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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">We here present 3 Venezuelan children with acute leukemia&#44; initially diagnosed as idiopathic juvenile arthritis because of the occurrence of pain and joint swelling at the onset of disease&#46; Joint pain was aggravated at night and the arthritis showed a migratory pattern&#44; mainly affecting large joints in an asymmetrical fashion&#46; One patient presented with persistent unilateral sacroiliac pain leading to a wrong diagnosis of spondyloarthritis&#46; The elevation of acute phase reactants&#44; disproportionate to the extent of joint disease&#44; and marked elevation of serum lactate dehydrogenase&#44; as well as characteristic radiological changes allowed the correct diagnosis in all cases&#46; This combination of clinical manifestations&#44; clinical laboratory findings&#44; and joint and bone imaging should prompt the clinician to an early diagnosis of acute leukemia in children with arthritis&#46;</p>"
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        "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se presentan 3 ni&#241;os venezolanos con leucemia aguda cuya enfermedad se inici&#243; con dolor e inflamaci&#243;n articular&#44; inicialmente se les diagnostic&#243; artritis idiop&#225;tica juvenil&#46; El cuadro cl&#237;nico se caracteriz&#243; por artritis migratoria de grandes articulaciones&#44; dolor &#243;seo metafisario de predominio nocturno&#44; aumento de los reactantes de fase aguda desproporcionado para el n&#250;mero de articulaciones afectadas y elevaci&#243;n de la lactatodeshidrogenasa&#46; Un paciente present&#243; dolor sacroil&#237;aco persistente que condujo al diagn&#243;stico incorrecto de espondiloartritis&#46; Los hallazgos radiol&#243;gicos predominantes fueron osteopenia&#44; oste&#243;lisis y presencia de bandas radiotransparentes metafisarias&#46; Esta combinaci&#243;n de manifestaciones cl&#237;nicas&#44; hallazgos de laboratorio y cambios radiol&#243;gicos debe hacer sospechar una enfermedad mieloproliferativa en ni&#241;os con inflamaci&#243;n articular&#46;</p>"
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Journal Information
Vol. 4. Issue 2.
Pages 70-73 (March - April 2008)
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Vol. 4. Issue 2.
Pages 70-73 (March - April 2008)
Clinical Cases
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Acute Leukemia in Children Erroneously Diagnosed as Idiopathic Juvenile Arthritis
Leucemia aguda en niños con diagnóstico erróneo de artritis idiopática juvenil
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Natalí Serra-Bonetta, Yusmary Guzmánb, Ernesto Rodrígueza, Alberto Millána, Martín A. Rodrígueza,
Corresponding author
martinalbertove@yahoo.com

Correspondence: Hospital Universitario de Caracas. Caracas. Apartado 47365. Caracas 1010. Venezuela.
a Servicio de Reumatología, Centro Nacional de Enfermedades Reumáticas, Caracas, Venezuela
b Servicio de Pediatría, Hospital Universitario de Caracas, Caracas, Venezuela
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We here present 3 Venezuelan children with acute leukemia, initially diagnosed as idiopathic juvenile arthritis because of the occurrence of pain and joint swelling at the onset of disease. Joint pain was aggravated at night and the arthritis showed a migratory pattern, mainly affecting large joints in an asymmetrical fashion. One patient presented with persistent unilateral sacroiliac pain leading to a wrong diagnosis of spondyloarthritis. The elevation of acute phase reactants, disproportionate to the extent of joint disease, and marked elevation of serum lactate dehydrogenase, as well as characteristic radiological changes allowed the correct diagnosis in all cases. This combination of clinical manifestations, clinical laboratory findings, and joint and bone imaging should prompt the clinician to an early diagnosis of acute leukemia in children with arthritis.

Key words:
Acute leukemia
Juvenile arthritis
Osteolysis

Se presentan 3 niños venezolanos con leucemia aguda cuya enfermedad se inició con dolor e inflamación articular, inicialmente se les diagnosticó artritis idiopática juvenil. El cuadro clínico se caracterizó por artritis migratoria de grandes articulaciones, dolor óseo metafisario de predominio nocturno, aumento de los reactantes de fase aguda desproporcionado para el número de articulaciones afectadas y elevación de la lactatodeshidrogenasa. Un paciente presentó dolor sacroilíaco persistente que condujo al diagnóstico incorrecto de espondiloartritis. Los hallazgos radiológicos predominantes fueron osteopenia, osteólisis y presencia de bandas radiotransparentes metafisarias. Esta combinación de manifestaciones clínicas, hallazgos de laboratorio y cambios radiológicos debe hacer sospechar una enfermedad mieloproliferativa en niños con inflamación articular.

Palabras clave:
Leucemia
Artritis juvenil
Osteólisis
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Copyright © 2008. Sociedad Española de Reumatología and Colegio Mexicano de Reumatología
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