We discuss this case in detail to raise awareness and to highlight its characteristics and potential complications in the clinic.ĥ27.49 nmol/L (7-9 am: 145.4-619.4 nmol/L, 3-5 pm 94.9-462.4 nmol/L) This case illustrates the refractoriness of multisystem LCH in adults and highlights the important characteristics of LCH biology. We report the case of a nonsmoking 46-year-old man with a history of hypo thyroidism and DI who visited his doctor due to respiratory symptoms. Although LCH rarely invades the thyroid gland, it is often accompanied by lymphocytic thyroiditis (mainly diffuse or nodular swelling), and in approximately 70% of cases, thyroid hypofunction ensues. In cases with hypothalamus involvement, polydipsia and diabetes insipidus (DI) may occur. Chest imaging typically reveals nodules, cavities and cysts in both lungs, mainly in the upper and middle fields. As one of the most commonly affected organs, the lung may be involved as an isolated organ or as part of multisystemic LCH. Furthermore, LCH can involve multiple systems in adults, including osteolytic lesions and the lungs, pituitary, thyroid, liver, lymph nodes and skin. These factors cause local or systemic infiltration and granuloma formation, constituting a potentially fatal condition. Langerhans cell histiocytosis (LCH) is a group of diseases characterized by abnormal clonal accumulation of CD207+ CD1a+ cells that resemble epidermal mononuclear phagocytes, i.e., Langerhans cells.
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