The discriminating value of serum lactate dehydrogenase levels in children with malignant neoplasms presenting as joint pain.
OBJECTIVE
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.


METHODS
Retrospective case-comparison study.


METHODS
Tertiary care, outpatient clinics.


METHODS
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.


METHODS
None.


RESULTS
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.


CONCLUSIONS
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.
Children's Hospital, National Jewish Center for Immunology and Respiratory Medicine, Denver, USA.
M
M
Wallendal
L
L
Stork
J R
JR
Hollister
D000293:Adolescent; D018771:Arthralgia / Q000201:enzymology / Q000209:etiology*; D001171:Arthritis, Juvenile / Q000175:diagnosis / Q000201:enzymology; D001772:Blood Cell Count; D001799:Blood Sedimentation; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D016002:Discriminant Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000201:enzymology*; D012189:Retrospective Studies
D007770:L-Lactate Dehydrogenase