The discriminating value of serum lactate dehydrogenase levels in children with malignant neoplasms presenting as joint pain
Article Abstract:
High blood levels of lactate dehydrogenase (LDH) in children with joint pain may indicate cancer. LDH is commonly measured during standard diagnostic work-ups, and studies have shown elevated levels in patients with certain types of cancer. Joint pain is a symptom of cancers such as leukemia, but sometimes blood cells appear normal. This can lead to delay in correct diagnosis, and corticosteroid treatment for presumed juvenile rheumatoid arthritis (JRA), which may adversely affect prognosis. Twelve children were originally diagnosed as having JRA who were eventually diagnosed as having cancer. Researchers compared their LDH levels with 24 children whose final diagnosis was JRA. The average value in cancer patients was over twice that of JRA patients, and only one cancer patient had an LDH level within normal range. Four JRA patients also had LDH levels exceeding normal range. High LDH levels should suggest the need for additional diagnostic tests to rule out cancer.
Publication Name: Archives of Pediatrics & Adolescent Medicine
Subject: Health
ISSN: 1072-4710
Year: 1996
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Subspecialty Referrals for Pauciarticular Juvenile Rheumatoid Arthritis
Article Abstract:
Pediatricians generally refer patients in whom they suspect a diagnosis of juvenile rheumatoid arthritis (JRA) to an orthopedic surgeon first, rather than directly to a rheumatologist. One possible reason is that pediatric rheumatology has been a board-certified subspecialty only since 1992, and there are very few practitioners compared to the number of orthopedic surgeons. Of 49 patients with pauciarticular JRA, 30 (62%) were referred to orthopedic surgeons before going on to examination by either adult or pediatric rheumatologists. The other 19 (38%) were referred directly from the primary care physician to either pediatric or adult rheumatologists.
Publication Name: Archives of Pediatrics & Adolescent Medicine
Subject: Health
ISSN: 1072-4710
Year: 2000
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Appropriateness of Urgent Referrals by Nurses at a Hospital-Based Pediatric Call Center
Article Abstract:
An after-hours referral (AHR) service staffed by nurses appears to be an effective method of delivering health care services. This was the conclusion of a study of 409 parents who called the After-Hours Call Center of the Children's Hospital, Denver, Colorado. Nurses who staff this service use a computerized triage system and refer parents to one of five urgent care sites. Doctors who evaluated the referrals decided that 91% were appropriate. Eighty-three percent of the parents complied with the referral.
Publication Name: Archives of Pediatrics & Adolescent Medicine
Subject: Health
ISSN: 1072-4710
Year: 2000
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