American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: Editor-in-chief: Samy, I. McFarlane
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American Journal of Medical Case Reports. 2016, 4(8), 293-295
DOI: 10.12691/ajmcr-4-8-9
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Histiocytosis with Pulmonary Involvement Mimicking Rheumatoid Arthritis

Imene Boukhris1, , Hana Zoubaidi1, Ines kechaou1, Eya Chérif1, Ines mahmoud2, Anis Hariz1, Nédia Znaidi3 and Narjes Khalfallah1

1Internal Medicine Department, University Hospital of Charles Nicolle, Tunis, Tunisia

2Rheumatology Department, University Hospital of Charles Nicolle, Tunis, Tunisia

3Department of Diagnostic Pathology, University Hospital of Charles Nicolle, Tunis, Tunisia

Pub. Date: September 14, 2016

Cite this paper:
Imene Boukhris, Hana Zoubaidi, Ines kechaou, Eya Chérif, Ines mahmoud, Anis Hariz, Nédia Znaidi and Narjes Khalfallah. Histiocytosis with Pulmonary Involvement Mimicking Rheumatoid Arthritis. American Journal of Medical Case Reports. 2016; 4(8):293-295. doi: 10.12691/ajmcr-4-8-9


In Langerhans cell histiocytosis pulmonary involvement is often isolated. It is rarely a part of a multifocal form. Tenosynovitis is exceptional. Hand bones involvement is atypical. We report the case of a 75-year-old, non-smoker man, without medical history, who presented with arthritis and fever. Examination found arthritis affecting large and small joints. In biology, there was an inflammatory syndrome. Radiographs of the hands showed erosions of the carpal bones. Doppler ultrasonography of the hands showed active synovitis. Tc99 bone scintigraphy highlighted joint uptake in the hands, knees, spine and right upper jaw. Blood cultures and infectious investigations were negative. Anti-nuclear antibodies and rheumatoid factor were negatives. CT scan showed cystic lung lesions and nodular aspect. Bronchoalveolar lavage fluid revealed positivity of anti-CD1a at 6%. A surgical biopsy showed an infiltrate of eosinophilic cells, positive for CD1a in immunohistochemistry studies. The diagnosis of Langerhans cell histiocytosis was retained.

langerhans cell histiocytosis lung arthritis synovitis bronchoalveolar lavage

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