Lab testsLaboratory Tests in the Diagnosis and Follow-Up of Pediatric Rheumatic Diseases: An Update
Section snippets
Methods
We used the MEDLINE databases to June 2008 (no earlier date limit) to search the keywords: “laboratory,” “erythrocyte sedimentation rate” (ESR), “C-reactive protein” (CRP), “procalcitonin” (PCT), “C3,” “C4,” “ferritin,” “serum amyloid A” (SAA), “blood cytology,” “autoantibodies,” “antinuclear antibodies” (ANA), “rheumatoid factor” (RF), “anticyclic citrullinated peptide antibodies” (anti-CCP antibodies), “antiphospholipid antibodies” (aPL), “antineutrophil cytoplasmic autoantibodies” (ANCA),
Acute Phase Reactants
The initial routine laboratory assessment should consist of a complete blood cell count, including a white blood cell and differential count, and the determination of acute phase indicators such as ESR and CRP.
Acute phase reactants are plasmatic proteins that increase during acute phase of inflammation (Table 1). They are produced by the liver under regulation of circulating cytokines such as interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α), released by
Discussion
Laboratory investigations play an important role in the diagnosis and follow-up of inflammatory rheumatic diseases of children. They can allow the confirmation of a suspected diagnosis, assess disease activity, and measure the response to treatment (1, 2). Testing of the ESR, CRP, hemoglobin level, white blood cell count, protein electrophoresis, and urinalysis is helpful in many cases. Autoantibody determination and genetic studies are required in some patients. However, physicians must be
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