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白血性关节炎和青少年异常性关节炎之间的区别
Alfonso Ragnar Torres Jimenez1, Eunice Solis Vallejo2, Adriana Ivonne Cespedes Cruz2
1Department of Pediatric Rheumatology, National Medical Center, La Raza, IMSS, Vallejo Y Jacarandas, Colonia La Raza, Azcapotzalco, Mexico City, 02990, México. dr-poncho@hotmail.com.
Pediatric rheumatology online journal
|May 31, 2023
概括
区分白血病性关节炎 (LA) 和青少年异常性关节炎 (JIA) 是至关重要的. 在LA中出现更严重的全身症状,如发烧和体重减轻,以及特定的血液学变化,如白血病和中性病.
科学领域:
- 儿科风湿病学 儿科风湿病学
- 儿科血液瘤学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 青春期异常性关节炎 (JIA) 是儿童慢性关节炎的常见原因之一.
- 白血性关节炎 (LA),急性淋巴细胞白血病 (ALL) 的表现,可以模仿JIA,延迟诊断和治疗.
- 早期区分LA和JIA对于适当的患者管理至关重要.
研究的目的:
- 在疾病发作时识别明显的临床和实验室特征,区分白血病性关节炎 (LA) 与青少年异常性关节炎 (JIA).
- 开发一个模型来准确区分儿科患者的LA和JIA.
主要方法:
- 对76名被诊断为可能患有JIA的儿科患者 (16岁以下) 的回顾性分析,包括最终被诊断为ALL (LA) 或JIA的患者.
- 在LA和JIA组之间对临床 (年龄,性别,症状) 和实验室 (血液计数) 特性进行比较.
- 使用千平方,相对风险,曼·惠特尼U,T测试和二进制后勤回归进行统计分析.
主要成果:
- 与JIA相比,LA组观察到诊断时的平均年龄较低,症状发病时间较短.
- 拉斯维加斯患者表现出更明显的全身症状 (发烧,体重减轻,夜间出汗,肝壮,淋巴腺病) 和不成比例的关节疼痛.
- 实验室显著的差异包括LA的贫血,白血病和中性质衰竭,而LA的血小板数量低于LA的正常数量,而不是JIA. 后勤回归模型实现了100%的分类准确性.
结论:
- 在患有关节炎和血液学异常的儿童中,必须考虑急性淋巴细胞白血病 (ALL),特别是白血病和中性病.
- 关键的LA指标包括严重的关节疼痛不响应止痛药,夜间疼痛,发烧,淋巴腺病变和肝炎.
- 确定的标准可以有效地区分白血病性关节炎和青少年异常性关节炎,使得及时诊断和干预.
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