Evaluation of Children Referred to Pediatric Rheumatology Outpatient Clinic with Suspicious Laboratory Test Results

INTRODUCTION: We aimed to evaluate the patients who were referred to the pediatric rheumatology outpatient clinic with suspicious laboratory test results. METHODS: All patients who were referred to our outpatient clinic with suspicious laboratory test results between March 2018 and March 2019 were evaluated. RESULTS: A total of 273 new patients who were referred with suspicious laboratory test results were evaluated. Among them; 48% were girls and 52% were boys and they were referred mostly from the clinics of child health and diseases (70.3%). The most frequent indications for referrals were anti-streptolysin O (ASO) elevation (n=86) and anti-nuclear antibody (ANA) positivity (n=47), while 66% of the patients were not diagnosed with rheumatic disease. None of the patients without complaints but with suspicious laboratory test results (n=49) were diagnosed with rheumatic disease. While 64.6% of those diagnosed with rheumatic diseases had periodic fever syndrome, 17.1% had juvenile idiopathic arthritis, 8.5% had postinfectious arthritis, and the remaining 9.8% had connective tissue diseases, vasculitis and uveitis. DISCUSSION AND CONCLUSION: Laboratory findings alone in childhood rheumatic diseases are not significant in patients without complaints. The diagnosis of rheumatic diseases should be made with the patient’s complaints, history, family history and physical examination findings and supported by laboratory findings. With the rational use of laboratory tests; unnecessary health expenses can be prevented and referrals of patients with nonrheumatic diseases to pediatric rheumatology outpatient clinics can be prevented.