Oral and systemic changes in Langerhans Cell Histiocytosis in a pediatric patient: Case report

Authors

DOI:

https://doi.org/10.33448/rsd-v10i4.14456

Keywords:

Langerhans Cell Histiocytosis; Chidrens; Oral Pathology; Pediatric dentistry.

Abstract

Langerhans Cell Histiocytosis (LCH) is a disorder associated with the proliferation of Langerhans cells. Due to its infiltrative nature, LCH can involve organs such as the skin, the ganglia, the lung and the liver. It is estimated that its incidence is approximately 5 to 10 cases in a million per year, mainly in children under 15 years old, with a predominance in males, in the proportion of 2: 1 and its pathogenesis remains unknown. The objective of this study was to describe the systemic and oral manifestations of LCH in a child, highlighting the importance of the dental surgeon in the early diagnosis of oral lesions in primary care. For the description of the clinical case, the information was obtained by consulting the patient's medical record at Hospital University Onofre Lopes - HUOL. Male patient, 4 months old, presented lesions in the oral cavity in the lower, upper alveolar ridge and hard palate, exophytic formed by erythroplastic and leukoplastic regions not removed during scraping, with abdominal distension, normotensive fontanelle, presence of parietal cephalic “nodule”, jaundice, choluria, fecal hypocholia and hyperemic genitals. We concluded that the child had a clinical condition compatible with LCH. This work also showed the importance of the dentist, especially in Primary Health Care, for the correct diagnosis of systemic diseases, with oral manifestations, as well as his responsibility in ordering care in the search for comprehensive care.

References

Anniballi, S., Cristalli, M. P., Solidane, M., Ciavarella, D., La Monaca, G., Suriano, M. M., Lo Muzio, L. & Lo Russo, L. (2009). Langerhans cell histiocytosis: oral/periodontal involvement in adult patients. Oral Dis.; 15: 596-601

Aricò, M., Clementi, R., Caselli, D. & Danesino, C. (2003). Histiocyte disorders. Hematol J. 2003;4(3):171-9.

Aruna, D., Pushpalatha, G., Galgali, S. & Prashanthy. (2011). Langerhans cell histiocytosis. J Indian Soc Periodontol.; 15(3): 276–279

Fistarol S., Itin, P., Häusermann, P., Oberholzer, M., Raineri, I., Lambrecht, T. & Lindenmüller, I. H. (2009). Unifocal Langerhans cell histiocytosis of the oral mucosa. J Dtsch Dermatol Ges. 7: 620 e 622.

Gey, T., Bergoin, C., Paupard, T., Cazals-Hatem, D. & Xuan, K. H. (2004). Langerhans cell histiocytosis and sclerosing cholangitis in adults. Rev Mal Respir. 21:997-1000.

Goodman, W. T & Barret, T. L. (2003) Histiocytoses. In: Bolognia, J. L., Jorizzo, J. L. & Rapini, R. P., editors. Dermatology. Philadelfia: Mosby; p.1429-33

Guthery, S. L. & Heubi, J. E. (2001). Liver involvement in childhood histiocytic syndromes. Current Opinion in Gastroenterology. 17:474–78.

Haupt, R., Minkov, M., Astigarraga, I., Shäfer, E., Nanduri, V., Jubran, R., Egeler, R. M., Janka, G., Micic, D., Rodrigues-Galindo, C., Gool, S. V., Visser, J., Weitzman, S. & Donadieu, J. (2013). Langerhans cell histiocytosis (LCH): guidelines for diagnosis, clinical work-up, and treatment for patients till the age of 18 years. Pediatr Blood Cancer. 60(2):175-84.

Kapoor, R., Loizedes, A. M., Sascdeva, S. & Paul, P. (2015). Disseminated Langerhans Cell Histiocytosis Presenting as Cholestatic Jaundice. Journal of Clinical and Diagnostic Research., Vol-9(2): SD03-SD05.

Kilborn, T. N., The, J. & Goodman, T. R. (2003). Paediatric Manifestations of Langerhans Cell Histiocytosis: a Review of the Clinical and Radiological Findings. Clinical Radiology. 58, 269–278.

Liu, D. G., Zhang, Y. & Li, F. (2012). Multisystem Langerhans cell histiocytosis with liver dysfunction as the first presentation: A case report. Oncol Lett.; 3(2):391-94. Epub 2011 Oct 26.

Magno, J. C. C., D’Almeida, D. G., Magalhães, V. J. P., Araújo, M. L., Miranda, C. B. & Nagel, J. (2007). Histiocitose de Células de Langerhans em Margem Anal: Relato de Caso e Revisão da Literatura. Rev Bras Coloproct. 27:83-8.

Murray, M., Dean, J. & Slater, L. (2011). Multifocal oral Langerhans cell histiocytosis. J Oral Maxillofac Surg. 2011;69:2585-91.

Neville, Brad W. (2016). Patologia Oral e Maxilofacial. Trad.4a Ed., Rio de Janeiro: Elsevier, 824p.

Pereda-Martínez-Madrigal, C., Rodríguez-Guerrero, V., Moya-Guisado, B. & García-Meniz, C. (2009). Langerhans cell histiocytosis: literature review and descriptive analysis of oral manifestations. Med Oral Patol Oral Cir Bucal. 2009; 4:222-8.

Postini, A. M., Prever, A. B., Pagano, M., Rivetti, E., Berger, M., Asaftei, S. D., Barat, V., Andreacchio, A. & Fagioli F. (2012). Langerhans cell histiocytosis: 40 years’ experience. J Pediatr Hematol Oncol. 2012 Jul;34(5):353-8

Ribeiro, B. B., Guerra, L. M., Galhardi, W. M. P. & Cortellazzi, K. L. (2012). Importância do reconhecimento das manifestações bucais de doenças e de condições sistêmicas pelos profissionais de saúde com atribuição de diagnóstico. Odonto. 20(39): 61-70.

Savasan, Süreyya. (2006). An enigmatic disease: childhood Langerhans cell histiocytosis in 2005. Int J Dermatol. 45:182-8.

Schmidt, S., Eich, G., Hanquinet, S., Tschäppeler, H. Waibel, P. & Gudinchet, F. (2004). Extraosseous involvement of Langerhans’ cell histiocytosis in children. Pediatr Radiol. 34:313-321.

Vieira, A. G.; Guedes, L. S. & Azulay, D. R. (2004). Histiocitoses. In: Azulay RD, Azulay DR, editors. Dermatologia. 3 ed. Rio de Janeiro: Guanabara Koogan; p.355-6.

Published

18/04/2021

How to Cite

CABRAL, C. de L.; SOUZA, N. L. I. de .; CUNHA, R. D. da .; SOARES, A. L. F. de H. . Oral and systemic changes in Langerhans Cell Histiocytosis in a pediatric patient: Case report. Research, Society and Development, [S. l.], v. 10, n. 4, p. e48210414456, 2021. DOI: 10.33448/rsd-v10i4.14456. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/14456. Acesso em: 8 may. 2021.

Issue

Section

Health Sciences