Al Masroori Eman, Al Hadhrami Sumaiya, Al Shamli Nawal
Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman.
Oman Med J. 2025 Mar 31;40(2):e743. doi: 10.5001/omj.2025.12. eCollection 2025 Mar.
A previously healthy five-year-old boy was seen in the rheumatology clinic with a five-month history of migrating joint discomfort, followed by right knee and left ankle arthritis. He showed no signs of lymphadenopathy, organomegaly, rashes, or fever. He could not bear weight and had nocturnal pain that was out of proportion to juvenile idiopathic arthritis. Blood tests revealed no pancytopenia. Whole-body magnetic resonance imaging showed extensive enhancement in nearly all bones, suggestive of chronic recurrent multifocal osteomyelitis. However, bone biopsy followed by marrow aspiration confirmed a diagnosis of pre-B-cell leukemia. This case highlights the importance of considering the possibility of childhood malignancies mimicking juvenile idiopathic arthritis and chronic recurrent multifocal osteomyelitis, even in the absence of typical neoplasm symptoms.
一名此前健康的五岁男孩因有五个月的游走性关节不适病史，随后出现右膝和左踝关节关节炎，而在风湿病诊所就诊。他没有淋巴结肿大、器官肿大、皮疹或发热的迹象。他无法负重，夜间疼痛程度与幼年特发性关节炎不符。血液检查未发现全血细胞减少。全身磁共振成像显示几乎所有骨骼均有广泛强化，提示慢性复发性多灶性骨髓炎。然而，骨活检及骨髓穿刺确诊为前B细胞白血病。该病例凸显了即使在没有典型肿瘤症状的情况下，也需考虑儿童恶性肿瘤模仿幼年特发性关节炎和慢性复发性多灶性骨髓炎的可能性。
