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Histiocytosis - Treatment

Alternative Names

Histiocytosis X; Langerhans cell histiocytosis; Eosinophilic granuloma; Pulmonary histiocytosis X; Nonlipid reticuloendotheliosis; Pulmonary Langerhans cell granulomatosis; Hand-Schuller-Christian disease; Letterer-Siwe disease

Treatment:

This disorder is treated with corticosteroids, which suppress immune function (including the dangerous cells). Smoking may worsen the response to treatment and should be stopped.

Children may be given other medications depending on their estimated outlook. Such medications may include:

  • Cyclophosphamide
  • Etoposide
  • Methotrexate
  • Vinblastine

Radiation therapy or surgery may also be used to treat bone lesions.

Other treatments may include:

  • Antibiotics to fight infections
  • Breathing support (with a breathing machine)
  • Hormone replacement therapy
  • Physical therapy
  • Special shampoos for scalp problems
  • Supportive care to relieve symptoms

Support Groups:

Histiocytosis Association of America -- www.histio.org

Expectations (prognosis):

Histiocytosis X affects many organs and can lead to death.

About half of those with pulmonary histiocytosis see improvement, while others eventually have permanent loss of lung function.

In very young patients, the outlook depends on the specific histiocytosis and severity of the disease. Some children can live a normal life with minimal disease involvement, while others may have a poor outcome. Young children, especially infants, are more likely to have body-wide symptoms that lead to death.

Complications:

Complications may include:

Children may also develop:

  • Anemia caused by spreading of the tumors to the bone marrow
  • Diabetes insipidus
  • Lung problems that lead to lung failure
  • Problems with the pituitary gland that lead to growth failure

Calling your health care provider:

Call your health care provider if you or your child have symptoms of this disorder. Go to the emergency room if shortness of breath or chest pain develop.

  • Reviewed last on: 4/30/2010
  • Todd Gersten, M.D., Hematology/Oncology, Palm Beach Cancer Institute, West Palm Beach, FL. Review provided by VeriMed Healthcare Network.Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Ladisch S. Histiocytosis syndromes of childhood. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 507.

Raghu G. Interstitial lung disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 92.

Lipton JM, Arceci RJ. Histiocytic Disorders. In: Hoffman R, Benz EJ, Shattil SS, et al, eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 52.

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