КЛИНИЧЕСКИЕ «ДВОЙНИКИ» В РЕВМАТОЛОГИИ И ОНКОГЕМАТОЛОГИИ: СРАВНИТЕЛЬНЫЙ АНАЛИЗ И ПОИСК ДИАГНОСТИЧЕСКИХ КЛЮЧЕЙ ДЕБЮТА ОСТРОГО ЛИМФОБЛАСТНОГО ЛЕЙКОЗА ПРИ ПОДОЗРЕНИИ НА СИСТЕМНУЮ ФОРМУ ЮВЕНИЛЬНОГО ИДИОПАТИЧЕСКОГО АРТРИТА

CLINICAL «MIMICS» IN RHEUMATOLOGY AND ONCOHEMATOLOGY: COMPARATIVE ANALYSIS AND SEARCH FOR DIAGNOSTIC KEYS TO THE ONSET OF ACUTE LYMPHOBLASTIC LEUKEMIA WITH SUSPECTED SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS

Children with systemic juvenile idiopathic arthritis (sJIA) often require differential diagnosis from acute lymphoblastic leukemia (ALL). Objective: To develop a diagnostic model for early differentiation between ALL and sJIA in routine clinical practice. Materials and Methods: A single-center ambispective cohort study was conducted. The diagnostic model was constructed using logistic regression. The study included 140 patients: 18 (13%) with ALL and 122 (87%) with sJIA. Results: Compared to sJIA patients, ALL patients showed significantly higher frequencies of: bone pain/night pain (p<0.001), asthenia (p<0.001), weight loss (p<0.001), night sweats (p<0.001), elbow joint arthritis/arthralgia (p=0.034), neutropenia (p<0.001), thrombocytopenia (p=0.013), trilinear cytopenia (p=0.021). SJIA patients demonstrated significantly more frequent: fever (p=0.045), rash (p<0.001), hepatomegaly (p=0.010), splenomegaly (p=0.009), leukocytosis (p<0.001), neutrophilia (p<0.001), elevated C-reactive protein (p=0.021). The median number of affected joints was significantly higher in sJIA (2.5 [2.0; 4.8] vs 1.5 [1.0; 2.0], p=0.016). ALL patients had significantly higher serum uric acid levels (p=0.048). Conclusion: The diagnostic model incorporating the number of affected joints, neutrophil count, and serum uric acid level demonstrates high accuracy for distinguishing ALL from sJIA. © 2025, Pediatria Ltd.. All rights reserved.