Wallendal M, Stork L, Hollister J R
Children's Hospital, National Jewish Center for Immunology and Respiratory Medicine, Denver, USA.
Arch Pediatr Adolesc Med. 1996 Jan;150(1):70-3. doi: 10.1001/archpedi.1996.02170260074012.
To determine if serum lactate dehydrogenase levels distinguish patients with malignant neoplasm presenting with musculoskeletal complaints from patients with juvenile rheumatoid arthritis who reported similar symptoms.
Retrospective case-comparison study.
Tertiary care, outpatient clinics.
Twelve patients with malignant neoplasms who presented with arthritis or arthralgias and normal complete blood cell counts and blood smears in whom rheumatologic diagnosis was initially made were compared with 24 children with a final diagnosis of juvenile rheumatoid arthritis. The patients with malignant neoplasms all had normal blood counts and elevated sedimentation rates at symptom onset.
None.
Serum lactate dehydrogenase levels were significantly higher in the cancer patients at 2.2 times the normal values vs 0.8 times high normal for patients with juvenile rheumatoid arthritis (P =.004, Mann-Whitney U test) No significant differences were observed in white blood cell counts, hemoglobin levels, platelet counts, erythrocyte sedimentation rate, or uric acid or aspartate aminotransferase levels at initial evaluation.
Serum lactate dehydrogenase values may distinguish patients with malignant neoplasms from those with rheumatic disease early in the course of illness when symptoms and other laboratory values are not helpful.
确定血清乳酸脱氢酶水平能否区分出现肌肉骨骼症状的恶性肿瘤患者与报告有类似症状的青少年类风湿关节炎患者。
回顾性病例对照研究。
三级医疗门诊诊所。
12例出现关节炎或关节痛且全血细胞计数和血涂片正常、最初被诊断为风湿病的恶性肿瘤患者与24例最终诊断为青少年类风湿关节炎的儿童进行比较。恶性肿瘤患者在症状出现时全血细胞计数均正常且血沉升高。
无。
癌症患者的血清乳酸脱氢酶水平显著高于青少年类风湿关节炎患者，前者为正常值的2.2倍，后者为正常高限的0.8倍（P = 0.004，曼-惠特尼U检验）。初始评估时，白细胞计数、血红蛋白水平、血小板计数、红细胞沉降率、尿酸或天冬氨酸转氨酶水平无显著差异。
当症状和其他实验室检查结果无助于诊断时，血清乳酸脱氢酶值可能有助于在疾病早期区分恶性肿瘤患者与风湿性疾病患者。
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