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Multicentric reticulohistiocytosis.

Y C Giam1, B H Ong

  • 1Middle Road Hospital, Singapore.

Annals of the Academy of Medicine, Singapore
|October 1, 1988
PubMed
Summary

This report details the first diagnosed case of multicentric reticulohistiocytosis, a benign histiocytic disorder, presenting without arthritis. Methotrexate treatment proved ineffective for this rare condition.

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Area of Science:

  • Dermatology
  • Rheumatology
  • Pathology

Background:

  • Multicentric reticulohistiocytosis (MCHR) is a rare, benign proliferative histiocytic disorder.
  • Characterized by a distinctive triad of dermatoarthritis, extensive red nodules, and rheumatoid-like arthritis.
  • Histological features include multinucleated giant cells with ground-glass cytoplasm and mononuclear histiocytes in granulomatous infiltrates.

Observation:

  • First reported case of MCHR diagnosed at Middle Road Hospital in 1987.
  • Patient presented with multiple reddish-brown papules and nodules.
  • Crucially, the patient exhibited no signs of arthritis at presentation.

Findings:

  • Systemic review excluded any associated malignancies.
  • Treatment with methotrexate was administered but yielded no therapeutic benefit.
  • The granulomatous infiltrate extended beyond the skin and synovium to involve other tissues.

Implications:

  • Highlights the varied clinical presentation of MCHR, which may not always include arthritis.
  • Underscores the importance of histological diagnosis for this rare histiocytic disorder.
  • Suggests that methotrexate may not be an effective treatment for MCHR, necessitating exploration of alternative therapies.

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