The discriminating value of serum lactate dehydrogenase levels in children with malignant neoplasms presenting as joint pain
M. Wallendal, L. Stork and J. R. Hollister
Children's Hospital, National Jewish Center for Immunology and Respiratory Medicine, Denver, USA.
OBJECTIVES: 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. DESIGN: Retrospective case-comparison study. SETTING: Tertiary
care, outpatient clinics. PATIENTS: 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.
INTERVENTIONS: 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.
