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[Osteoarticular pains as early manifestation of malignancies in children].
Przegl Lek. 2009; 66(1-2):39-44.PL

Abstract

Based on the rewiew of the literature and own clinical observations, we presented examples of the most common pediatric onco-hematologic malignancies, that are manifested early by osteoarticular complaints. When these complaints predominate in the clinical presentation, they lead the diagnosis towards nonmalignant conditions, that are most common cause of such symptoms in children, like injuries, nonspecific reactive arthritis or inflammatory connective tissue diseases. However, in acute lymphoblastic leukaemia, the most prevalent childhood malignancy, bone and joint pains are present early in 40-60% of cases and they frequently anticipate any abnormalities in complete blood counts. Findings reported in the literature and own observations indicate that these complaints correlate with: lower white cell counts, lower percentage of blast cells in the peripheral blood and lower incidence of organomegaly - that may delay the decision of bone marrow aspiration. In our study we have also presented 4 cases of other malignancies in children, who were complaining of the osteoarticular pains, that limited they activity, long time before the beginning of treatment in Department of Oncology and Pediatric Hematology of University's Pediatric Hospital in Cracow. Long-lasting and intensive osteoarticular complains, that restraint normal activity and do not resolve during rest, spinal compression symptoms, coexisting adenopathy, hepatosplenomegaly, weight loss, change of behaviour, unexplicained fever must be recognized as specific "red flags". Oncologic vigilance must be inspired by discreet hematological abnormalites (like increased anemia, lower white cell counts with lymphocytosis, mild thrombocytopenia) -that indicate bone marrow infiltration, as well as high erythrocyte sedimentation rate, accompanied by moderately elevated C-reactive protein - characteristic for malignancy. Basic and commonly accessible radiological imaging may provide valuable information, because it can reveal tumors, osteolytic lesions or destruction of bone architecture. Laboratory tests of lactate dehydrogenase (LDH) and uric acid level, often raised in malignancies are also helpful. The aim of this study was to focus the attention of pediatricians to the necessity of including malignancy in the differential diagnosis of intensive or unexplained osteoarticular complaints.

Authors+Show Affiliations

Klinika Onkologii i Hematologii Dzieciecej, Polsko-Amerykański Instytut Pediatrii UJ CM, Kraków. mcwikli@op.plNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

pol

PubMed ID

19485254

Citation

Cwiklińska, Magdalena, and Walentyna Balwierz. "[Osteoarticular Pains as Early Manifestation of Malignancies in Children]." Przeglad Lekarski, vol. 66, no. 1-2, 2009, pp. 39-44.
Cwiklińska M, Balwierz W. [Osteoarticular pains as early manifestation of malignancies in children]. Przegl Lek. 2009;66(1-2):39-44.
Cwiklińska, M., & Balwierz, W. (2009). [Osteoarticular pains as early manifestation of malignancies in children]. Przeglad Lekarski, 66(1-2), 39-44.
Cwiklińska M, Balwierz W. [Osteoarticular Pains as Early Manifestation of Malignancies in Children]. Przegl Lek. 2009;66(1-2):39-44. PubMed PMID: 19485254.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Osteoarticular pains as early manifestation of malignancies in children]. AU - Cwiklińska,Magdalena, AU - Balwierz,Walentyna, PY - 2009/6/3/entrez PY - 2009/6/3/pubmed PY - 2009/9/2/medline SP - 39 EP - 44 JF - Przeglad lekarski JO - Przegl Lek VL - 66 IS - 1-2 N2 - Based on the rewiew of the literature and own clinical observations, we presented examples of the most common pediatric onco-hematologic malignancies, that are manifested early by osteoarticular complaints. When these complaints predominate in the clinical presentation, they lead the diagnosis towards nonmalignant conditions, that are most common cause of such symptoms in children, like injuries, nonspecific reactive arthritis or inflammatory connective tissue diseases. However, in acute lymphoblastic leukaemia, the most prevalent childhood malignancy, bone and joint pains are present early in 40-60% of cases and they frequently anticipate any abnormalities in complete blood counts. Findings reported in the literature and own observations indicate that these complaints correlate with: lower white cell counts, lower percentage of blast cells in the peripheral blood and lower incidence of organomegaly - that may delay the decision of bone marrow aspiration. In our study we have also presented 4 cases of other malignancies in children, who were complaining of the osteoarticular pains, that limited they activity, long time before the beginning of treatment in Department of Oncology and Pediatric Hematology of University's Pediatric Hospital in Cracow. Long-lasting and intensive osteoarticular complains, that restraint normal activity and do not resolve during rest, spinal compression symptoms, coexisting adenopathy, hepatosplenomegaly, weight loss, change of behaviour, unexplicained fever must be recognized as specific "red flags". Oncologic vigilance must be inspired by discreet hematological abnormalites (like increased anemia, lower white cell counts with lymphocytosis, mild thrombocytopenia) -that indicate bone marrow infiltration, as well as high erythrocyte sedimentation rate, accompanied by moderately elevated C-reactive protein - characteristic for malignancy. Basic and commonly accessible radiological imaging may provide valuable information, because it can reveal tumors, osteolytic lesions or destruction of bone architecture. Laboratory tests of lactate dehydrogenase (LDH) and uric acid level, often raised in malignancies are also helpful. The aim of this study was to focus the attention of pediatricians to the necessity of including malignancy in the differential diagnosis of intensive or unexplained osteoarticular complaints. SN - 0033-2240 UR - https://www.unboundmedicine.com/medline/citation/19485254/[Osteoarticular_pains_as_early_manifestation_of_malignancies_in_children]_ L2 - https://medlineplus.gov/cancerinchildren.html DB - PRIME DP - Unbound Medicine ER -