Evidence map›Paper›PMID 42490775›Full record

ArticleJournal of clinical medicine research2026

Differentiating Juvenile Idiopathic Arthritis From Acute Lymphoblastic Leukemia in Children: A Multidisciplinary Diagnostic Approach, Systematic Review and Meta-Analysis.

Heba M Reyad, Narmen Eltrafi, Walaa H Ali, Mohamed Abdelrazek, Marwa Khairy Abd Elwahab, Eiman Ibrahim, Seham Nabil Ramdan, Ahmed Akef, Jumana Ahmed Eid, Mohamed Hashem Youssef Abdou and 5 more

Abstract read
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In one paragraph

Article in Journal of clinical medicine research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Heba M ReyadDepartment of Pediatrics, Faculty of Medicine, Kafr Elsheikh University, Egypt.
Narmen EltrafiDepartment of Pediatrics, Mediclinic Airport Road Hospital, Abu Dhabi, UAE.
Walaa H AliChild Health Department, National Research Centre, Dokki, Giza, Egypt.
Mohamed AbdelrazekOrthopaedic Department, Mansoura University Hospitals, Faculty of Medicine, Mansoura University, Egypt.
Marwa Khairy Abd ElwahabDepartment of Clinical Pathology, Faculty of Medicine for girls, Al-Azhar University, Cairo, Egypt.
Eiman IbrahimDepartment of Pharmacy Practice, College of Pharmacy, Qassim University, Buraydah, Saudi Arabia.
Seham Nabil RamdanDepartment of Pediatrics, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Ahmed AkefDepartment of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Jumana Ahmed EidDepartment of Pediatrics, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Mohamed Hashem Youssef AbdouOrthopedic and Spine Surgery Department, Makkah Medical Center Hospital, Makkah, Saudi Arabia.
Soad A EltokhyClinical Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
Sedeek MosaidOrthopaedic Department, United Lincolnshire Hospitals, Lincoln, UK.
Mona E HashemDepartment of Clinical Pathology, Faculty of Medicine, Zagazig University, Egypt.
Iman Ahmed KassemDepartment of Clinical Pathology, Faculty of Medicine for girls, Al-Azhar University, Cairo, Egypt.
Ramy Saleh AbdelghanyDepartment of Pediatrics, Armed Forces College of Medicine, Cario, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Juvenile idiopathic arthritis (JIA) and acute lymphoblastic leukemia (ALL) share overlapping musculoskeletal presentations in pediatric patients, and the misclassification of ALL as JIA carries life-threatening consequences due to inappropriate initiation of corticosteroid or immunosuppressive therapy. A rigorous synthesis of contemporary evidence identifying the most reliable clinical and laboratory discriminators between these two conditions is long overdue. This systematic review and meta-analysis aimed to evaluate clinical, laboratory, and biomarker-based features that differentiate ALL from JIA in pediatric patients. The primary focus was on studies published between January 2021 and April 2026, while selectively incorporating seminal pre-2021 studies with major diagnostic relevance and extractable comparative data to strengthen quantitative synthesis. Methods: A comprehensive search of PubMed, EMBASE, Web of Science, CINAHL, and Cochrane Library was conducted using pre-specified search terms. Two independent reviewers screened titles, abstracts, and full texts. Methodological quality was assessed with the Newcastle-Ottawa Scale (NOS). Pooled odds ratios (ORs) were estimated under a random-effects model (DerSimonian-Laird), and heterogeneity was quantified using the I Results: Eighteen studies were included in the qualitative synthesis, of which 12 primary comparative studies contributed quantitative data to the meta-analysis, encompassing 5,198 pediatric patients across 12 countries. Thrombocytopenia (platelets < 100 × 10 Conclusion: The triad of thrombocytopenia, neutropenia, and anemia constitutes the most powerful hematological screening strategy for distinguishing ALL from JIA in children presenting with arthropathy. Bone marrow aspiration should be pursued without hesitation when two or more cell lines are affected. Clinicians must resist initiating immunosuppressive therapy before excluding an underlying malignancy, particularly when pain is nocturnal, disproportionate to findings, or associated with weight loss and organomegaly.

Indexed as

Acute lymphoblastic leukemiaDifferential diagnosisJuvenile idiopathic arthritisLeukemic arthritisMeta-analysisNeutropeniaPediatric rheumatologyThrombocytopenia

Identifiers

PMID42490775
PMCPMC13375429

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.