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Multicentric reticulohistocytosis (MRH), a rare condition, can mimic autoimmune diseases like dermatomyositis. This case highlights ultrasound

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Area of Science:

  • Rheumatology
  • Dermatology
  • Oncology

Background:

  • Multicentric reticulohistocytosis (MRH) is a rare systemic non-Langerhans cell histiocytosis.
  • MRH presents with destructive polyarthritis and skin nodules, often linked to malignancy.
  • Distinguishing MRH from autoimmune conditions like dermatomyositis can be challenging.

Purpose of the Study:

  • To present a case of MRH initially misdiagnosed as dermatomyositis.
  • To illustrate the diagnostic utility of ultrasonography in MRH.
  • To emphasize the importance of considering MRH in patients with polyarthritis and skin lesions, especially when malignancy is suspected.

Main Methods:

  • Case report of a 74-year-old Japanese man.
  • Clinical presentation, laboratory findings, and histopathological analysis.
  • Malignancy screening including ultrasonography and imaging.
  • Diagnostic comparison with autoimmune diseases.

Main Results:

  • The patient initially presented with symptoms suggestive of dermatomyositis.
  • Invasive bladder cancer was diagnosed and treated.
  • Despite treatment, persistent joint destruction confirmed MRH.
  • Ultrasonography revealed significant joint inflammation and tendon involvement.

Conclusions:

  • MRH poses a diagnostic challenge, often mimicking autoimmune polyarthritis.
  • Early detection of associated malignancy is crucial.
  • Ultrasonography is a valuable tool for assessing joint and tendon involvement in MRH.
  • Prompt diagnosis and management are essential to prevent irreversible joint damage.