Agodi, Antonella

Barchitta, Martina

Barone, Patrizia

Di Cataldo, Andrea

Garozzo, Rosaria

La Rosa, Manuela

Marino, Silvia

Russo, Giovanna

Timpanaro, Tiziana

Trigilia, Cristina

English

PubMed

Agodi Antonella

Russo Giovanna

La Rosa Manuela

Garozzo Rosaria

Marino Silvia

Timpanaro Tiziana

Barchitta Martina

Trigilia Cristina

Barone Patrizia

Di Cataldo Andrea

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Pediatric Rheumatology

Predictive clinical and hematological factors in the differential diagnosis between malignancy and arthritis in children: a case-control study

Cristina Trigilia

Martina Barchitta

Tiziana Timpanaro

Silvia Marino

Rosaria Garozzo

Manuela La Rosa

Giovanna Russo

Antonella Agodi

Patrizia Barone

Andrea Di Cataldo

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POSTER PRESENTATION Open Access
Predictive clinical and hematological factors in
the differential diagnosis between malignancy
and arthritis in children: a case-control study
Cristina Trigilia, Martina Barchitta, Tiziana Timpanaro, Silvia Marino, Rosaria Garozzo, Manuela La Rosa,
Giovanna Russo, Antonella Agodi, Patrizia Barone, Andrea Di Cataldo
From 18th Pediatric Rheumatology European Society (PReS) Congress
Bruges, Belgium. 14-18 September 2011
Introduction
Musculoskeletal pain is a common symptom in child-
hood and in a few cases is the initial sign of a severe
disease such a chronic inflammatory disease or a
malignancy.
Aim
To identify the predictive factors for malignancies in
children presenting with musculoskeletal pain, and ulti-
mately diagnosed to have JRA or malignancy.
Patients and methods: it is a retrospective case-control
chart review study examining data from the initial visit
of all the patients referred to our Department for mus-
culoskeletal pain during the period January 2001–
December 2010 and then diagnosed with a tumour or
with JRA. The value of given diagnostic test as a predic-
tive factor for neoplasia in comparison to JRA, were
assessed by calculating its sensitivity, specificity, positive
predictive value, negative predictive value.
Results
No significant difference was found for sex, age and pat-
tern of pain. Fever and lymphadenopathy were more fre-
quent in children with neoplasia. Elevation of CRP and
of ESR and an abnormal platelet count were not rele-
vant parameters. Anaemia and an abnormal neutrophil
count were most frequent among patients with tumours.
High LDH level presents with a higher frequency and
a statistically significant difference (sensitivity 88% and
specificity 32.6%) among the tumours group and
resulted a useful predictive factor for tumours, with
high sensitivity.
Conclusions
Our results suggest to take into great account even
“soft” changes in the neutrophil count particularly if it is
associated to a low Hb level, and to evaluate LDH that,
if associated to other abnormal laboratory data should
require to go thoroughly into the analysis to always
exclude a malignancy.
Published: 14 September 2011
Reference
1. Jones OY, Spencer CH, Bowyer SL, et al: A multicenter case-control study
on predictive factors distinguishing childhood leukemia from juvenile
rheumatoid arthritis. Pediatrics 2006, 117(5):e840-4.
doi:10.1186/1546-0096-9-S1-P236
Cite this article as: Trigilia et al.: Predictive clinical and hematological
factors in the differential diagnosis between malignancy and arthritis in
children: a case-control study. Pediatric Rheumatology 2011 9(Suppl 1):
P236.
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Trigilia et al. Pediatric Rheumatology 2011, 9(Suppl 1):P236
http://www.ped-rheum.com/content/9/S1/P236
© 2011 Trigilia et al; licensee 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.


A multicenter case-control study on predictive factors distinguishing childhood leukemia from juvenile rheumatoid arthritis. Pediatrics

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Predictive clinical and hematological factors in the differential diagnosis between malignancy and arthritis in children: a case-control study

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