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  • Poster presentation
  • Open Access

Clues to remind leukemia in patients with arthritis: case presentations

  • 1,
  • 1,
  • 1 and
  • 1
Pediatric Rheumatology20086 (Suppl 1) :P172

https://doi.org/10.1186/1546-0096-6-S1-P172

  • Published:

Keywords

  • Public Health
  • Arthritis
  • Leukemia
  • Acute Lymphocytic Leukemia
  • Disease Onset
Acute lymphocytic leukemia (ALL) may initially present with musculoskeletal symptoms such as pain or swelling, even before appearance of blasts in the peripheral blood. Fifteen to 30% of all ALL patients have musculoskeletal complaints at disease onset. Such presentation may lead to misdiagnosis of the patients causing a delay in proper management. Here, we present 5 patients who were referred to Pediatric Rheumatology Department for the evaluation of arthritis and were finally diagnosed as ALL (table 1).
Table 1

Five patients who were referred to Pediatric Rheumatology Department for the evalution of arthritis and were finall diagnosed as ALL

Patient

Presentation

Provisional diagnosis

Final diagnosis

10 y, ♂

Migratory arthritis, fatigue

Acute rheumatic fever

ALL

3 y, ♂

Fever, arthritis of the left hip

Septic arthritis

ALL

2 y, ♀

Arthritis of the right hip

Transient synovitis

ALL

3 y, ♂

Pain in legs, inability to walk

JIA

ALL

6 y, ♀

Arthritis of the left elbow, fatigue

Postviral arthritis

ALL

The peripheral blood changes were absent or subtle in these patients. Some clinical, laboratory, and radiological clues helped to establish the diagnosis of ALL. We aimed to discuss the usefulness of history, physical findings, and simple laboratory and radiographic tests in decision-making.

Authors’ Affiliations

(1)
Dokuz Eylul University Hospital, Izmir, Turkey

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