Congenital Langerhans cell histiocytosis

Katherine Barrios , Oscar Patiño, Nelson Muñoz, Carlos Moneriz, .

Keywords: Langerhans cells, histiocytosis, infant, newborn, infant, Colombia

Abstract

Langerhans cell histiocytosis is a rare pathology with different clinical manifestations in the neonatal period ranging from isolated bone lesions to systemic compromise.
We report a case of Langerhans cell histiocytosis including a literature review focused on the clinical manifestations, diagnosis, and treatment. A one-month-old patient was brought to medical consultation with lymphadenopathy and skin lesions, which were initially managed as an infectious pathology. The disease continued its progression without improvement with the treatment until the patient died due to respiratory failure.
The lymph node and skin biopsies revealed infiltration of atypical cells with positive immunohistochemistry for S100, CD1, and CD68 confirming Langerhans cell histiocytosis.
This disorder represents a great challenge and, therefore, it is important to alert and sensitize medical teams about it for timely diagnosis and management.

Downloads

Download data is not yet available.
  • Katherine Barrios Grupo de Investigación de Bioquímica y Enfermedad, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia; Hospital Infantil Napoleón Franco Pareja, Cartagena, Colombia https://orcid.org/0000-0002-7426-1831
  • Oscar Patiño Grupo de Investigación de Bioquímica y Enfermedad, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia https://orcid.org/0000-0003-4742-4137
  • Nelson Muñoz Grupo de Investigación de Bioquímica y Enfermedad, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia; Hospital Infantil Napoleón Franco Pareja, Cartagena, Colombia; Departamento de Pediatría, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia https://orcid.org/0000-0002-0066-7302
  • Carlos Moneriz Grupo de Investigación de Bioquímica y Enfermedad, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia https://orcid.org/0000-0002-0306-8049

References

Morimoto A, Oh Y, Shioda Y, Kudo K, Imamura T. Recent advances in Langerhans cell histiocytosis. Pediatr Int. 2014;56:451-61. https://doi.org/10.1111/ped.12380

Filipovich A, McClain K, Grom A. Histiocytic disorders: Recent insights into pathophysiology and practical guidelines. Biol Blood Marrow Transplant. 2010;16(Suppl.):S82-9. https://doi.org/10.1016/j.bbmt.2009.11.014

Jaffe R. The diagnostic histopathology of Langerhans cell histiocytosis. In: Egeler RM, Weitzman S, editors. Histiocytic disorders of children and adults: Basic science, clinical features and therapy. Cambridge: Cambridge University Press; 2005. p. 14-39. https://doi.org/10.1017/CBO9780511545252.003

Jezierska M, Stefanowicz J, Romanowicz G, Kosiak W, Lange M. Langerhans cell histiocytosis in children - a disease with many faces. Recent advances in pathogenesis, diagnostic examinations and treatment. Postepy Dermatol Alergol. 2018;35:6-17. https://doi.org/10.5114/pdia.2017.67095

Abla O, Egeler RM, Weitzman S. Langerhans cell histiocytosis: Current concepts and treatments. Cancer Treat Rev. 2010;36:354-9. https://doi.org/10.1016/j.ctrv.2010.02.012

Grana N. Langerhans cell histiocytosis. Cancer Control. 2014;21:328-34. https://doi.org/10.1177/107327481402100409

Salotti JA, Nanduri V, Pearce MS, Parker L, Lynn R, Windebank KP. Incidence and clinical features of Langerhans cell histiocytosis in the UK and Ireland. Arch Dis Child. 2009;94:376-80. https://doi.org/10.1136/adc.2008.144527

Castro EC, Blázquez C, Boyd J, Correa H, de Chadarevian JP, Felgar RE, et al. Clinicopathologic features of histiocytic lesions following ALL, with a review of the literature. Pediatr Dev Pathol. 2010;13:225-37. https://doi.org/10.2350/09-03-0622-OA.1

Krooks J, Minkov M, Weatherall AG. Langerhans cell histiocytosis in children: Diagnosis, differential diagnosis, treatment, sequelae, and standardized follow-up. J Am Acad Dermatol. 2018;78:1047-56. https://doi.org/10.1016/j.jaad.2017.05.060

Frade AP, Godinho MM, Batalha AB, Bueno APS. Congenital Langerhans cell histiocytosis: A good prognosis disease? An Bras Dermatol. 2017;92:40-2. https://doi.org/10.1590/abd1806-4841.20175308

Grois N, Pötschger U, Prosch H, Minkov M, Arico M, Braier J, et al. Risk factors for diabetes insipidus in langerhans cell histiocytosis. Pediatr Blood Cancer. 2006;46:228-33. https://doi.org/10.1002/pbc.20425

Merglova V, Hrusak D, Boudova L, Mukensnabl P, Valentova E, Hosticka L. Langerhans cell histiocytosis in childhood - review, symptoms in the oral cavity, differential diagnosis and report of two cases. J Craniomaxillofac Surg. 2014;42:93-100. https://doi.org/10.1016/j.jcms.2013.03.005

Krooks J, Minkov M, Weatherall AG. Langerhans cell histiocytosis in children: History, classification, pathobiology, clinical manifestations, and prognosis. J Am Acad Dermatol. 2018;78:1035-44. https://doi.org/10.1016/j.jaad.2017.05.059

Kapur P, Erickson C, Rakheja D, Carder KR, Hoang MP. Congenital self-healing reticulohistiocytosis (Hashimoto-Pritzker disease): Ten-year experience at Dallas Children’s Medical Center. J Am Acad Dermatol. 2007;56:290-4. https://doi.org/10.1016/j.jaad.2006.09.001

Berres ML, Merad M, Allen CE. Progress in understanding the pathogenesis of Langerhans cell histiocytosis: Back to histiocytosis X? Br J Haematol. 2015;169:3-13. https://doi.org/10.1111/bjh.13247

Gadner H, Heitger A, Grois N, Gatterer-Menz I, Ladisch S. Treatment strategy for disseminated langerhans cell histiocytosis. Med Pediatr Oncol. 1994;23:72-80. https://doi.org/10.1002/mpo.2950230203

Hutter C, Minkov M. Insights into the pathogenesis of Langerhans cell histiocytosis: The development of targeted therapies. Immunotargets Ther. 2016;5:81-91. https://doi.org/10.2147/ITT.S91058

Nakajima K, Morisawa R, Kodama H, Sano S. Successful treatment with cyclophosphamide of Langerhans cell histiocytosis involving the skin and lymph nodes in an adult patient. Clin Exp Dermatol. 2010;35:791-2. https://doi.org/10.1111/j.1365-2230.2010.03802.x

Gadner H, Grois N, Arico M, Broadbent V, Ceci A, Jakobson A, et al. A randomized trial of treatment for multisystem Langerhans cell histiocytosis. J Pediatr. 2001;138:728-34. https://doi.org/10.1067/mpd.2001.111331

Morimoto A, Ikushima S, Kinugawa N, Ishii E, Kohdera U, Sako M, et al. Improved outcome in the treatment of pediatric multifocal Langerhans cell histiocytosis. Cancer. 2006;107:613-9. https://doi.org/10.1002/cncr.21985

Ronceray L, Pötschger U, Janka G, Gadner H, Minkov M. Pulmonary involvement in pediatric-onset multisystem langerhans cell histiocytosis: Effect on course and outcome. J Pediatr. 2012;161:129-33.e3. https://doi.org/10.1016/j.jpeds.2011.12.035

Gadner H, Minkov M, Grois N, Pötschger U, Thiem E, Aricò M, et al. Therapy prolongation improves outcome in multisystem Langerhans cell histiocytosis. Blood. 2013;121:5006-14. https://doi.org/10.1182/blood-2012-09-455774

How to Cite
1.
Barrios K, Patiño O, Muñoz N, Moneriz C. Congenital Langerhans cell histiocytosis. biomedica [Internet]. 2020 Sep. 1 [cited 2024 May 18];40(3):464-71. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/5150

Some similar items:

Published
2020-09-01
Section
Case presentation

Altmetric

Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views
QR Code