Langerhans cell histiocytosis can involve single or multiple organ/tissue systems and may go undiagnosed for years until it enters the clinician’s differential diagnosis framework. We report on a young patient who initially presented with diabetes insipidus and subsequently with pyrexia of unknown origin. She progressed from single system Langerhans cell histiocytosis to multisystem involvement and remains in long-term remission following chemotherapy.
KannourakisGAbbasA.The role of cytokines in the pathogenesis of Langerhans cell histiocytosis. Br J Cancer Suppl1994; 23:S37–40.
2.
EgelerRMFavaraBEVan MeursMDifferential in situ cytokine profiles of Langerhans-like cells and T cells in Langerhans cell histiocytosis: abundant expression of cytokines relevant to disease and treatment. Blood1999; 94:4195–201.
3.
OrnvoldKCarstensenHLarsenJKFlow cytometric DNA analysis of lesions from 18 children with langerhans cell histiocytosis (histiocytosis x). Am J Pathol1990; 136:1301–7.
4.
HaltonJWhittonAWiernikowskiJ Disseminated Langerhans cell histiocytosis in identical twins unresponsive to recombinant human alpha-interferon and total body irradiation. Am J Pediatr Hematol Oncol 1992; 14:269–72. http://dx.doi.org/10.1097/00043426-199208000-00016
5.
de Graaf JH, Tamminga RY, Kamps WA Expression of cellular adhesion molecules in Langerhans cell histiocytosis and normal Langerhans cells. Am J Pathol1995; 147:1161–71.
6.
BaumgartnerIvon HochstetterABaumertB Langerhans cell histiocytosis in adults. Med Pediatr Oncol 1997; 28:9–14. http://dx.doi.org/10.1002/(SICI)1096-911X(199701)28:1<9::AIDMPO3>3.0.CO;2-P
7.
MalpasJS.Langerhans cell histiocytosis in adults. Hematol Oncol Clin North Am 1998; 12:259–68. http://dx.doi.org/10.1016/S0889-8588(05)70509-8
8.
García Gallo MS, Martínez MP, Abalovich MS Endocrine manifestations of Langerhans cell histiocytosis diagnosed in adults. Pituitary 2010; 13:298–303. http://dx.doi.org/10.1007/s11102-010-0233-8
9.
KaltsasGAPowlesTBEvansonJ Hypothalamo-pituitary abnormalities in adult patients with langerhans cell histiocytosis: clinical, endocrinological, and radiological features and response to treatment. J Clin Endocrinol Metab 2000; 85:1370–6. http://dx.doi.org/10.1210/jc.85.4.1370
10.
KaplanKJGoodmanZDIshakKG.Liver involvement in Langerhans’ cell histiocytosis: a study of nine cases. Mod Pathol1999; 12:370–8.
11.
HaasSTheuerkaufIKühnenA [Langerhans’ cell histiocytosis of the liver. Differential diagnosis of a rare chronic destructive sclerosing cholangitis.] Pathologe 2003; 24:119–23. German.
12.
LauSKChuPGWeissLM.Immunohistochemical expression of langerin in Langerhans cell histiocytosis and non-Langerhans cell histiocytic disorders. Am J Surg Pathol 2008; 32:615–9. http://dx.doi.org/10.1097/PAS.0b013e31815b212b
13.
BroadbentVGadnerH. Current therapy for Langerhans cell histiocytosis. Hematol Oncol Clin North Am 1998; 12:327–38. http://dx.doi.org/10.1016/S0889-8588(05)70513-X
14.
GadnerHHeitgerAGroisN Treatment strategy for disseminated Langerhans cell histiocytosis. DAL HX-83 Study Group. Med Pediatr Oncol 1994; 23:72–80. http://dx.doi.org/10.1002/mpo.2950230203
15.
GadnerHGroisNPotschgerU Improved outcome in multisystem Langerhans cell histiocytosis is associated with therapy intensification. Blood 2008; 111:2556–62. http://dx.doi.org/10.1182/blood-2007-08-106211
16.
McClainKL.Drug therapy for the treatment of Langerhans cell histiocytosis. Expert Opin Pharmacother 2005; 6:2435–41. http://dx.doi.org/10.1517/14656566.6.14.2435
17.
BernardFThomasCBertrandY Multi-centre pilot study of 2-chlorodeoxyadenosine and cytosine arabinoside combined chemotherapy in refractory Langerhans cell histiocytosis with haematological dysfunction. Eur J Cancer 2005; 41:2682–9. http://dx.doi.org/10.1016/j.ejca.2005.02.007
18.
SteinerMMatthes-MartinSAttarbaschiA Improved outcome of treatment-resistant high-risk Langerhans cell histiocytosis after allogeneic stem cell transplantation with reduced-intensity conditioning. Bone Marrow Transplant 2005; 36:215–25. http://dx.doi.org/10.1038/sj.bmt.1705015