Abstract
Langerhans cells histiocytosis is a rare disease characterized by monoclonal proliferation and migration of special dendritic cells in a variety of organs, most commonly appears eosinophilic granuloma localized, often solitary, and bone lesions that occurs predominantly in pediatric patients. Although is most prevalent in children under the age of 15, this disorder presents in all ages and occurs at a rate of 2 to 5 cases per million per year. LCH is a complex entity; the clinic manifestations can mimic other common conditions and therefore a comprehensive evaluation is indicated. Since oral manifestations are frequent, the early diagnose of this pathology could be detected by dental professionals. The aim of this case report is to describe a case of LCH who initially was misdiagnosed and treated for a dental infection. This disease requires accurate histopathological diagnosis and timely treatment; hence it is necessary to raise awareness among dentists to avoid misdiagnose of oral manifestations of LCH.
References
Margo C.E., Goldman D.R. Langerhans cell histiocytosis. Surv Ophthalmol. 2008; 53: 332-58. doi:10.1016/j.survophthal.2008.04.007
Satter E.K., High W.A. Langerhans cell histiocytosis: a review of the current recommendations of the Histiocyte Society. Pediatr Dermatol. 2008; 25: 291-5. doi:10.1111/j.1525-1470.2008.00669.x
Allen C.E., Merad M., McClain K.L. Langerhans-cell histiocytosis. N Eng J Med. 2018, 379 (9), 856-868. doi: 10.1056/NEJMra1607548
Krooks J., Minkov M., Weatherall A.G. Langerhans cell histiocytosis in children: History, classification, pathobiology, clinical manifestations, and prognosis. J Am Acad Dermatol. 2018 Jun; 78 (6): 1035-1044. doi: 10.1016/j.jaad.2017.05.059. PMID: 29754885
Guyot-Goubin A., Donadieu J., Barkaoui M., Bellec S., Thomas C., Clavel J. Descriptive epidemiology of childhood Langerhans cell histiocytosis in France, 2000-2004. Pediatr Blood Cancer 2008; 51: 71-5. doi:10.1002/pbc.21498
Stålemark H., Laurencikas E., Karis J., Gavhed D., Fadeel B., Henter J-I. Incidence of Langerhans cell histiocytosis in children: a population-based study. Pediatr Blood Cancer. 2008; 51: 76-81. doi:10.1002/pbc.21504
Peckham-Gregory E.C., McClain K.L., Allen C.E., Scheurer M.E., Lupo P.J. The role of parental and perinatal characteristics on Langerhans cell histiocytosis: characterizing increased risk among Hispanics. Ann Epidemiol. 2018; 28: 521-8. https://doi.org/10.1016/j.annepidem.2018.04.005
Venkatramani R., Rosenberg S., Indramohan G., Jeng M., Jubran R. An exploratory epidemiological study of Langerhans cell histiocytosis. Pediatr Blood Cancer 2012; 59: 1324-6. doi:10.1002/pbc.24136
Haupt R., Minkov M., Astigarraga I., Schäfer E., Nanduri V., Jubran R., et al. Langerhans cell histiocytosis (LCH): guidelines for diagnosis, clinical work-up, and treatment for patients till the age of 18 years. Pediatr Blood Cancer. 2013; 60: 175-184. doi:10.1002/pbc.24367
Su M., Gao Y-J, Pan C., Chen J., Tang J-Y. Outcome of children with Langerhans cell histiocytosis and single-system involvement: A retrospective study at a single center in Shanghai, China. Pediatr Hematol Oncol. 2018; 35: 385-92. doi:10.1080/08880018.2018.1545814
Eden P., Abeyasinghe, Mufeesc M.B.M., Jayasooriya P.R. A series of 13 new cases of langerhans cell histiocytosis of the oral cavity: a master of disguise. Oral Health Care 2. 2017. DOI: 10.15761/OHC.1000110
Li Z., Yanqiu L., Yan W., Xiaoying Q., Hamze F., Siyuan C., et al. Two case report studies of Langerhans cell histiocytosis with an analysis of 918 patients of Langerhans cell histiocytosis in literatures published in China. Int J Dermatol. 2010; 49: 1169-1174. doi:10.1111/j.1365-4632.2009.04360.x
Varga E., Korom I., Polyánka H., Szabó K., Széll M., Baltás E., et al. BRAFV600E mutation in cutaneous lesions of patients with adult Langerhans cell histiocytosis. J Eur Acad Dermatol Venereol. 2015;29: 1205-1211. doi:10.1111/jdv.12792
Rigaud C., Barkaoui M.A., Thomas C., Bertrand Y., Lambilliotte A., Miron J., et al. Langerhans cell histiocytosis: therapeutic strategy and outcome in a 30-year nationwide cohort of 1478 patients under 18 years of age. Br J Haematol. 2016; 174 (6): 887-898. doi:10.1111/bjh.14140
Emile J.F., Abla O., Fraitag S., Horne A., Haroche J., Donadieu J., et al. Histiocyte Society. Revised classification of histiocytoses and neoplasms of the macrophage-dendritic cell lineages. Blood. 2016 Jun 2; 127 (22): 2672-81. doi: 10.1182/blood-2016-01-690636
Leung A.K., Lam J.M., Leong K.F. Childhood Langerhans cell histiocytosis: a disease with many faces. World Journal of Pediatrics,2019; 1-10. doi: https://doi.org/10.1007/s12519-019-00304-9
Thacker N.H., Abla O. Pediatric Langerhans cell histiocytosis: state of the science and future directions. Clin Adv Hematol Oncol. 2019;17: 122-31.
Rodriguez G.C., Allen C.E. Langerhans cell histiocytosis. Blood 2020; 135 (16): 1319-1331. doi: 10.1182/blood.2019CM0000
Neves-Silva R., Fernandes D.T., Fonseca F.P., Rebelo P.H.A., Ferreira B.B., Santos-Silva R.A., et al. Oral manifestations of Langerhans cell histiocytosis: A case series. Spec Care Dentist. 2018; 38: 426-433. https://doi.org/10.1111/scd.12330
Goyal G., Shah M.V., Hook C.C., et al. Adult disseminated Langerhans cell histiocytosis: incidence, racial disparities and long-term outcomes. Br J Haematol. 2018; 182 (4): 579-581. doi:10.1111/bjh.14818
Ribeiro K.B., Degar B., Antoneli C.B.G., Rollins B., Rodriguez-Galindo C. Ethnicity, race, and socioeconomic status influence incidence of Langerhans cell histiocytosis. Pediatr Blood Cancer. 2015; 62 (6): 982-987. doi:10.1002/pbc.25404
Chow T.W., Leung W.K., Cheng F.W.T., Kumta S.M., Chu W.C.W., Lee V., Li C.K., et al. Late outcomes in children with Langerhans cell histiocytosis. Arch Dis Child. 2017; 102 (9): 830-835.
Merglová V., Hrušák D., Boudova L., Mukenšnabl P., Valentová E., Hostička L. Langerhans cell histiocytosis in childhood–Review, symptoms in the oral cavity, differential diagnosis and report of two cases.J Craniomaxillofac Surg. 2014; 42 (2), 93-100. http://dx.doi.org/10.1016/j.jcms.2013.03.005