Langerhans Cell Histiocytosis with Extensive Spinal and Thyroid Gland Involvement Presenting with Quadriparesis: An Unusual Case in an Adult Patient

Soh, Mohd Ariff

doi:10.5704/moj/1111.004

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…The designation of LCH replaced the previous nomenclature for the group of disorders termed histiocytosis X, which included eosinophilic granuloma (EG), Hand–Schüller–Christian disease (HSCD), and Letterer-Siwe disease (LSD). These conditions vary greatly in presentation and outcome, but share similar pathology of clonal proliferation and accumulation of a specific histiocyte, the Langerhans cell [ 13 ].EG is the most common form, reportedly accounting for 60–70% of all cases, usually presenting as solitary bone lesions. EG refers to the localized form of LCH, in which the disease is limited to bone or lung.…”

Section: Discussionmentioning

confidence: 99%

Langerhans Cell Histiocytosis in the Adult Lumbar Spine – A Case Report and Literature Review

Dhillon

Tantry

Ega

et al. 2020

JOCR

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Section: Discussionmentioning

confidence: 99%

Langerhans Cell Histiocytosis in the Adult Lumbar Spine – A Case Report and Literature Review

Dhillon

Tantry

Ega

et al. 2020

JOCR

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“…In a recent small case series study, the use of a suture button device, including the TightRope device, was associated with good functional outcomes and radiographic results [30]. In their case series of 18 patients with a distal clavicle fracture treated using a TightRope system, Cho et al reported a bony union rate of 94.4% (17/18 patients), with a mean ASES score of 88.6 [31].…”

Section: Discussionmentioning

confidence: 99%

Treatment of unstable distal-third clavicule fractures using minimal invasive closed-loop double endobutton technique

Zheng

Liu

2019

J Orthop Surg Res

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BackgroundClavicle fractures are common clinical problems, accounting for approximately 10% of all fractures. Neer’s type II fractures disrupt the integrity of the coracoclavicular ligament and, therefore, are inherently unstable, requiring an extended period time to achieve bone union and being associated with a high rate of non- or malunion. Restoration of the stability of the distal clavicle is an important factor to decrease the rate of non- or malunion. As such, the aim of our study was to describe our technique of indirect osteosynthesis, using a minimally invasive closed-loop double endobutton (TightRope) technique for fixation of unstable (Neer’s type II) distal clavicle factures, and to evaluate the short-term clinical outcomes.MethodsFifteen patients with a Neer’s type II fracture of the distal clavicle were treated surgically using the TightRope fixation, between January 2016 and December 2017. Clinical and radiological results were assessed using the American Shoulder and Elbow Surgeons Shoulder Score (ASES) and the Constant score.ResultsDefinitive fracture healing was achieved in most of the patients. No major complication was identified over a mean follow-up of 9 months, and none of the patients required additional surgery related to the index procedure. At the last follow-up, all patients had recovered functional range of motion of the shoulder, with high Constant and ASES scores, and low pain score.ConclusionThe use of TightRope fixation provided sufficient stability to reduce the medially displaced fragment of the Neer’s type II fracture, with satisfactory radiological and clinical outcomes achieved over a mean follow-up of 9 months. Future studies on the long-term outcomes are needed.

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Spontaneous Thyroid Hemorrhage Caused by Langerhans Cell Histiocytosis: A Case Report and Literature Review

et al. 2021

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PurposeLangerhans cell histiocytosis (LCH) is a rare clonal disorder of Langerhans antigen-presenting cells. However, thyroid LCH involvement is relatively rare. We present the first case of spontaneous thyroid hemorrhage due to LCH progression and discuss the clinical features, diagnosis, and treatments of thyroid LCH in a literature review.MethodsClinical data were collected. Previously published articles on thyroid LCH involvement were reviewed to assess the clinical features, diagnosis, and treatments for thyroid LCH.ResultsA 54-year-old female presented with a multi-system LCH, affecting the uterus, liver, pituitary gland, and thyroid gland. Clinical stability was achieved after systemic chemotherapy. After 7 years of regular follow up, the patient complained of a sudden painful neck swelling and progressive dyspnea. Computed Tomography revealed bilateral goiter with hematoma, and the patient was diagnosed with spontaneous thyroid bleeding based on her clinical symptoms and radiological findings. The patient was incubated to relieve airway compromise and partial thyroidectomy was performed for definitive treatment. Pathological evaluation further confirmed the diagnosis of thyroid LCH. The patient recovered well after surgery.ConclusionSpontaneous thyroid bleeding due to thyroid LCH progression is extremely rare. Treatments for LCH vary depending on the severity of the disease. We suggest that, for patients with multi-system LCH with thyroid lesion, long-term active surveillance of thyroid hormone concentrations, and thyroid gland volume is required. Physicians should be alert of the potentially life-threatening spontaneous thyroid hemorrhage when aggravated diffuse goiter and hypothyroidism appear. Further investigation is required to establish the guidelines for thyroid LCH treatment.

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Langerhans Cell Histiocytosis with Extensive Spinal and Thyroid Gland Involvement Presenting with Quadriparesis: An Unusual Case in an Adult Patient

Cited by 3 publications

References 5 publications

Langerhans Cell Histiocytosis in the Adult Lumbar Spine – A Case Report and Literature Review

Langerhans Cell Histiocytosis in the Adult Lumbar Spine – A Case Report and Literature Review

Treatment of unstable distal-third clavicule fractures using minimal invasive closed-loop double endobutton technique

Spontaneous Thyroid Hemorrhage Caused by Langerhans Cell Histiocytosis: A Case Report and Literature Review

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