학술논문
Persistent osteoarticular pain in children: early clinical and laboratory findings suggestive of acute lymphoblastic leukemia (a multicenter case-control study of 147 patients)
Document Type
article
Author
Mathilde Louvigné; Josué Rakotonjanahary; Laurence Goumy; Aude Tavenard; Jean-François Brasme; Fanny Rialland; André Baruchel; Marie-Françoise Auclerc; Véronique Despert; Marie Desgranges; Sylvie Jean; Albert Faye; Ulrich Meinzer; Mathie Lorrot; Chantal Job-Deslandre; Brigitte Bader-Meunier; Virginie Gandemer; Isabelle Pellier; on behalf of the GOCE Group
Source
Pediatric Rheumatology Online Journal, Vol 18, Iss 1, Pp 1-8 (2020)
Subject
Language
English
ISSN
1546-0096
Abstract
Abstract Background The aim of this study was to identify early clinical and laboratory features that distinguish acute lymphoblastic leukemia (ALL) from juvenile idiopathic arthritis (JIA) in children presenting with persistent bone or joint pain for at least 1 month. Methods We performed a multicenter case-control study and reviewed medical records of children who initially presented with bone or joint pain lasting for at least 1 month, all of whom were given a secondary diagnosis of JIA or ALL, in four French University Hospitals. Each patient with ALL was paired by age with two children with JIA. Logistic regression was used to compare clinical and laboratory data from the two groups. Results Forty-nine children with ALL and 98 with JIA were included. The single most important feature distinguishing ALL from JIA was the presence of hepatomegaly, splenomegaly or lymphadenopathy; at least one of these manifestations was present in 37 cases with ALL, but only in 2 controls with JIA, for an odds ratio (OR) of 154 [95%CI: 30–793] (regression coefficient: 5.0). If the presence of these findings is missed or disregarded, multivariate analyses showed that non-articular bone pain and/or general symptoms (asthenia, anorexia or weight loss) (regression coefficient: 4.8, OR 124 [95%CI: 11.4–236]), neutrophils