Jung A, Nielsen S M
H:S Rigshospitalet, Juliane Marie Centret, børneafdelingen.
Ugeskr Laeger. 1998 May 4;160(19):2889-90.
Three children out of 30 (10%) referred for juvenile chronic arthritis had leukaemia. The patients had complained of intermittent musculoskeletal pain and painful joint swelling for three weeks, nine months and eighteen months prior to admission. On admission two of the patients had active arthritis with soft tissue swelling in one and three joints respectively. The third patient had only arthralgias and no joint swelling. All patients had slight anaemia, normal to slightly reduced thrombocyte count, slight neutropenia and absence of blasts in the peripheral blood. The correct diagnosis was made by bone marrow aspiration. Two children had acute lymphoblastic leukaemia and the third acute myeloblastic leukaemia. Leukaemia thus remains an important differential diagnosis in children presenting with musculoskeletal pain and/or arthritis.
在因青少年慢性关节炎转诊的30名儿童中,有3名(10%)患有白血病。这些患者在入院前分别有三周、九个月和十八个月的间歇性肌肉骨骼疼痛和疼痛性关节肿胀症状。入院时,其中两名患者患有活动性关节炎,分别有一个和三个关节出现软组织肿胀。第三名患者只有关节痛,没有关节肿胀。所有患者均有轻度贫血,血小板计数正常或略降低,轻度中性粒细胞减少,外周血中无原始细胞。通过骨髓穿刺做出了正确诊断。两名儿童患有急性淋巴细胞白血病,第三名患有急性髓细胞白血病。因此,白血病仍然是出现肌肉骨骼疼痛和/或关节炎的儿童的重要鉴别诊断。