Langerhans cell histiocytosis case with dense metaphyseal band sign.

Abstract

Eosinophilic granuloma, a type of Langerhans cell histiocytosis, exhibits a classic vertebral collapse, which is called vertebra plana (Calve's disease) and it manifests as a solitary bony lesion. Vertebra plana can cause severe pain in patients. Bisphosphonates (clodronate, pamidronate and zoledronic acid) have been recently used to treat osteolytic bone lesions of LCH. Zoledronic acid has 100 times relative potency that of pamidronate. We report a case of a 10-year-old girl who had zoledronic acid treatment for severe back pain due to vertebra plana. X-ray photographs of the patient's body showed dense metaphyseal band sign, which can be found in lead poisoning, treated leukemia, healing rickets, recovery from scurvy, vitamin D hypervitaminosis, congenital hypothyroidism and hypoparathyroidism. Increased biological potent zoledronic acid deprived her of severe back pain due to vertebra plana and might cause dense metaphyseal band sign of her skeleton. Conclusion; We have cured the severe back pain of a 10-year-old girl case of eosinophilic granuloma with zoledronic acid. After that treatment, X-ray photographs of the patient's body showed dense metaphyseal band sign. There have been few such cases reported until now.

• Authors: Ichiro Kikkawa, Toshinori Aihara, Akira Morimoto, Hideaki Watanabe, Rieko Furukawa
• Journal: Pediatrics international : official journal of the Japan Pediatric Society (Pediatr Int) Vol. 55 Issue 1 Pg. 96-8 (Feb 2013) ISSN: 1442-200X [Electronic] Australia
• PMID: 23409985 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

Chemical References

• Bone Density Conservation Agents
• Diphosphonates
• Imidazoles
• Zoledronic Acid

Topics

• Bone Density Conservation Agents (adverse effects, therapeutic use)
• Child
• Diphosphonates (adverse effects, therapeutic use)
• Female
• Histiocytosis, Langerhans-Cell (complications)
• Humans
• Imidazoles (adverse effects, therapeutic use)
• Knee Joint (diagnostic imaging, drug effects)
• Radiography
• Spinal Diseases (diagnostic imaging, drug therapy, etiology)
• Thoracic Vertebrae (diagnostic imaging)
• Zoledronic Acid