M. Wallendal et al., THE DISCRIMINATING VALUE OF SERUM LACTATE-DEHYDROGENASE LEVELS IN CHILDREN WITH MALIGNANT NEOPLASMS PRESENTING AS JOINT PAIN, Archives of pediatrics & adolescent medicine, 150(1), 1996, pp. 70-73
Objectives: To determine if serum lactate dehydrogenase levels disting
uish patients with malignant neoplasm presenting with musculoskeletal
complaints from patients with juvenile rheumatoid arthritis who report
ed similar symptoms. Design: Retrospective case-comparison study. Sett
ing: Tertiary care, outpatient clinics. Patients: Twelve patients with
malignant neoplasms who presented with arthritis or arthralgias and n
ormal complete blood cell counts and blood smears in whom rheumatologi
c diagnosis was initially made were compared with 24 children with a f
inal diagnosis of juvenile rheumatoid arthritis. The patients with mal
ignant neoplasms all had normal blood counts and elevated sedimentatio
n rates at symptom onset. Interventions: None. Results: Serum lactate
dehydrogenase levels were significantly higher in the cancer patients
at 2.2 times the high normal values vs 0.8 times high normal for patie
nts with juvenile rheumatoid arthritis (P=.004, Mann-Whitney U test).
No significant differences were observed in white blood cell counts, h
emoglobin levels, platelet counts, erythrocyte sedimentation rate, or
uric acid or aspartate aminotransferase levels at initial evaluation.
Conclusion: Serum lactate dehydrogenase values may distinguish patient
s with malignant neoplasms from those with rheumatic disease early in
the course of illness when symptoms and other laboratory values are no
t helpful.