A Multicenter Case-Control Study on Predictive Factors Distinguishing Childhood Leukemia From Juvenile Rheumatoid Arthritis

Jones, Olcay Y.; Spencer, Charles H.; Bowyer, Suzanne L.; Dent, Peter B.; Gottlieb, Beth S.; Rabinovich, C. Egla

doi:10.1542/peds.2005-1515

Cited by 124 publications

(99 citation statements)

References 15 publications

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“…Short-term clinical signs, immaturity of affected cells, and a high leukocyte count have been described as helpful to establish the diagnosis of acute leukemia. 22 To sum up, the results of this study are consistent with the literature. Among all clinical manifestations preceding diagnosis reported by mothers, the prevalence of joint pain is striking since this was described in an open (not direct) question at the end of the survey.…”

Section: Discussionsupporting

confidence: 91%

“…4,6 Joint symptoms and their potential for confusion with other diagnosis have been the focus of some studies. [19][20][21][22] Among such studies, the one conducted by Jones established that, in children with unexplained musculoskeletal manifestations, the three most common findings that predicted the diagnosis of ALL were a low leukocyte count, a normallow platelet count, and a history of night pain; when these three were present, there was a 100% sensitivity and an 85% specificity. 22 The presence of significant lymphadenopathy should increase the suspicion of childhood leukemia.…”

Section: Discussionmentioning

confidence: 99%

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Approach to prediagnostic clinical semiology, noticed by mothers, of childhood acute lymphoblastic leukemia

Castro-Jiménez¹,

Rueda-Arenas

Cabrera-Rodríguez³

2015

Arch Argent Pediat

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Approach to prediagnostic clinical semiology, noticed by mothers, of childhood acute lymphoblastic leukemia

Castro-Jiménez¹,

Rueda-Arenas

Cabrera-Rodríguez³

2015

Arch Argent Pediat

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“…Attempts have been made to distinguish SJIA from its mimics, such as infection and malignancy (2,3). Usual markers of inflammation, such as C-reactive protein, erythrocyte sedimentation rate, and ferritin are not specific for SJIA.…”

mentioning

confidence: 99%

Comparison of biomarkers for systemic juvenile idiopathic arthritis

Shenoi

Ni³

et al. 2015

Pediatr Res

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Background: Differentiation of systemic juvenile idiopathic arthritis (SJIA) fever from other childhood fevers is often delayed due to the lack of reliable, specific biomarkers. We hypothesized that PD-L1 expression is dysregulated in SJIA monocytes and compared it to other candidate SJIA biomarkers. Methods: This pilot study enrolled children with fever without source and compared PD-L1 expression on myeloid cells to C-reactive protein, erythrocyte sedimentation rate, leukocyte counts, S100A12, S100A8, S100A9, calprotectin, and procalcitonin. Logistic regression models were fit to test SJIA diagnosis with each marker used as an independent predictor. Receiver operating characteristic curves and area under curve were calculated. Gene expression profiling on a subset of samples was performed. results: Twenty subjects (10 active SJIA, 10 febrile non-SJIA) were enrolled. S100 proteins were significantly elevated in SJIA with >80% sensitivity and >90% specificity. PD-L1 expression was significantly lower in SJIA. Other markers were not specific for SJIA. On exploratory gene analysis, 106 genes were significant for SJIA association, and several of these are associated with immune response pathways. conclusion: In this small cohort, S100 proteins were specific diagnostic biomarkers for SJIA in children with fever. Decreased PD-L1 surface expression on circulating myeloid cells in SJIA suggests possible mechanism for loss of peripheral immune regulation.

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“…Bone pain in ALL is due to leukemic infiltration of bone and periosteum, and often occurs in long bones [5]. Several unusual initial presentations of ALL in children were reported as rare presentations.…”

Section: Introductionmentioning

confidence: 99%

Anterior Chest Wall Bulging: A Rare Initial Manifestation of Acute Lymphoblastic Leukemia in a Child

Zareifar¹,

Shakibazad²

2016

J Leuk

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Acute lymphoblastic leukemia (ALL) has several clinical manifestations on the base of bone marrow infiltration and the extent of extra medullary involvement. Anterior chest wall bulging as an initial presentation is rare. The aim of this case report study is to present a 3.5 year-old-boy presented with anterior chest wall bulging without history of trauma since 1 month ago. Tc99m-MDP bone scan showed multifocal active bony pathology in sternum, lower thoracic and all lumbar vertebra and right sacral ala. Bone marrow aspiration and biopsy was in favor of acute precursor lymphoblastic leukemia, B cell type. Therefore, acute lymphoblastic leukemia has different initial presentation and anterior chest wall bulging can be a rare initial sign of acute lymphoblastic leukemia in children.

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A Multicenter Case-Control Study on Predictive Factors Distinguishing Childhood Leukemia From Juvenile Rheumatoid Arthritis

Abstract: When a child develops new-onset bone-joint complaints, the presence of subtle complete blood count changes combined with nighttime pain should lead to consideration of leukemia as the underlying cause.

Cited by 124 publications

References 15 publications

Approach to prediagnostic clinical semiology, noticed by mothers, of childhood acute lymphoblastic leukemia

Approach to prediagnostic clinical semiology, noticed by mothers, of childhood acute lymphoblastic leukemia

Comparison of biomarkers for systemic juvenile idiopathic arthritis

Anterior Chest Wall Bulging: A Rare Initial Manifestation of Acute Lymphoblastic Leukemia in a Child

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