep Throat
NCT00654511	PHASE4	COMPLETED	Dexmedetomidine for Immediate Perioperative Analgesia in Pediatric Patients Undergoing Tonsillectomy
NCT01267136	PHASE4	COMPLETED	A Comparison of Postoperative Tramadol Versus Acetaminophen With Codeine in Children Undergoing Tonsillectomy
NCT01465009	PHASE4	COMPLETED	Placebo and Active Controlled Study to Compare the Efficacy of Aspirin and Paracetamol in Treatment of Sore Throat Associated With a Common Cold
NCT01721486	PHASE4	COMPLETED	Acetaminophen’s Efficacy For Post-operative Pain
NCT02162433	PHASE4	TERMINATED	The Effect of Dexmedetomidine on Airway Complications After Deep or Awake Extubation
NCT02205580	PHASE4	UNKNOWN	Continuous Intravenous Sufentanil Infusion for Postoperative Pain Management Following Tonsillectomy or Adeno-tonsillectomy in Children
NCT02296840	PHASE4	TERMINATED	Post-operative Pain Control After Pediatric Adenotonsillectomy
NCT02444533	PHASE4	COMPLETED	EXPAREL® for Pain After Tonsillectomy
NCT02712307	PHASE4	COMPLETED	Study of 5 and 10 Days Treatment With Penicillin Against Sore Throat Caused by Streptococci
NCT03323047	PHASE4	UNKNOWN	Perioperative Tonsillectomy Protocol Development
NCT04528173	PHASE4	TERMINATED	Opioid-Free Anesthetic for Tonsillectomy
NCT00095368	PHASE3	COMPLETED	APC-111 Once a Day (QD) for 7 Days vs. Penicillin Taken Four Times a Day (QID) for 10 Days in Patients With Strep Throat
NCT00242281	PHASE3	COMPLETED	APC-111 MP Tablet Once a Day vs.Penicillin VK Four Times a Day Both for 10 Days in Patients With Strep Throat
NCT00315042	PHASE3	TERMINATED	TELI TON - Telithromycin in Tonsillitis
NCT00315549	PHASE3	TERMINATED	TELI TAD - Telithromycin in Tonsillitis in Adolescents and Adults
NCT00393744	PHASE3	COMPLETED	Efficacy Study of Pristinamycin Versus Amoxicillin to Treat Tonsillitis Induced by Streptococcus in Children
NCT00459927	PHASE2/PHASE3	WITHDRAWN	Comparison of Floseal Hemostasis Tonsillectomy With Coblation Tonsillectomy and Cautery Hemostasis Tonsillectomy
NCT00643149	PHASE3	COMPLETED	A Multicenter, Randomized, Double-Blind, Double-Dummy Study Of Azithromycin SR Versus Amoxicillin For The Treatment Of Strep Throat In Children
NCT00644293	PHASE3	COMPLETED	A Multicenter, Randomized, Double-Blind, Double-Dummy Comparative Trial of Azithromycin Sustained Release Versus 3-Day Azithromycin for the Treatment of Strep Throat in Adolescents and Adults
NCT01361399	PHASE3	COMPLETED	Active and Placebo Controlled Study to Test the Efficacy and Safety of an Aspirin-Lidocaine Lozenge in the Symptomatic Treatment of Sore Throat Associated With a Common Cold
NCT04016051	PHASE3	COMPLETED	Acceptance of Clarithromycin in a Straw Compared to Syrup in Children With Upper Respiratory Tract Infections
NCT04551196	PHASE3	COMPLETED	Management of Post-Tonsillectomy Pain in Pediatric Patients
NCT06543823	PHASE1/PHASE2	RECRUITING	ST250 as a Therapeutic Option for Head & Neck Reconstruction
NCT00583453	PHASE2	COMPLETED	Celecoxib as a Post-tonsillectomy Pain Medication
NCT01193790	PHASE2	UNKNOWN	Evaluation of Coblation Channeling in Treating Chronic Tonsillitis
NCT01498796	PHASE2	TERMINATED	KITS Study -Ketorolac In Tonsillectomy Surgery: a Double Blinded, Randomized Clinical Trial
NCT01691690	PHASE2	COMPLETED	Analgesic Effect of IV Acetaminophen in Tonsillectomies
NCT01919996	PHASE2	TERMINATED	PASS Study To Evaluate The Potential Of Zithromax To Cause Ocular Problems In Pediatric Patients
NCT03995628	PHASE2	COMPLETED	Steroids and Pain Control After Tonsillectomy
NCT05244226	PHASE2	COMPLETED	Pediatric Pain Optimization After Tonsillectomy
NCT04230681	EARLY_PHASE1	COMPLETED	Hydromorphone vs Fentanyl in Children Undergoing Tonsillectomy Surgery
NCT03654742	Not specified	ACTIVE_NOT_RECRUITING	Intracapsular Tonsillectomy in Adults
NCT05575401	Not specified	RECRUITING	Lateral Pharyngoplasty Outcomes in Children Undergoing Tonsillectomy
NCT05656365	Not specified	RECRUITING	Evaluating the Genetics and Immunology of Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis (PFAPA) Syndrome and Other Tonsil Disorders

Drugs tested across these trials (top 30)

Molecule	Max phase	Trials referencing
DEXMEDETOMIDINE	4	6
PENICILLIN G	4	6
AZITHROMYCIN	4	3
HYDROMORPHONE	4	2
KETOROLAC	4	2
PENICILLIN V	4	2
TELITHROMYCIN	4	2
ACETAMINOPHEN	4	1
FENTANYL	4	1
GABAPENTIN	4	1
IBUPROFEN	4	1
METHADONE	4	1
NITROUS OXIDE	4	1
TRAMADOL	4	1
MEDETOMIDINE	3	2
CLAMOXYQUIN HYDROCHLORIDE	3	1
CHEMBL1215848	0	2
CHEMBL4059722	0	1
CHEMBL5592090	0	1
(R,R)-TRAMADOL	0	1
PRISTINAMYCIN 1A	0	1