[Granulomatous histiocytosis in a 70-year-old woman, revealed by prolonged fever ; osseous lesions in the femur and tibia were associated with diabetes insipidus and hypernatremia (author's transl)].
The different patterns of histiocytosis X are usually classified into three forms according to their clinical and pathological expression. One form is acute and disseminated ; the two others are chronic, unifocal or multifocal. Borderline cases and intermediate forms can be seen. For instance, onset can be acute or subacute in chronic disseminated forms, such as Hand-Schüller-Christian disease ; acute or subacute exacerbations may occur during the course of the disease. We report an observation of this type which is remarkable for three reasons. Fever was the initial manifestation and remained apparently isolated for one year. Subsequent osseous involvement was limited to the femur and tibia. Hypernatremia developed as a result of both diabetes insipidus and disrupted thirst control. These unusual features of our case-report led us to review previously published data.
D000368:Aged; D001847:Bone Diseases / Q000209:etiology*; D003919:Diabetes Insipidus / Q000209:etiology*; D005260:Female; D005269:Femur; D005334:Fever / Q000209:etiology*; D006646:Histiocytosis, Langerhans-Cell / Q000150:complications*; D006801:Humans; D006955:Hypernatremia / Q000209:etiology*; D013977:Tibia; D013997:Time Factors
Fièvre au long cours chez une femme de soixante-dix ans révélant une histiocytose granulomateuse associant lésion osseuse fémoro-tibiale et diabète insipide avec hypernatrémie.