Thoracic spine Langerhans cell histiocytosis in a child with achondroplasia
| Autor: | Zoe Chan, Lesley A. Simpson, Pasquale Gallo |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Indomethacin 030105 genetics & heredity Conservative Treatment Thoracic Vertebrae Achondroplasia 03 medical and health sciences 0302 clinical medicine Langerhans cell histiocytosis Spinal cord compression medicine Humans Child Braces Unusual Presentation of More Common Disease/Injury business.industry Anti-Inflammatory Agents Non-Steroidal Soft tissue General Medicine medicine.disease Spinal cord Magnetic Resonance Imaging Osteopenia Histiocytosis Langerhans-Cell medicine.anatomical_structure Treatment Outcome Back Pain Prednisolone Neurosurgery Radiology business Tomography X-Ray Computed Spinal Cord Compression 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | BMJ Case Rep |
| ISSN: | 1757-790X |
| Popis: | Multifocal bone Langerhans cell histiocytosis (LCH) is usually treated with prednisolone and vinblastine. We present a case conservatively treated with indomethacin with good clinical and radiological response. A 7-year-old achondroplastic boy presented with worsening thoracic back pain and leg weakness. An admission MRI spine showed a pathological T1 vertebrae fracture with posterior soft tissue extension compressing and distorting the spinal cord. A CT guided biopsy revealed an LCH. Steroids were avoided to reduce osteopenia risk and further vertebral fragility. Considering the risk of a thoracic surgical approach in a child with this background, he was managed conservatively with indomethacin and a Sternal Occipital Mandibular Immobilizer (SOMI) Brace. Pain resolved completely within 6 months and the brace was discontinued. Serial follow-up scans showed progressive resolution of the pathological T1 fracture and complete resolution of the spinal cord compression. |
| Databáze: | OpenAIRE |
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