Department of Neurology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
Department of Internal Medicine, Division of Hematology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
Neuropathology. 2024 Feb;44(1):59-67. doi: 10.1111/neup.12930. Epub 2023 Jun 26.
Erdheim-Chester disease is a non-Langerhans cell histiocytosis syndrome characterised by histiocytic infiltration of different organs and systems in the body. Erdheim-Chester disease with isolated central nervous system (CNS) involvement causes diagnostic difficulties due to the absence of systemic findings and may result in misdiagnosis and inaccurate treatment choices. The case discussed in this report exemplifies how challenging it is to diagnose Erdheim-Chester disease with isolated CNS involvement. This case, which presented with progressive pyramidocerebellar syndrome, was clinically and radiologically resistant to all immunosuppressive and immunomodulatory treatments administered. The presence of false negative results in repeated histopathological investigations and the absence of evidence for systemic disease hindered the diagnosis and treatment work-up. In this study, we reviewed and discussed the prominent features of the presented case in light of the relevant literature.
厄尔-当-切斯特病是一种非朗格汉斯细胞组织细胞增生症,其特征是身体不同器官和系统的组织细胞浸润。由于缺乏全身表现,孤立性中枢神经系统(CNS)受累的厄尔-当-切斯特病导致诊断困难,并可能导致误诊和不准确的治疗选择。本报告讨论的病例说明了诊断孤立性中枢神经系统受累的厄尔-当-切斯特病具有挑战性。该病例表现为进行性小脑-脑桥角综合征,对所有给予的免疫抑制和免疫调节治疗均具有临床和影像学耐药性。在反复的组织病理学研究中出现假阴性结果,且缺乏全身疾病的证据,这阻碍了诊断和治疗的评估。在本研究中,我们根据相关文献复习并讨论了所提出病例的显著特征。