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PReS-FINAL-2083: The rate of malignancy in iranian children with joint manifestations
© Shafaie et al.; licensee BioMed Central Ltd. 2013
Published: 5 December 2013
Different reports of shared manifestations for malignancy and rheumatic diseases in children since 1970s indicate the presentation of malignancies, particularly ALL, with musculoskeletal (MS) symptoms.
To evaluate the rate and the characteristics of hematological malignancies in Iranian children with joint manifestations based on two different scopes of data collection since 1981.
In this retrospective review, we considered two different aspects of evaluation within two pediatric tertiary centers in Iran: 1- Children's Hematology/Oncology Research Center, 2- Pediatric Rheumatology Center.
Period of Study
Malignant cases with MS symptoms/total patients
Mean age at diagnosis (years)
Mean delay to diagnosis (months)
Most common age group (years)
Most commonly involved Joints
Children's Hematology/Oncology Research Center
Anemia 59% Leukopenia 18% Leukocytosis 61%
Raised ESR 37%
Leukopenia 34% Leukocytosis 14%
Raised ESR 58%
Raised LDH 34%
Pediatric Rheumatology Center
The relative increase in the rate of malignancy in this review (period of 1981-2012) could be an alarm to perform BM aspiration in children with joint manifestations harboring the following as "Red Flags": (i) Boys at the age of 5-7, (ii) Large joint involvement (particularly hip, knee and ankle) and (iii) Arthralgia at presentation. According to recent recommendations by ACR for early aggressive treatments in JIA patients, this precautionary measure may minimize the potential dangers and consequences of misdiagnosis prior to initiation of any treatment.
Disclosure of interest
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.