Spontaneous transient remission of disseminated histiocytosis X during pregnancy.
Disseminated histiocytosis X with cutaneous and lymph node involvement was diagnosed in a 25-year-old women. The diagnosis was established on the basis of a positive cell-surface staining with OKT 6 and typical signs on electron microscopy. Both the specific skin rash and lymph node swelling completely disappeared during pregnancy, but recurred 2 weeks before delivery. Therapeutic trials with 0.25 mg ethinylestradiol/day and a later application of human chorionic gonadotropin up to 5000 IU i.m. twice weekly as well as prednisolone 25 mg three times per day were unsuccessful. A second pregnancy was not desired. Polychemotherapy with initial high-dose prednisolone plus vincristine and a consolidation therapy with 5-mercaptopurine 300 mg/day led to full recovery. The observation of transient remission of histiocytosis X during pregnancy suggests that at least some forms of this disease may have prevailing immunological features where an immunosuppressive effect of pregnancy could be beneficial.
Department of Internal Medicine I, University Hospital Ulm, Germany.
W A
WA
Scherbaum
F J
FJ
Seif
D000328:Adult; D005260:Female; D006646:Histiocytosis, Langerhans-Cell / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D012075:Remission, Spontaneous