A case of acute lymphoblastic leukemia mimicking juvenile idiopathic arthritis

Özet

Patients with leukemia can be presented with monoarthritis without any hematologic abnormalities. These patients may bemisdiagnosed with juvenile idiopathic arthritis (JIA), and the main treatment can also be delayed. An 11-year-old girl wasadmitted to our pediatric rheumatology outpatient clinic with a 4-week history of swelling in the left ankle. JIA was consideredas a preliminary diagnosis after the antinuclear antibody was found to be positive, and non-steroidal anti-inflammatory drugwas started. Diffuse bony edema was observed in the talus, navicular, cuboid, and cuneiform bones in magnetic resonanceimaging of the left ankle. Despite the treatments, the patient’s joint pain increased. There were no abnormalities in repeatedperipheral blood smears. On week 3 of follow-up, after bicytopenia was revealed in complete blood count, bone marrowbiopsy was performed, and she was diagnosed with precursor B cell acute lymphoblastic leukemia. We presented this case toemphasize that malignancies must be evaluated in the differential diagnosis of patients with arthritis.