Differential diagnosis of neoplastic and rheumatic diseases in children

The early phase of the disease in 30 children referred to this Clinic with the diagnosis of rheumatic disease and whose condition was ultimately diagnosed as malignancy was analysed. A correct diagnosis was established after a period of 1-22 months. thus acute leukemia, non-Hodgkin's lymphoma, Hodgkin's disease and solid tumours were diagnosed in 13, 7, 3, 7 consecutive patients. It was demonstrated that in an early stage of neoplastic diseases, signs may occur which are typical also of rheumatic diseases. Fever, arthralgia or arthritis, hepatosplenomegaly, lymphadenopathy and signs of cardiac involvement predominated in the early picture of the disease. The need for diagnostic investigations ruling out neoplastic diseases has been emphasized. They should be performed even in children fulfilling the diagnostic criteria for rheumatic diseases. Attention has been called to the importance of carefully performed hematological and morphological analysis.