PReS-FINAL-2083: The rate of malignancy in iranian children with joint manifestations

Abstract

Introduction: Different reports of shared manifestations for malignancy and rheumatic diseases in children since 1970s indicate the presentation of malignancies, particularly ALL, with musculoskeletal (MS) symptoms. Objective(s): To evaluate the rate and the characteristics of hematological malignancies in Iranian children with joint manifestations based on two different scopes of data collection since 1981. Method(s): In this retrospective review, we considered two different aspects of evaluation within two pediatric tertiary centers in Iran: 1- Children's Hematology/Oncology Research Center, 2- Pediatric Rheumatology Center. Result(s): Here we report the results of 3 studies (I, II & III) conducted through 1981-2006, followed by current (IV) study performed since 2006. Findings of four different studies are mentioned in detail, in Table 1. An additional study was performed in parallel to study I comprising 46 dead patients in addition to 54 current patients, which showed the similar results. ALL was the most frequent type of malignancy (80-100%). Conclusion(s): The relative increase in the rate of malignancy in this review (period of 1981-2012) could be an alarm to perform BM aspiration in children with joint manifestations harboring the following as "Red Flags": (i) Boys at the age of 5-7, (ii) Large joint involvement (particularly hip, knee and ankle) and (iii) Arthralgia at presentation. According to recent recommendations by ACR for early aggressive treatments in JIA patients, this precautionary measure may minimize the potential dangers and consequences of misdiagnosis prior to initiation of any treatment. (Table presented) .