Baek In-Woon, Yoo Sang Hoon, Yang Hyun, Park Jeongmi, Kim Ki-Jo, Cho Chul-Soo
a Division of Rheumatology, Department of Internal Medicine , College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea.
Mod Rheumatol. 2017 Jan;27(1):165-168. doi: 10.3109/14397595.2014.952702. Epub 2014 Sep 11.
Multicentric reticulohistiocytosis (MRH) is a rare non-Langerhans histiocytosis of unknown etiology with a predilection for joint and skin. The characteristic clinical features are papulonodular skin eruptions and inflammatory polyarthritis, sometimes progressive to arthritis mutilans, a severe destructive arthropathy. Although these manifestations can present at the same time, it is more common that one feature precedes the others. Notably, these features are similar to those found in some rheumatic diseases, such as rheumatoid arthritis or dermatomyositis, and this can lead to a misdiagnosis, especially during periods where only one feature is present. Herein, we report a female patient with polyarthralgia and subsequent skin eruptions, who was eventually diagnosed with MRH. Her symptoms seemed to resemble those of some rheumatic diseases, but several features such as affected joints and the characteristic shape of the skin lesions did not correspond to that. The histological result of infiltration of histiocytes and multinucleated giant cells in the skin ultimately facilitated the correct diagnosis. In this paper, we review MRH briefly and highlight several differential points which enable us to increase the likelihood of correctly diagnosing MRH.
多中心网状组织细胞增生症（MRH）是一种病因不明的罕见非朗格汉斯组织细胞增生症，好发于关节和皮肤。其特征性临床症状为丘疹结节性皮肤疹和炎症性多关节炎，有时会进展为残毁性关节炎，这是一种严重的破坏性关节病。尽管这些表现可能同时出现，但更常见的情况是一种症状先于其他症状出现。值得注意的是，这些症状与某些风湿性疾病（如类风湿关节炎或皮肌炎）的症状相似，这可能导致误诊，尤其是在仅出现一种症状的时期。在此，我们报告一名患有多关节痛及随后出现皮肤疹的女性患者，最终被诊断为MRH。她的症状似乎与某些风湿性疾病相似，但一些特征（如受累关节和皮肤病变的特征形状）并不相符。皮肤中组织细胞和多核巨细胞浸润的组织学结果最终有助于做出正确诊断。在本文中，我们简要回顾了MRH，并强调了几个鉴别要点，这些要点能使我们提高正确诊断MRH的可能性。
