The application of laboratory tests in pediatric rheumatology practice

Year 2013, , 258 - 261, 01.06.2013

Aydın Ece Cahit Şahin

https://doi.org/10.5799/ahinjs.01.2013.02.0279

Abstract

Rheumatologic diseases in children are an important group of disorders that may lead to severe complications and growth retardation. There are no specific diagnostic tests for rheumatologic diseases, except for anti-nuclear antibody and anti-dsDNA for systemic lupus erythematosus and c-ANCA for Wegener\'s disease. Because of, taking a detailed patient\'s medical history and performing a good physical examination most probably can provide a diagnosis, and there is no specific test or “test panel” to diagnose or exclude rheumatologic disorders; it is imperative to choose laboratory tests selectively, based on a good clinical knowledge. Another important point is the existence of false positive test results in normal healthy population. In this review, the use laboratory investigations and their importance in diagnosis and follow up of disease in pediatric rheumatology practice has been discussed. J Clin Exp Invest 2013; 4 (2): 443-446

Keywords

Pediatric rheumatology, laboratory investigations, diagnosis, differential diagnosis

The application of laboratory tests in pediatric rheumatology practice

Abstract

Çocuklarda romatizmal hastalıklar ciddi komplikasyonlara ve büyüme-gelişme geriliğine yol açabilen önemli bir hastalık grubudur. Anti-nükleer antikorlar ve anti-ds DNA\'nın sistemik lupus eritematozus için ve c-ANCA\'nın Wegener hastalığı için tanısal kriter olması dışında, romatizmal hastalıklar için tanı koyduracak spesifik testler bulunmamaktadır. Çocuk romatolojisinde ayrıntılı bir hastalık öyküsü ve iyi bir fizik muayene ile çok yüksek oranda hastalık tanısı konabildiği ve hastalıklar için tanı koydurucu veya ekarte ettirici özgül tek bir test veya “test paneli” bulunmadığı için, laboratuvar testlerini iyi bir klinik bilgi temelinde seçici olarak istemek gerekir. Bu konuda önemli bir nokta da testlerin sağlıklı bireylerde de belli oranlarda pozitif sonuç vermesidir. Bu derlemede çocuk romatolojisi pratiğinde kullanılan testlerin endikasyonları, hastalık tanısı ve izlemindeki önemleri tartışılmıştır.

Keywords

Çocuk romatolojisi, laboratuvar testleri, tanı, ayırıcı tanı

References

• Agarwal M, Sawhney S. Laboratory tests in pediatric rheumatology. In- dian J Pediatr 2010;77:1011-1016.
• Mehta J. Laboratory testing in pediatric rheumatology. Pediatr Clin North Am 2012;59:263-284.
• Jarvis JN. Commentory - Ordering lab tests for suspected rheumatic disease. Pediatr Rheumatol 2008;6:19-20.
• Naik S. Laboratory tests and the paediatric rheumatologist: What does he need to know? Indian J Rheumatol 2012;7:106–111.
• Breda L, Nozzi M, De Sanctis S, Chiarelli F. Laboratory tests in the diagnosis and follow-up of pediatric rheumatic diseases: an update. Semin Arthritis Rheum 2010;40:53-72.
• Rosa Neto NS, de Carvalho JF, Shoenfeld Y. Screening tests for in- flammatory activity: applications in rheumatology. Mod Rheumatol 2009;19:469-477.
• Dayer E, Dayer JM, Roux-Lombard P. Primer: the practical use of bio- logical markers of rheumatic and systemic inflammatory diseases. Nat Clin Pract Rheumatol 2007;3:512-520.
• Saulsbury FT, Sabio H. Acute leukemia presenting as arthritis in chil- dren. Clin Pediatr 1985:5:625-628.
• Perilloux BC, Shetty AK, Leiva LE, Gedalia A. Antinuclear antibody (ANA) and ANA profile tests in children with autoimmune disorders: a retrospective study. Clin Rheumatol 2000;19:200-203.
• McGhee JL, Kickingbird L, Jarvis JN. Clinical utility of ANA tests in children. BMC Pediatrics 2004;4:13.
• Malleson PN, Mackinnon MJ, Sailer-Hoeck M, Spencer CH. Review for the generalist: The antinuclear antibody test in children - When to use it and what to do with a positive titer? Pediatr Rheumatol 2010;8:27-31.
• Tan EM, Feltkamp TE, Smolen JS, et al. Range of antinuclear antibod- ies in “healthy” individuals. Arthritis Rheum 1997;40:1601-1611.
• Benseler SM, Silverman ED: Systemic lupus erythematosus. Pediatr Clin N Am 2005;52:443-467.
• Petty RE, Southwood TR, Manners P, et al. International League of As- sociations for Rheumatology classification of juvenile idiopathic arthri- tis: second revision, Edmonton 2001. J Rheumatol 2004;31:390-392.
• Eichenfield AH, Athreya BH, Doughty RA, Cebul RD. Utility of rheuma- toid factor in the diagnosis of juvenile rheumatoid arthritis. Pediatrics 1986;78:480-484.
• Habib HM, Mosaad YM, Youssef HM. Anti-cyclic citrullinated peptide antibodies in patients with juvenile idiopathic arthritis. Immunol Invest 2008;37:849-857.
• Baqi N, Moazami S, Singh A, Ahmad H, Balachandra S, Tejani A. Lu- pus nephritis in children: a longitudinal study of prognostic factors and therapy. J Am Soc Nephrol 1996;7:924-929.
• Gabay C, Kushner I. Acute phase proteins and other systemic re- sponses to inflammation. N Engl J Med 1999;340:448-454