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AB1234 (2022)
RHEUMATIC MASKS OF ONCOLOGICAL DISEASES IN CHILDREN
N. Zhuravleva1, T. Smirnova2, O. Sharapova3,4, L. Gerasimova5,6, L. Markelova7
1Chuvash State University named after I. N. Ulyanov, Department of Internal Medicine, Cheboksary, Russian Federation
2Chuvash State University Named After I. N. Ulyanov, Department of Obstetrics and Gynecology, Cheboksary, Russian Federation
3City Clinical Hospital of Vinogradov V.V., Head physician, Moscow, Russian Federation
4I.M. Sechenov First Moscow State Medical University, Department of Obstetrics and Gynecology, Moscow, Russian Federation
5City Clinical Hospital of Vinogradov V.V., The Educational and Methodical Office, Moscow, Russian Federation
6Moscow State University of Food Production, Department of Obstetrics and Gynecology, Moscow, Russian Federation
7Institute for Advanced Medical Education, Department of Therapy and Family Medicine, Cheboksary, Russian Federation

Background: Early diagnosis of oncological pathology, which can occur under the guise of other diseases, including rheumatic diseases, is relevant.


Objectives: To analyze the features of the course of rheumatic masks of oncological diseases in children.


Methods: An analysis was made of the features of the course of oncological diseases in 15 children (5 girls and 10 boys) aged 3 to 15 years, hospitalized in the rheumatology department of the Republican Children’s Clinical Hospital for the period from 2012 to 2021.


Results: The disease was manifested by fever in 11 of 15 patients.

Complaints when contacting a rheumatologist: pain and limitation of movement in the joints (15/15), in the lumbar region (2/15), weakness (8/15), abdominal pain (3/15), vomiting (2/15), myalgia (3/15), hair loss (1/15), nosebleeds (1/15).

On physical examination: peripheral lymphadenopathy (4/15), periorbital shadows, pallor (10/15), lupus-like erythema on the face (1/15), joint tenderness on palpation and movement (11/15), joint deformity (2/15). 15), spinal rigidity (3/15), hepatosplenomegaly (5/15).

On laboratory examination: anemia (7/15), leukopenia (3/15), leukocytosis (4/15), thrombocytopenia (3/15), thrombocytosis (1/15), pancytopenia (1/15), hypoalbuminemia (2/15). 15), increase in ESR (11/15), CRP (11/15), LDH (4/15), AST, ALT (3/15).

Established preliminary clinical diagnoses: juvenile rheumatoid arthritis (10/15), systemic lupus erythematosus (2/15), dermatomyositis (1/15), reactive arthropathy (1/15), fever of unknown origin (1/17). Appointed: NSAIDs (8/16), glucocorticoids (9/15), methotrexate (5/15), cyclophosphamide (1/15).

An oncological search was carried out. The following diagnoses were verified: stage 4 neuroblastoma (4/15), acute lymphoblastic leukemia (5/15), stage 4 B-large cell lymphosarcoma (1/15), stage 4 B-lymphoblastic lymphoma/leukemia (1/15), T-cell lymphoma (1/15), stage 3 glioma (1/15), malignant histiocytoma (1/15), brain tumor (1/15).


Conclusion: Oncological diseases in children can occur under the guise of rheumatic diseases. Immunosuppressants and glucocorticoids mask the true clinical picture of the neoplasm and prevent early diagnosis.


Disclosure of Interests: None declared

Citation: , volume 81, supplement 1, year 2022, page 1728
Session: Paediatric rheumatology (Publication Only)