Arthritis as the presenting feature of childhood leukemia

Fink, Chester W.; Windmiller, Joan; Sartain, Peggy

doi:10.1002/art.1780150404

Cited by 59 publications

(25 citation statements)

References 7 publications

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“…2,3 Several studies concerning the musculoskeletal manifestations of childhood leukemias have shown the importance of these complaints in the clinical presentation and follow-up of these patients. 1,[4][5][6][7][8][9][10] The aims of the present study were to determine retrospectively the frequency and type of occult neoplasias in children who initially presented with musculoskeletal complaints, as well as determining the clinical features and laboratory alterations that can suggest such malignancy.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of malignancies in children with musculoskeletal complaints

et al. 2005

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CONTEXT: Musculoskeletal complaints may be associated with neoplasias as an initial manifestation of the disease. When these symptoms predominate at the onset of the disease, the differential diagnosis includes several rheumatic diseases. OBJECTIVE: To assess the frequency, clinical features and types of cancer manifested in children presenting with musculoskeletal complaints over a seven-year period. TYPE OF STUDY: Retrospective. SETTING: Discipline of Allergy, Clinical Immunology and Rheumatology, Universidade Federal de São Paulo - Escola Paulista de Medicina. METHODS: The medical records of patients with musculoskeletal complaints and final diagnosis of malignant disease were reviewed. The data collected were: age when symptoms initially presented, age at diagnosis, clinical features presented, laboratory findings, and the initial and final diagnoses. RESULTS: A final diagnosis of cancer was found in nine out of 3,528 patients (0.25%) whose initial symptom was musculoskeletal pain. The mean time between disease onset and final diagnosis was five months. The most common features presented were pauciarticular arthritis or arthralgia involving the large joints. Juvenile rheumatoid arthritis was the most frequent initial diagnosis, in four out of nine patients. Anemia was the most frequent initial hematological change. Six out of eight patients had an increased erythrocyte sedimentation rate. The lactate dehydrogenase level was raised in five out of eight patients. The malignancies found included acute lymphocytic leukemia, acute myeloid leukemia, lymphoma, neuroblastoma and Ewing's sarcoma. DISCUSSION: The frequency of neoplasia in patients with musculoskeletal pain resembled reports in the literature. Consumptive symptoms were not the warning signal in most of our patients. In subsidiary tests, progressive anemia was the most common finding, although the peripheral blood cell count may continue to be normal for weeks or months after symptom onset. CONCLUSION: Malignancy always needs to be ruled out in cases of children with musculoskeletal complaints. Uncharacteristic clinical manifestations and nonspecific laboratory tests may cause difficulty in the final diagnosis, and rigorous investigation should be performed.

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Section: Introductionmentioning

confidence: 99%

Diagnosis of malignancies in children with musculoskeletal complaints

et al. 2005

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“…Bu bulgular nonspesifik olup, ateş yüksekliği, hâlsizlik, solukluk, ekstremite ve eklem ağrılarıdır (1) . ALL ço-cuklarda kemik ve ekstremite ağrılarından çok tek veya çoklu eklem tutulumu ile seyretmektedir (8,9) . Olgumuz da üç yaşında erkek hasta olup, sağ dirsek eklemi ağrısı nedeniyle başvurmuştu.…”

Section: Discussionunclassified

Case of an Acute lymphoblastic Leukemia Presenting as Elbow Septic Arthritis

Erol¹,

Adanır²,

Gayret³

et al. 2016

Okmeydani Medical Journal

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“…Há vários trabalhos na literatura que observaram a freqüência e características deste tipo de manifestação inicial nas doenças linfoproliferativas 7,8,15,16 . No nosso estudo, ocorreram em 62% dos casos, semelhante ao apresentado na literatura estudada.…”

Section: Discussionunclassified

“…Alguns trabalhos têm descrito as manifestações reumatológicas das leucemias, uma vez que queixas músculo-esqueléticas podem ser sua manifestação inicial 7,[12][13][14][15][16] . A artrite em leucemias pode ser crônica ou recorrente, e geralmente apresenta-se de forma pauciarticular assimétri-ca, geralmente aditiva, mas pode ser também migratória e seu início pode ser súbito ou insidioso 6 .…”

Section: Introductionunclassified

Manifestações músculo-esqueléticas como apresentação inicial das leucemias agudas na infância

Barbosa¹,

Nakamura

Terreri

et al. 2002

J. Pediatr. (Rio J.)

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ResumoObjetivo: estudar a prevalência e as características clínicas e laboratoriais dos pacientes com manifestações músculo-esqueléti-cas na apresentação inicial das leucemias agudas.Métodos: estudo de casos prevalentes, retrospectivo, descritivo, no qual foram avaliados pacientes com diagnóstico de leucemia aguda, atendidos no Instituto de Oncologia Pediátrica da UNIFESP, de novembro de 1999 a fevereiro de 2000. As queixas músculo-esqueléticas foram investigadas através de um questionário. Os dados referentes ao exame físico e provas laboratoriais, no início da doença, foram obtidos através da revisão de prontuários.Resultados: sessenta e uma crianças foram incluídas neste estudo, sendo que 93% apresentavam leucemia linfóide aguda, e 7% leucemia mielóide aguda. Trinta e oito crianças (62%) apresentaram dor músculo-esquelética no início da doença. Artrite foi observada em 8 casos (13%). A média de articulações acometidas foi 2,5 (variando de 1 a 6), sendo as mais acometidas os joelhos, os tornozelos e os cotovelos. Três pacientes (4,9%) apresentavam hemograma normal, 54 (88%) hemoglobina baixa (em 6 pacientes foi a única alteração), leucopenia em 14 (22%), leucocitose em 26 (42%), e plaquetopenia em 46 (75%) pacientes. Oito pacientes (13%) mostravam blastos em sangue periférico.Conclusão: as queixas músculo-esqueléticas são manifestações iniciais freqüentes das leucemias agudas, e devem ser consideradas no diagnóstico diferencial da dor em membros e das artrites agudas ou crônicas da infância. Os exames laboratoriais podem ser inicialmente normais, tornando ainda mais difícil esta diferenciação.J Pediatr (Rio J) 2002;78(6):481-4: manifestações músculo-esqueléticas, artrite, dor em membros, leucemias, crianças. AbstractObjective: to study the frequency, the clinical features and laboratory exams of patients with musculoskeletal symptoms at the onset of acute leukemia.Methods: retrospective, descriptive study including patients diagnosed with acute leukemia, and treated at the Institute of Pediatric Oncology of UNIFESP, carried out from November 1999 to February 2000. The data on musculoskeletal complaints were obtained from a questionnaire. The medical records were revised in order to get data on the clinical examination and laboratory tests at the beginning of the illness.

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Arthritis as the presenting feature of childhood leukemia

Cited by 59 publications

References 7 publications

Diagnosis of malignancies in children with musculoskeletal complaints

Diagnosis of malignancies in children with musculoskeletal complaints

Case of an Acute lymphoblastic Leukemia Presenting as Elbow Septic Arthritis

Manifestações músculo-esqueléticas como apresentação inicial das leucemias agudas na infância

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