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Multicentric reticulohistiocytosis: systemic macrophage disorder

Identifieur interne : 002F66 ( Main/Exploration ); précédent : 002F65; suivant : 002F67

Multicentric reticulohistiocytosis: systemic macrophage disorder

Auteurs : David A. Campbell ; N. Lawrence Edwards

Source :

RBID : ISTEX:5F1F2DFB8C1A0ACFFC3112B5B9CA346D3AA4C4E9

English descriptors

Abstract

Summary: Multicentric reticulohistiocytosis is a rare multisystem disorder that reflects a reactive inflammatory response to an undetermined stimulus. While the disease is characterized as a dermatoarthritis, multiple organ systems including cardiac and skeletal muscle, the pleura and gastrointestinal tract have been involved in reported cases. The synovitis can be quite destructive with arthritis mutilans developing in a substantial percentage. The dermatitis may be particularly disfiguring when the face is involved.This chapter describes the clinical and laboratory features of the 33 cases of MRH previously reviewed by Barrow and Holubar and an additional 33 cases that have appeared in the medical literature since that report. We note an apparent decline in frequency of some manifestations of MRH. This may be due in part to the nature of the recent reports which often present a brief clinical report and focus primarily on specific disease associations, unusual manifestations, new organ system involvement or treatment regimens.The primary cell involved in the reactive inflammatory response of MRH is the phagocytic tissue histiocyte (macrophage). While uncontrolled proliferation of these reticulohistiocytes is seen in several infectious and malignant conditions there is presently no direct evidence of a particular organism or neoplasm involved in the aetiopathogenesis of MRH. There is evidence of tuberculosis exposure in one third of cases with active tuberculosis present in 5%. Likewise, malignancies are reported concomitantly with MRH in 15–28% of cases.The therapeutic trend in MRH is to treat early and aggressively to prevent the devastating arthropathy and disfiguring cutaneous sequelae. This recommendation, however, is largely based on anecdotal reports and thus the physician encountering a case of MRH needs to proceed with circumspection.

Url:
DOI: 10.1016/S0950-3579(05)80285-7


Affiliations:


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<term>Alkylating agents</term>
<term>American academy</term>
<term>American journal</term>
<term>Archives</term>
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<term>Arthritis mutilans</term>
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<term>Barrow holubar</term>
<term>Bone formation</term>
<term>Case reports</term>
<term>Chronic gout</term>
<term>Clinical pathology</term>
<term>Collagen bundles</term>
<term>Collagen phagocytosis</term>
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<term>Cutaneous lesions</term>
<term>Cytotoxic</term>
<term>Cytotoxic agent</term>
<term>Cytotoxic agents</term>
<term>Dermatology</term>
<term>Differential diagnosis</term>
<term>Disease activity</term>
<term>Edwards table</term>
<term>Electron microscopy</term>
<term>English language literature</term>
<term>Erosive</term>
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<term>Erosive osteoarthritis</term>
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<term>Foreign body type</term>
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<term>Golgi apparatus</term>
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<term>Gout</term>
<term>Granular cytoplasm</term>
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<term>Granuloma</term>
<term>Great britain</term>
<term>Hand deformity</term>
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<term>Histiocytic disorders</term>
<term>Histiocytosis</term>
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<term>Larger nodules</term>
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<term>Multicentric reticulohistiocytosis</term>
<term>Multinucleated</term>
<term>Multisystem disorder</term>
<term>Mutilans</term>
<term>Nodule</term>
<term>Nuclear medicine</term>
<term>Pathological features</term>
<term>Primary biliary cirrhosis</term>
<term>Prominent nucleoli</term>
<term>Psoriatic arthritis</term>
<term>Radiographic appearance</term>
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<term>Reticulohistiocytosis</term>
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<term>Skin nodules</term>
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<div type="abstract" xml:lang="en">Summary: Multicentric reticulohistiocytosis is a rare multisystem disorder that reflects a reactive inflammatory response to an undetermined stimulus. While the disease is characterized as a dermatoarthritis, multiple organ systems including cardiac and skeletal muscle, the pleura and gastrointestinal tract have been involved in reported cases. The synovitis can be quite destructive with arthritis mutilans developing in a substantial percentage. The dermatitis may be particularly disfiguring when the face is involved.This chapter describes the clinical and laboratory features of the 33 cases of MRH previously reviewed by Barrow and Holubar and an additional 33 cases that have appeared in the medical literature since that report. We note an apparent decline in frequency of some manifestations of MRH. This may be due in part to the nature of the recent reports which often present a brief clinical report and focus primarily on specific disease associations, unusual manifestations, new organ system involvement or treatment regimens.The primary cell involved in the reactive inflammatory response of MRH is the phagocytic tissue histiocyte (macrophage). While uncontrolled proliferation of these reticulohistiocytes is seen in several infectious and malignant conditions there is presently no direct evidence of a particular organism or neoplasm involved in the aetiopathogenesis of MRH. There is evidence of tuberculosis exposure in one third of cases with active tuberculosis present in 5%. Likewise, malignancies are reported concomitantly with MRH in 15–28% of cases.The therapeutic trend in MRH is to treat early and aggressively to prevent the devastating arthropathy and disfiguring cutaneous sequelae. This recommendation, however, is largely based on anecdotal reports and thus the physician encountering a case of MRH needs to proceed with circumspection.</div>
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