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Michele Wallendal, MD; Linda Stork, MD; J. Roger Hollister, MD

Arch Pediatr Adolesc Med. 1996;150(1):70-73.

Abstract
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 high normal values vs 0.8 times high normal for patients with juvenile rheumatoid arthritis (P=.004, MannWhitney 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.

Conclusion
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.

(Arch Pediatr Adolesc Med. 1996;150:70-73)

Author Affiliations
From The Children's Hospital, National Jewish Center for Immunology and Respiratory Medicine, and the Department of Pediatrics, University of Colorado School of Medicine, Denver.

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