Department of Orthopaedic Surgery, McLaren Regional Medical Center, Flint, MI.
Department of Orthopaedic Surgery, McLaren Regional Medical Center, Flint, MI.
J Hand Surg Am. 2020 May;45(5):457.e1-457.e5. doi: 10.1016/j.jhsa.2019.06.001. Epub 2019 Jul 15.
Multicentric reticulohistiocytosis is a rare non-Langerhans cell histiocytic rheumatologic disorder characterized by multiple skin lesions, painful hand nodules, and destructive polyarthritis that results in arthritis mutilans in 20% to 30% of patients. In the current literature, there have been approximately 300 cases reported and the pathogenesis remains unclear. Currently, there is no diagnostic serologic test and no consensus on management. In this case report, we present a patient with multicentric reticulohistiocytosis who was treated with selective excision of 3 painful nodules on the hand. The patient was seen 1 year after surgery. One of the nodules reoccurred whereas the other 2 remained quiescent. This procedure has the potential to produce considerable pain relief and improve quality of life in a disease process for which optimal medical regimen remains to be determined.
多发性网状组织细胞增生症是一种罕见的非朗格汉斯细胞组织细胞性风湿性疾病，其特征为多发性皮肤损害、手痛性结节和破坏性多关节炎，20%至 30%的患者会发展为关节炎畸形。目前文献中约有 300 例报告，其发病机制尚不清楚。目前尚无诊断性血清学检测，也没有关于其管理的共识。在本病例报告中，我们介绍了一位接受手部 3 个疼痛性结节选择性切除术治疗的多发性网状组织细胞增生症患者。患者在手术后 1 年就诊。其中 1 个结节再次出现，而另外 2 个结节保持静止。对于这种疾病，目前还没有确定最佳的治疗方案，这种手术方法有可能减轻相当多的疼痛，并改善生活质量。
