Differences between leukemic arthritis and juvenile idiopathic arthritis
Abstract Objectives To determine the clinical and laboratory differences between leukemic arthritis (LA) and juvenile idiopathic arthritis (JIA) at the onset of the disease. Material and methods Patients under 16 years of age, both genders, who presented for the first time to the pediatric rheumatol...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | Pediatric Rheumatology Online Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12969-023-00836-5 |
| _version_ | 1797811621165268992 |
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| author | Alfonso Ragnar Torres Jimenez Eunice Solis Vallejo Adriana Ivonne Cespedes Cruz Julia Veronica Ramirez Miramontes Guadalupe del Consuelo Cortina Olvera Alejandra Velazquez Cruz Berenice Sanchez Jara |
| author_facet | Alfonso Ragnar Torres Jimenez Eunice Solis Vallejo Adriana Ivonne Cespedes Cruz Julia Veronica Ramirez Miramontes Guadalupe del Consuelo Cortina Olvera Alejandra Velazquez Cruz Berenice Sanchez Jara |
| author_sort | Alfonso Ragnar Torres Jimenez |
| collection | DOAJ |
| description | Abstract Objectives To determine the clinical and laboratory differences between leukemic arthritis (LA) and juvenile idiopathic arthritis (JIA) at the onset of the disease. Material and methods Patients under 16 years of age, both genders, who presented for the first time to the pediatric rheumatology service with a diagnosis of probable JIA, with arthritis and without peripheral blood blasts, in which the final diagnosis was acute lymphoblastic leukemia (ALL) or JIA. The clinical and laboratory characteristics of the patients were compared, chi-square and relative risk were used for categorical variables, and the Mann–Whitney U and T-test for the comparison of means between groups. A binary logistic regression model was developed to differentiate leukemic arthritis from JIA. Results A total of 76 patients, 14 with LA and 62 with JIA, were analyzed. The mean age at diagnosis was lower in the leukemic arthritis group, the female gender prevailed in the JIA group, and the time to onset of symptoms was lower in the leukemic arthritis group. Patients with leukemic arthritis showed increased pain intensity, fever, weight loss, nocturnal diaphoresis, lymph node enlargement, hepatosplenomegaly, and pain that did not improve with analgesic administration. Laboratory parameters with statistical significance were the presence of anemia, leukopenia, and neutropenia. The platelet count was significant but in a low normal value, compared to the JIA. A binary logistic regression model was developed to differentiate leukemic arthritis from JIA. The probability associated with the statistic (Chi-square) was 0.000, and the Cox and Snell R2 and Nagelkerke R2 values were 0.615 and 1, respectively. The developed model correctly classified 100% of the cases. Conclusions The diagnosis of acute lymphoblastic leukemia should be ruled out in patients who present with arthritis and hematological alterations, mainly leukopenia and neutropenia, with joint pain disproportionate to the degree of arthritis, predominantly at night and that does not improve with the use of analgesics, fever, lymph nodes, and hepatosplenomegaly. Criteria are suggested to differentiate both diseases. |
| first_indexed | 2024-03-13T07:25:25Z |
| format | Article |
| id | doaj.art-7fb7cc7dadcb42ce9905abec43781ea1 |
| institution | Directory Open Access Journal |
| issn | 1546-0096 |
| language | English |
| last_indexed | 2024-03-13T07:25:25Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Pediatric Rheumatology Online Journal |
| spelling | doaj.art-7fb7cc7dadcb42ce9905abec43781ea12023-06-04T11:23:27ZengBMCPediatric Rheumatology Online Journal1546-00962023-05-012111610.1186/s12969-023-00836-5Differences between leukemic arthritis and juvenile idiopathic arthritisAlfonso Ragnar Torres Jimenez0Eunice Solis Vallejo1Adriana Ivonne Cespedes Cruz2Julia Veronica Ramirez Miramontes3Guadalupe del Consuelo Cortina Olvera4Alejandra Velazquez Cruz5Berenice Sanchez Jara6Department of Pediatric Rheumatology, National Medical Center, La Raza, IMSSDepartment of Pediatric Rheumatology, National Medical Center, La Raza, IMSSDepartment of Pediatric Rheumatology, National Medical Center, La Raza, IMSSDepartment of Pediatric Rheumatology, National Medical Center, La Raza, IMSSDepartment of Pediatric Rheumatology, National Medical Center, La Raza, IMSSDepartment of Pediatric Rheumatology, National Medical Center, La Raza, IMSSDepartment of Pediatric Hematology, National Medical Center La Raza, IMSSAbstract Objectives To determine the clinical and laboratory differences between leukemic arthritis (LA) and juvenile idiopathic arthritis (JIA) at the onset of the disease. Material and methods Patients under 16 years of age, both genders, who presented for the first time to the pediatric rheumatology service with a diagnosis of probable JIA, with arthritis and without peripheral blood blasts, in which the final diagnosis was acute lymphoblastic leukemia (ALL) or JIA. The clinical and laboratory characteristics of the patients were compared, chi-square and relative risk were used for categorical variables, and the Mann–Whitney U and T-test for the comparison of means between groups. A binary logistic regression model was developed to differentiate leukemic arthritis from JIA. Results A total of 76 patients, 14 with LA and 62 with JIA, were analyzed. The mean age at diagnosis was lower in the leukemic arthritis group, the female gender prevailed in the JIA group, and the time to onset of symptoms was lower in the leukemic arthritis group. Patients with leukemic arthritis showed increased pain intensity, fever, weight loss, nocturnal diaphoresis, lymph node enlargement, hepatosplenomegaly, and pain that did not improve with analgesic administration. Laboratory parameters with statistical significance were the presence of anemia, leukopenia, and neutropenia. The platelet count was significant but in a low normal value, compared to the JIA. A binary logistic regression model was developed to differentiate leukemic arthritis from JIA. The probability associated with the statistic (Chi-square) was 0.000, and the Cox and Snell R2 and Nagelkerke R2 values were 0.615 and 1, respectively. The developed model correctly classified 100% of the cases. Conclusions The diagnosis of acute lymphoblastic leukemia should be ruled out in patients who present with arthritis and hematological alterations, mainly leukopenia and neutropenia, with joint pain disproportionate to the degree of arthritis, predominantly at night and that does not improve with the use of analgesics, fever, lymph nodes, and hepatosplenomegaly. Criteria are suggested to differentiate both diseases.https://doi.org/10.1186/s12969-023-00836-5Leukemic arthritis; juvenile idiopathic arthritisNeutropeniaAcute lymphoblastic leukemiaArthritis |
| spellingShingle | Alfonso Ragnar Torres Jimenez Eunice Solis Vallejo Adriana Ivonne Cespedes Cruz Julia Veronica Ramirez Miramontes Guadalupe del Consuelo Cortina Olvera Alejandra Velazquez Cruz Berenice Sanchez Jara Differences between leukemic arthritis and juvenile idiopathic arthritis Pediatric Rheumatology Online Journal Leukemic arthritis; juvenile idiopathic arthritis Neutropenia Acute lymphoblastic leukemia Arthritis |
| title | Differences between leukemic arthritis and juvenile idiopathic arthritis |
| title_full | Differences between leukemic arthritis and juvenile idiopathic arthritis |
| title_fullStr | Differences between leukemic arthritis and juvenile idiopathic arthritis |
| title_full_unstemmed | Differences between leukemic arthritis and juvenile idiopathic arthritis |
| title_short | Differences between leukemic arthritis and juvenile idiopathic arthritis |
| title_sort | differences between leukemic arthritis and juvenile idiopathic arthritis |
| topic | Leukemic arthritis; juvenile idiopathic arthritis Neutropenia Acute lymphoblastic leukemia Arthritis |
| url | https://doi.org/10.1186/s12969-023-00836-5 |
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