TY - JOUR
T1 - Musculoskeletal Symptoms and Misdiagnoses in Children With Acute Myeloid Leukaemia
T2 - A Nationwide Cohort Study
AU - Jensen, Anne Birthe Helweg
AU - Andersen, Helene Riis Pontoppidan
AU - Jensen, Sarah Thorius
AU - Jensen, Christina Friis
AU - Amstrup, Jesper
AU - Mathiasen, René
AU - Henriksen, Kasper Amund
AU - Hasle, Henrik
AU - Callesen, Michael Thude
AU - Brix, Ninna
N1 - © 2024 The Author(s). European Journal of Haematology published by John Wiley & Sons Ltd.
PY - 2024/9/18
Y1 - 2024/9/18
N2 - OBJECTIVES: Childhood cancer often presents with non-specific signs and symptoms that might mimic non-malignant disorders including musculoskeletal diseases, potentially leading to rheumatic and orthopaedic misdiagnoses. We aimed to compare clinical presentation, diagnostic interval and survival in paediatric acute myeloid leukaemia (AML) with and without initial musculoskeletal symptoms.METHODS: This nationwide retrospective, cohort study reviewed medical records of 144 children below 15 years diagnosed with AML in Denmark from 1996 to 2018.RESULTS: Musculoskeletal symptoms occurred in 29% (42/144) of children with AML and 8% (11/144) received an initial musculoskeletal misdiagnosis, being mainly non-specific and pain-related. The children with and without musculoskeletal symptoms did not differ markedly up to the diagnosis of AML and blood counts were affected equally in both groups. However, the children with prior musculoskeletal symptoms were more likely to have elevated levels of LDH and ferritin. Furthermore, they revealed a tendency towards a longer total interval (median 53 days vs. 32 days, p = 0.07), but the overall survival did not differ.CONCLUSION: AML should be considered as an underlying cause in children with unexplained musculoskeletal symptoms and abnormal blood counts. Concomitant elevation of LDH and ferritin should strengthen the suspicion.
AB - OBJECTIVES: Childhood cancer often presents with non-specific signs and symptoms that might mimic non-malignant disorders including musculoskeletal diseases, potentially leading to rheumatic and orthopaedic misdiagnoses. We aimed to compare clinical presentation, diagnostic interval and survival in paediatric acute myeloid leukaemia (AML) with and without initial musculoskeletal symptoms.METHODS: This nationwide retrospective, cohort study reviewed medical records of 144 children below 15 years diagnosed with AML in Denmark from 1996 to 2018.RESULTS: Musculoskeletal symptoms occurred in 29% (42/144) of children with AML and 8% (11/144) received an initial musculoskeletal misdiagnosis, being mainly non-specific and pain-related. The children with and without musculoskeletal symptoms did not differ markedly up to the diagnosis of AML and blood counts were affected equally in both groups. However, the children with prior musculoskeletal symptoms were more likely to have elevated levels of LDH and ferritin. Furthermore, they revealed a tendency towards a longer total interval (median 53 days vs. 32 days, p = 0.07), but the overall survival did not differ.CONCLUSION: AML should be considered as an underlying cause in children with unexplained musculoskeletal symptoms and abnormal blood counts. Concomitant elevation of LDH and ferritin should strengthen the suspicion.
UR - http://www.scopus.com/inward/record.url?scp=85204498730&partnerID=8YFLogxK
U2 - 10.1111/ejh.14303
DO - 10.1111/ejh.14303
M3 - Journal article
C2 - 39295289
SN - 0902-4441
JO - European Journal of Haematology
JF - European Journal of Haematology
ER -