Erdheim-Chester disease with prominent pericardial effusion

Multisystem Erdheim-Chester disease presenting with pericardial effusion confirmed by the effusion cytology specimen

Erdheim-Chester disease (ECD) is a rare histiocytosis characterized by the foamy CD68+CD1a- histiocytes infiltrating multiple organs and tissues. ECD might be asymptomatic or present with variable manifestations. The diagnosis of ECD requires characteristic radiological findings and pathological features. Herein, we described a 52-year-old female patient who was admitted to our hospital for recurrent pericardial effusion for two months. She has a medical history of papillary thyroid carcinoma (PTC) and underwent a total thyroidectomy two years before admission. The radiological findings suggested a potential diagnosis of ECD. Cytological analysis of the effusion cytology specimen revealed CD68+CD1a- histiocytes, confirming the ECD diagnosis. The BRAF V600E mutation was identified in the histiocytes, prompting the administration of vemurafenib, a BRAF inhibitor. After two months of standard-dose vemurafenib treatment, the disease was well controlled with pericardial effusion regression.

A case report of Erdheim-Chester disease-clinically characterized by recurrent fever, multiple bone destruction, and antinuclear antibodies

Background

Erdheim-Chester disease is a form of histiocytosis. It is an extremely rare illness. Since its discovery, hundreds of cases of this disease have been identified across the globe. Pathologically, the condition is characterized by proliferation of lipid-rich foam-like tissue cells, which is especially prevalent in bones. Approximately 50% of patients develop infiltration into organs other than the bones.

Case description

A patient with fever and bone pain is described in this case report. After visiting multiple hospitals and departments, undergoning battery of investigations, and ruling out other diseases, the patient was pathologically diagnosed with Erdheim-Chester disease after a biopsy of the associated bone destruction. The condition improved with symptomatic therapy.

Conclusion

Numerous clinical symptoms make non-Langerhans cell histiocytosis challenging to diagnose and requires pathological diagnosis. Patients with unexplained multiple bone destruction must be alert against this disease from a clinical standpoint.

Pericardial Effusion in Erdheim-Chester Disease: A Case Report and a Mini Literature Review

A 68-year-old man diagnosed with Erdheim-Chester disease presented to the emergency department with shortness of breath of one-day duration. Upon presentation, the patient was dyspnoeic and hypoxemic. The initial laboratory workup showed raised inflammation markers, and a chest x-ray showed the presence of bilateral lung infiltrates; therefore, he was managed for community-acquired pneumonia with antimicrobial and other supportive measures. Due to lack of improvement, he had transthoracic echocardiography (ECHO), which showed a large pericardial effusion without tamponade. He was treated with corticosteroids and underwent pericardiocentesis, which resulted in remarkable symptomatic improvement. This case presents a serious manifestation of a rare disease and summarizes treatment options from the literature. 

Reticulohistiocytoma of the orbit

Reticulohistiocytoma is a rare, benign histiocytic proliferation of the skin or soft tissue. While ocular involvement has been documented in the past, there have been no previously reported cases of reticulohistiocytoma of the orbit. In this report, the authors describe a reticulohistiocytoma of the orbit in a middle-aged woman.