The histiocytosis Erdheim-Chester disease is an inflammatory myeloid neoplasm

被引:29
作者
Haroche, Julien [1 ,2 ,3 ]
Cohen-Aubart, Fleur [1 ,2 ,3 ]
Charlotte, Frederic [3 ,4 ]
Maksud, Philippe [3 ,5 ]
Grenier, Philippe A. [3 ,6 ]
Cluzel, Philippe [3 ,6 ]
Mathian, Alexis [1 ,2 ,3 ]
Emile, Jean-Francois [7 ,8 ]
Amoura, Zahir [1 ,2 ,3 ]
机构
[1] Hop La Pitie Salpetriere, AP HP, Dept Internal Med, Paris, France
[2] Hop La Pitie Salpetriere, AP HP, French Reference Ctr Rare Autoimmune & System Dis, Paris, France
[3] Univ Paris 06, Paris, France
[4] Hop La Pitie Salpetriere, AP HP, Dept Anatomopathol, Paris, France
[5] Hop La Pitie Salpetriere, AP HP, Dept Nucl Med, Paris, France
[6] Hop La Pitie Salpetriere, AP HP, Dept Radiol, Paris, France
[7] Univ Versailles, Boulogne, France
[8] Hop Ambroise Pare, AP HP, Boulogne, France
关键词
BRAF; Erdheim-Chester disease; histiocytosis; interferon alpha; Langerhans-cell histiocytosis; NRAS; PIK3CA; vemurafenib; LANGERHANS-CELL HISTIOCYTOSIS; IMATINIB MESYLATE; INTERFERON-ALPHA; BRAF MUTATIONS; INVOLVEMENT; MANIFESTATIONS; VEMURAFENIB; DIAGNOSIS; EFFICACY; PATIENT;
D O I
10.1586/1744666X.2015.1060857
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Erdheim-Chester disease (ECD) is a rare, non-Langerhans histiocytosis, characterized by the infiltration of tissues by foamy CD68(+) CD1a(-) histiocytes. 99 Technetium bone scintigraphy revealing almost constant tracer uptake by the long bones is highly suggestive of ECD, and a 'hairy kidney' appearance on abdominal computed tomography scan is observed in about half of all ECD cases. CNS involvement is a strong prognostic factor and independent predictor of death. IFN-alpha seems to be the best initial treatment for ECD. More than half of all ECD patients carry the BRAF(V600E) mutation. More than 30 patients worldwide harboring this mutation and displaying multisystemic, refractory ECD have been treated with vemurafenib, a BRAF inhibitor, which has proven highly beneficial. Other recurrent mutations of the MAPK and PIK3 pathways (NRAS, PIK3CA) have recently been described. These mutations should lead to a new classification of histiocytic disorders such that Langerhans cell histiocytosis and ECD are classified as inflammatory myeloid neoplasms.
引用
收藏
页码:1033 / 1042
页数:10
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