Langerhans cell histiocytosis laboratory tests: Difference between revisions
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{{Langerhans cell histiocytosis}} | {{Langerhans cell histiocytosis}} | ||
{{CMG}} | {{CMG}} {{AE}} {{HL}} | ||
==Overview== | ==Overview== | ||
Laboratory findings consistent with the diagnosis of Langerhans cell histiocytosis include abnormal [[complete blood count]], [[erythrocyte sedimentation rate]] (ESR), [[basic metabolic panel]], and [[immunohistochemistry]]. | |||
==Laboratory Findings== | ==Laboratory Findings== | ||
The following laboratory abnormalities may be found in patients suffering from Langerhans cells histiocytosis:<ref name="pmid25281259">{{cite journal| author=DiCaprio MR, Roberts TT| title=Diagnosis and Management of Langerhans Cell Histiocytosis. | journal=J Am Acad Orthop Surg | year= 2014 | volume= 22 | issue= 10 | pages= 643-652 | pmid=25281259 | doi=10.5435/JAAOS-22-10-643 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25281259 }} </ref><ref name="wiki">Langerhans cell histiocytosis. Wikipedia (2015) https://en.wikipedia.org/wiki/Langerhans_cell_histiocytosis Accessed on February, 2 2016</ref><ref name="radio">Langerhans cell histiocytosis. Radiopeadia (2015) http://radiopaedia.org/articles/langerhans-cell-histiocytosis Accessed on February, 3 2016</ref><ref name="PDQ">Langerhans Cell Histiocytosis Treatment (PDQ®): Health Professional Version. National Cancer Institute (2015) http://www.cancer.gov/types/langerhans/hp/langerhans-treatment-pdq Accessed on February, 3 2016</ref><ref name="pmid23109216">{{cite journal |vauthors=Haupt R, Minkov M, Astigarraga I, Schäfer E, Nanduri V, Jubran R, Egeler RM, Janka G, Micic D, Rodriguez-Galindo C, Van Gool S, Visser J, Weitzman S, Donadieu J |title=Langerhans cell histiocytosis (LCH): guidelines for diagnosis, clinical work-up, and treatment for patients till the age of 18 years |journal=Pediatr Blood Cancer |volume=60 |issue=2 |pages=175–84 |date=February 2013 |pmid=23109216 |pmc=4557042 |doi=10.1002/pbc.24367 |url=}}</ref> | |||
====Complete Blood Count==== | |||
* [[Anemia]] | |||
* | * [[Thrombocytopenia]] | ||
* Elevated [[erythrocyte sedimentation rate]] | |||
* Elevated [[CRP]] | |||
====Basic Metabolic Panel==== | |||
The following lab abnormalities may be seen on basal metabolic panel:<ref name="pmid29198444">{{cite journal |vauthors=Montefusco L, Harari S, Elia D, Rossi A, Specchia C, Torre O, Adda G, Arosio M |title=Endocrine and metabolic assessment in adults with Langerhans cell histiocytosis |journal=Eur. J. Intern. Med. |volume=51 |issue= |pages=61–67 |date=May 2018 |pmid=29198444 |doi=10.1016/j.ejim.2017.11.011 |url=}}</ref><ref name="pmid22740918">{{cite journal |vauthors=Liu DG, Zhang YX, Li F |title=Multisystem Langerhans cell histiocytosis with liver dysfunction as the first presentation: A case report |journal=Oncol Lett |volume=3 |issue=2 |pages=391–394 |date=February 2012 |pmid=22740918 |doi=10.3892/ol.2011.462 |url=}}</ref> | |||
* Elevated [[bilirubin]] concentration | |||
* Abnormal [[liver]] enzymes | |||
* Elevated [[alkaline phosphatase]] | |||
====Urinalysis==== | |||
* Low urine specific gravity (1.008) | |||
* Low specific gravity persisted during a water deprivation test | |||
* Urine osmolality and urine specific gravity normalize following desmopressin administration | |||
====Immunohistochemistry==== | |||
* On immunohistochemistry Langerhans cell histiocytosis is characterized by:<ref name="pmid27759703">{{cite journal |vauthors=Grace SA, Sutton AM, Armbrecht ES, Vidal CI, Rosman IS, Hurley MY |title=p53 Is a Helpful Marker in Distinguishing Langerhans Cell Histiocytosis From Langerhans Cell Hyperplasia |journal=Am J Dermatopathol |volume=39 |issue=10 |pages=726–730 |date=October 2017 |pmid=27759703 |doi=10.1097/DAD.0000000000000778 |url=}}</ref><ref name="pmid17527085">{{cite journal |vauthors=Sholl LM, Hornick JL, Pinkus JL, Pinkus GS, Padera RF |title=Immunohistochemical analysis of langerin in langerhans cell histiocytosis and pulmonary inflammatory and infectious diseases |journal=Am. J. Surg. Pathol. |volume=31 |issue=6 |pages=947–52 |date=June 2007 |pmid=17527085 |doi=10.1097/01.pas.0000249443.82971.bb |url=}}</ref> | |||
:* [[CD1a]] +ve | |||
:* S100 +ve | |||
:* CD207 (langerin) +ve | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]
Overview
Laboratory findings consistent with the diagnosis of Langerhans cell histiocytosis include abnormal complete blood count, erythrocyte sedimentation rate (ESR), basic metabolic panel, and immunohistochemistry.
Laboratory Findings
The following laboratory abnormalities may be found in patients suffering from Langerhans cells histiocytosis:[1][2][3][4][5]
Complete Blood Count
- Anemia
- Thrombocytopenia
- Elevated erythrocyte sedimentation rate
- Elevated CRP
Basic Metabolic Panel
The following lab abnormalities may be seen on basal metabolic panel:[6][7]
- Elevated bilirubin concentration
- Abnormal liver enzymes
- Elevated alkaline phosphatase
Urinalysis
- Low urine specific gravity (1.008)
- Low specific gravity persisted during a water deprivation test
- Urine osmolality and urine specific gravity normalize following desmopressin administration
Immunohistochemistry
- CD1a +ve
- S100 +ve
- CD207 (langerin) +ve
References
- ↑ DiCaprio MR, Roberts TT (2014). "Diagnosis and Management of Langerhans Cell Histiocytosis". J Am Acad Orthop Surg. 22 (10): 643–652. doi:10.5435/JAAOS-22-10-643. PMID 25281259.
- ↑ Langerhans cell histiocytosis. Wikipedia (2015) https://en.wikipedia.org/wiki/Langerhans_cell_histiocytosis Accessed on February, 2 2016
- ↑ Langerhans cell histiocytosis. Radiopeadia (2015) http://radiopaedia.org/articles/langerhans-cell-histiocytosis Accessed on February, 3 2016
- ↑ Langerhans Cell Histiocytosis Treatment (PDQ®): Health Professional Version. National Cancer Institute (2015) http://www.cancer.gov/types/langerhans/hp/langerhans-treatment-pdq Accessed on February, 3 2016
- ↑ Haupt R, Minkov M, Astigarraga I, Schäfer E, Nanduri V, Jubran R, Egeler RM, Janka G, Micic D, Rodriguez-Galindo C, Van Gool S, Visser J, Weitzman S, Donadieu J (February 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. doi:10.1002/pbc.24367. PMC 4557042. PMID 23109216.
- ↑ Montefusco L, Harari S, Elia D, Rossi A, Specchia C, Torre O, Adda G, Arosio M (May 2018). "Endocrine and metabolic assessment in adults with Langerhans cell histiocytosis". Eur. J. Intern. Med. 51: 61–67. doi:10.1016/j.ejim.2017.11.011. PMID 29198444.
- ↑ Liu DG, Zhang YX, Li F (February 2012). "Multisystem Langerhans cell histiocytosis with liver dysfunction as the first presentation: A case report". Oncol Lett. 3 (2): 391–394. doi:10.3892/ol.2011.462. PMID 22740918.
- ↑ Grace SA, Sutton AM, Armbrecht ES, Vidal CI, Rosman IS, Hurley MY (October 2017). "p53 Is a Helpful Marker in Distinguishing Langerhans Cell Histiocytosis From Langerhans Cell Hyperplasia". Am J Dermatopathol. 39 (10): 726–730. doi:10.1097/DAD.0000000000000778. PMID 27759703.
- ↑ Sholl LM, Hornick JL, Pinkus JL, Pinkus GS, Padera RF (June 2007). "Immunohistochemical analysis of langerin in langerhans cell histiocytosis and pulmonary inflammatory and infectious diseases". Am. J. Surg. Pathol. 31 (6): 947–52. doi:10.1097/01.pas.0000249443.82971.bb. PMID 17527085.