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Erdheim–Chester disease

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Erdheim–Chester disease was previously associated with high mortality rates. However, long-term survival is now more promising. Recent studies have reported that some patients receiving targeted therapies showed no disease progression. Targeted therapies using BRAF, MEK and/or other inhibitors have
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published guidelines for the diagnosis and treatment of the disease, stressing the importance of genetic testing: "Recent insights into their genomic architecture demonstrating mitogen-activated protein kinase/extracellular signal-regulated kinase pathway mutations have now enabled potential
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and histology are the main diagnostic features. Diagnosis can often be difficult because of the rareness of ECD as well as the need to differentiate it from LCH. A diagnosis from neurological imaging may not be definitive. The presence of symmetrical
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Lachenal F, Cotton F, Desmurs-Clavel H, Haroche J, Taillia H, Magy N, et al. (October 2006). "Neurological manifestations and neuroradiological presentation of Erdheim-Chester disease: report of 6 cases and systematic review of the literature".
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Long bone involvement is almost universal in ECD patients and is bilateral and symmetrical in nature. More than 50% of cases have some sort of extraskeletal involvement. This can include kidney, skin, brain and lung involvement, and less frequently
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Mossetti G, Rendina D, Numis FG, Somma P, Postiglione L, Nunziata V (2003). "Biochemical markers of bone turnover, serum levels of interleukin-6/interleukin-6 soluble receptor and bisphosphonate treatment in Erdheim-Chester disease".
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de Abreu MR, Castro MO, Chung C, Trudell D, Biswal S, Wesselly M, Resnick D (2009). "Erdheim-Chester disease: case report with unique postmortem magnetic resonance imaging, high-resolution radiography, and pathologic correlation".
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Haroche J, Amoura Z, Trad SG, Wechsler B, Cluzel P, Grenier PA, Piette JC (October 2006). "Variability in the efficacy of interferon-alpha in Erdheim-Chester disease by patient and site of involvement: results in eight patients".
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Haroche J, Amoura Z, Dion E, Wechsler B, Costedoat-Chalumeau N, Cacoub P, et al. (November 2004). "Cardiovascular involvement, an overlooked feature of Erdheim-Chester disease: report of 6 new cases and a literature review".
1089:"The Mayo Clinic Histiocytosis Working Group Consensus Statement for the Diagnosis and Evaluation of Adult Patients With Histiocytic Neoplasms: Erdheim-Chester Disease, Langerhans Cell Histiocytosis, and Rosai-Dorfman Disease" 1890: 1875: 1549:
Drier A, Haroche J, Savatovsky J, Godenèche G, Dormont D, Chiras J, et al. (May 2010). "Cerebral, facial, and orbital involvement in Erdheim-Chester disease: CT and MR imaging findings".
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Perlat A, Decaux O, Sébillot M, Grosbois B, Desfourneaux V, Meadeb J (May 2009). "Erdheim-Chester disease with predominant mesenteric localization: lack of efficacy of interferon alpha".
1618:"Images in cardiovascular medicine. Cardiac involvement in Erdheim-Chester disease: magnetic resonance and computed tomographic scan imaging in a monocentric series of 37 patients" 433: 1482:
Brun AL, Touitou-Gottenberg D, Haroche J, Toledano D, Cluzel P, Beigelman-Aubry C, et al. (November 2010). "Erdheim-Chester disease: CT findings of thoracic involvement".
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Bone pain is the most frequent of all symptoms associated with ECD and mainly affects the lower limbs, knees and ankles. The pain is often described as mild but permanent, and
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Lutz SZ, Schmalzing M, Vogel-Claussen J, Adam P, May AE (September 2011). "" [Recurrent pericardial effusion as first manifestation of Erdheim-Chester disease].
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Boissel N, Wechsler B, Leblond V (November 2001). "Treatment of refractory Erdheim-Chester disease with double autologous hematopoietic stem-cell transplantation".
828:"Dramatic efficacy of vemurafenib in both multisystemic and refractory Erdheim-Chester disease and Langerhans cell histiocytosis harboring the BRAF V600E mutation" 707:
Weidauer S, von Stuckrad-Barre S, Dettmann E, Zanella FE, Lanfermann H (April 2003). "Cerebral Erdheim-Chester disease: case report and review of the literature".
867: 1350:"18F-fluorodeoxyglucose-positron emission tomography scanning is more useful in followup than in the initial assessment of patients with Erdheim-Chester disease" 162:
occurs in some patients and is usually bilateral, symmetric and painless, and in most cases it occurs several years before the final diagnosis. Recurrent
1063: 753: 2075: 2001: 346:, an oral agent approved in 2019, targets the BRAF protein. It was approved after showing dramatic efficacy in ECD patients harboring the 503: 424:
Approximately 500 cases had been reported in the literature as of 2014. ECD affects predominantly adults, with a mean age of 53 years.
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is said to offer the greatest likelihood of reaching a diagnosis. It would appear that approximately half these patients harbor point
2185: 260:. ECD is not a common cause of exophthalmos but can be diagnosed by biopsy. However, like all biopsies, this may be inconclusive. 110:
in 2016. Onset typically is in middle age, although younger patients have been documented. The disease involves an infiltration of
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A review of 59 case studies by Veyssier-Belot et al. in 1996 reported the following symptoms in order of frequency of occurrence:
1955: 1385:"Pulmonary involvement in Erdheim-Chester disease: a single-center study of thirty-four patients and a review of the literature" 2123: 1852: 261: 1236: 776:"Erdheim-Chester disease: The role of video-assisted thoracoscopic surgery in diagnosing and treating cardiac involvement" 464:
of and promoting research into ECD. ECD families and patients are also supported by the Histiocytosis Association, Inc.
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Aouba A, Georgin-Lavialle S, Pagnoux C, Martin Silva N, Renand A, Galateau-Salle F, et al. (November 2010).
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may be used for diagnostic confirmation and also for therapeutic relief of recurrent pericardial fluid drainage.
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Veyssier-Belot C, Cacoub P, Caparros-Lefebvre D, Wechsler J, Brun B, Remy M, et al. (May 1996).
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Haroche J, Cohen-Aubart F, Emile JF, Arnaud L, Maksud P, Charlotte F, et al. (February 2013).
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Arnaud L, Pierre I, Beigelman-Aubry C, Capron F, Brun AL, Rigolet A, et al. (November 2010).
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Haroche J, Cluzel P, Toledano D, Montalescot G, Touitou D, Grenier PA, et al. (June 2009).
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Haroche J, Amoura Z, Charlotte F, Salvatierra J, Wechsler B, Graux C, et al. (June 2008).
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Haroche J, Arnaud L, Cohen-Aubart F, Hervier B, Charlotte F, Emile JF, Amoura Z (April 2014).
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Abeykoon JP, Lasho TL, Dasari S, Rech KL, Ranatunga WK, Manske MK, et al. (March 2022).
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Myra C, Sloper L, Tighe PJ, McIntosh RS, Stevens SE, Gregson RH, et al. (June 2004).
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Haroche J, Amoura Z, Touraine P, Seilhean D, Graef C, Birmelé B, et al. (June 2007).
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Arnaud L, Malek Z, Archambaud F, Kas A, Toledano D, Drier A, et al. (October 2009).
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Goyal G, Young JR, Koster MJ, Tobin WO, Vassallo R, Ryu JH, et al. (October 2019).
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Aziz SN, Proano L, Cruz C, Tenemaza MG, Monteros G, Hassen G, et al. (June 2022).
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can be a manifestation, as can morphological changes in adrenal size and infiltration.
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Virchows Archiv für Pathologische Anatomie und Physiologie und für Klinische Medizin
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Janku F, Amin HM, Yang D, Garrido-Laguna I, Trent JC, Kurzrock R (November 2010).
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infiltration by lipid-laden or foamy histiocytes, and are usually surrounded by
1921: 1465: 1448: 479: 371: 240: 212: 1884: 1765: 1495: 1315:"Rationale and efficacy of interleukin-1 targeting in Erdheim-Chester disease" 1154: 1137: 1013:"Vemurafenib in the Treatment of Erdheim Chester Disease: A Systematic Review" 720: 660:"Erdheim-Chester disease. Clinical and radiologic characteristics of 59 cases" 327:. In some, there is histiocyte proliferation, and on staining, the section is 2159: 1964: 1734: 1717: 657: 441: 277: 228: 218: 103: 42: 1562: 979: 1847: 1832: 1803: 1773: 1743: 1708: 1673: 1643: 1600: 1570: 1541: 1503: 1474: 1439: 1410: 1375: 1340: 1163: 1114: 1048: 997: 964:"Treatment of Erdheim-Chester disease with cladribine: a rational approach" 948: 853: 809: 728: 639: 598: 590: 553: 382: 377: 284: 188: 159: 80: 685: 1029: 706: 630: 613: 412: 399: 353: 343: 281: 252:
signal changes on T2-weighted images seem to be typical of ECD, however,
123: 1867: 1190: 1064:"FDA Approves Oral MEK Inhibitor Cobimetinib for Histiocytic Neoplasms" 364: 276:(LCH) in a number of ways. Unlike LCH, ECD does not stain positive for 245: 119: 115: 96: 92: 1665: 1401: 1384: 1366: 1349: 930: 394: 292: 198: 173: 131: 356:, an oral inhibitor of MEK1 and MEK2, was approved in November 2022. 308: 300: 193: 60: 457: 1212: 437: 208: 155: 1933: 1135: 576: 1879: 1718:"Response of histiocytoses to imatinib mesylate: fire to ashes" 483: 445: 432:
The first case of ECD was reported by the American pathologist
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Braiteh F, Boxrud C, Esmaeli B, Kurzrock R (November 2005).
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codon 600 substituting the amino acid glutamine for valine
534:. United States National Library of Medicine. 8 July 2008 504:"Erdheim-Chester Disease Declared a Histiocytic Neoplasm" 460:
is a support and advocacy group with the goal of raising
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There are two FDA-approved targeted drugs to treat ECD.
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and metabolic diseases must also be considered in the
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Egan A, Sorajja D, Jaroszewski D, Mookadam F (2012).
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treatment with targeted therapies in most patients."
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The Journal of Clinical Endocrinology and Metabolism
1061: 106:). It was declared a histiocytic neoplasm by the 2157: 1241:NORD (National Organization for Rare Disorders) 1177:Chester W (1930). "Über Lipoidgranulomatose". 2076:Hereditary progressive mucinous histiocytosis 2002:Congenital self-healing reticulohistiocytosis 1949: 1261:"What Do I Do Now? - Erdheim-Chester Disease" 780:International Journal of Surgery Case Reports 653: 651: 649: 748: 746: 411:been dramatically efficacious. In 2019, the 1129: 570: 99:(technically, this disease is termed a non- 1956: 1942: 646: 65: 41: 1733: 1698: 1633: 1464: 1400: 1365: 1330: 1153: 1104: 1038: 1028: 987: 938: 843: 799: 743: 675: 629: 1432:10.7326/0003-4819-135-9-200111060-00027 1176: 1062:The ASCO Post Staff (2 November 2022). 458:Erdheim–Chester Disease Global Alliance 2158: 2124:Interdigitating dendritic cell sarcoma 1792:Clinical and Experimental Rheumatology 451: 1937: 1231: 1229: 908: 906: 821: 819: 137: 968:The British Journal of Ophthalmology 955: 884: 262:Video-assisted thoracoscopic surgery 35:Polyostotic sclerosing histiocytosis 767: 579:Deutsche Medizinische Wochenschrift 151:and heart involvement is observed. 114:-laden macrophages, multinucleated 13: 2085:Multicentric reticulohistiocytosis 2031:Hemophagocytic lymphohistiocytosis 1306: 1226: 903: 816: 211:caused by interlobular septal and 14: 2197: 2129:Follicular dendritic cell sarcoma 2066:Progressive nodular histiocytosis 2056:Generalized eruptive histiocytoma 2013:non-Langerhans cell histiocytosis 1963: 1840: 1635:10.1161/CIRCULATIONAHA.108.825075 1593:10.1097/01.md.0000145368.17934.91 436:in 1930, during his visit to the 360:Other treatment options include: 272:Histologically, ECD differs from 2186:Diseases named after discoverers 2095:Indeterminate cell histiocytosis 677:10.1097/00005792-199605000-00005 516:– via erdheim-chester.org. 118:, an inflammatory infiltrate of 1992:Hand–Schüller–Christian disease 1277: 1253: 1205: 1170: 1080: 1055: 1004: 878: 860: 419: 1534:10.1016/j.clinimag.2008.09.009 919:American Journal of Hematology 756:. M. D. Anderson Cancer Center 700: 605: 546: 520: 496: 1: 2051:Benign cephalic histiocytosis 1974:Langerhans cell histiocytosis 489: 274:Langerhans cell histiocytosis 77:Erdheim–Chester disease (ECD) 1825:10.1016/j.jbspin.2008.09.013 1722:Journal of Clinical Oncology 1700:10.1182/blood-2008-03-148304 1332:10.1182/blood-2010-04-279240 1142:Current Rheumatology Reports 1106:10.1016/j.mayocp.2019.02.023 845:10.1182/blood-2012-07-446286 486:is Erdheim–Chester disease. 405: 334: 267: 234: 7: 1420:Annals of Internal Medicine 792:10.1016/j.ijscr.2011.12.001 10: 2202: 1466:10.1182/blood-2005-06-2238 885:Rosa K (2 November 2022). 427: 2181:Syndromes affecting blood 2137: 2103: 2010: 1971: 1861: 1766:10.1007/s00415-006-0160-9 1496:10.1007/s00330-010-1830-7 1285:"Internet Movie Database" 1265:Histiocytosis Association 1237:"Erdheim Chester disease" 1213:"Erdheim–Chester Disease" 1155:10.1007/s11926-014-0412-0 1138:"Erdheim-Chester disease" 754:"Erdheim Chester Disease" 721:10.1007/s00234-003-0950-z 558:Histiocytosis Association 554:"Erdheim-Chester Disease" 528:"Erdheim–Chester disease" 108:World Health Organization 54: 49: 40: 26: 21: 2026:Juvenile xanthogranuloma 1735:10.1200/JCO.2010.29.9073 1654:Arthritis and Rheumatism 1389:Arthritis and Rheumatism 1354:Arthritis and Rheumatism 532:Medical Subject Headings 478:, season 2 episode 17, " 467: 179:Retroperitoneal fibrosis 31:Erdheim–Chester syndrome 2119:Langerhans cell sarcoma 2106:malignant histiocytosis 2036:Erdheim-Chester disease 1563:10.1148/radiol.10090320 1093:Mayo Clinic Proceedings 980:10.1136/bjo.2003.035584 299:. Tissue samples show 122:and histiocytes in the 85:abnormal multiplication 50:Chester-Erdheim disease 22:Erdheim–Chester disease 2046:Sea-blue histiocytosis 1997:Eosinophilic granuloma 872:Pharmacy Practice News 591:10.1055/s-0031-1286368 258:differential diagnosis 203:central nervous system 87:of a specific type of 2145:Rosai–Dorfman disease 2081:Reticulohistiocytosis 2061:Xanthoma disseminatum 1987:Letterer–Siwe disease 1215:. ECD Global Alliance 83:characterized by the 2089:Reticulohistiocytoma 2041:Niemann–Pick disease 1979:X-type histiocytosis 1754:Journal of Neurology 1030:10.7759/cureus.25935 631:10.1210/jc.2006-2018 164:pericardial effusion 126:, and a generalized 2114:Histiocytic sarcoma 2018:Non-X histiocytosis 452:Society and culture 305:xanthogranulomatous 289:electron microscopy 2176:Skeletal disorders 1484:European Radiology 1191:10.1007/BF01942684 874:. 6 November 2017. 295:does not disclose 254:multiple sclerosis 184:Diabetes insipidus 138:Signs and symptoms 2153: 2152: 1931: 1930: 1760:(10): 1267–1277. 1728:(31): e633–e636. 1693:(11): 5413–5415. 1666:10.1002/art.22165 1660:(10): 3330–3336. 1628:(25): e597–e598. 1490:(11): 2579–2587. 1402:10.1002/art.27672 1395:(11): 3504–3512. 1367:10.1002/art.24848 1360:(10): 3128–3138. 1325:(20): 4070–4076. 1099:(10): 2054–2071. 931:10.1002/ajh.26441 585:(39): 1952–1956. 389:Radiation therapy 317:mutations of the 89:white blood cells 74: 73: 16:Medical condition 2193: 2071:Papular xanthoma 1958: 1951: 1944: 1935: 1934: 1859: 1858: 1836: 1813:Joint Bone Spine 1807: 1785: 1747: 1737: 1712: 1702: 1677: 1647: 1637: 1612: 1574: 1545: 1522:Clinical Imaging 1515: 1478: 1468: 1459:(9): 2992–2994. 1443: 1414: 1404: 1379: 1369: 1344: 1334: 1300: 1299: 1297: 1295: 1281: 1275: 1274: 1272: 1271: 1257: 1251: 1250: 1248: 1247: 1233: 1224: 1223: 1221: 1220: 1209: 1203: 1202: 1174: 1168: 1167: 1157: 1133: 1127: 1126: 1108: 1084: 1078: 1077: 1075: 1074: 1059: 1053: 1052: 1042: 1032: 1008: 1002: 1001: 991: 959: 953: 952: 942: 910: 901: 900: 898: 897: 882: 876: 875: 864: 858: 857: 847: 838:(9): 1495–1500. 823: 814: 813: 803: 771: 765: 764: 762: 761: 750: 741: 740: 704: 698: 697: 679: 655: 644: 643: 633: 624:(6): 2007–2012. 609: 603: 602: 574: 568: 567: 565: 564: 550: 544: 543: 541: 539: 524: 518: 517: 515: 514: 508: 500: 297:Birbeck granules 157: 79:is an extremely 70: 69: 45: 19: 18: 2201: 2200: 2196: 2195: 2194: 2192: 2191: 2190: 2156: 2155: 2154: 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Index


Specialty
Oncology
Edit this on Wikidata
rare disease
abnormal multiplication
white blood cells
histiocytes
macrophages
Langerhans-cell
histiocytosis
World Health Organization
lipid
giant cells
lymphocytes
bone marrow
sclerosis
long bones
retroorbital
pituitary gland
Exophthalmos
pericardial effusion
Bone pain
Retroperitoneal fibrosis
Diabetes insipidus
Exophthalmos
Xanthomas
Neurological
central nervous system
Dyspnea

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