Childhood Langerhans cell histiocytosis increased during El Niño 1997-98: a report from the Taiwan Pediatric Oncology Group.
From 1995-1999, a nation-wide study of Langerhans cell histiocytosis (LCH) in children less than 15 years old was conducted by the Taiwan Pediatric Oncology Group. The demographic and clinical data of 55 cases were analyzed. Thirty-two cases presented from the beginning of 1997 to the end of 1998, when the most severe El Niño in the century occurred. The incidence was higher than expected during this El Niño period (32 cases versus 22 cases, p = 0.003). During 1997-98, most LCH was diagnosed in summer (n = 15), autumn (n = 8), and winter (n = 8) but rarely in spring (n = 1); coincidentally, rainfall was least in winter but peaked in summer. During 1997-98, the most significant increase occurred in the polyostotic LCH subcategory (p = 0.017), with younger ages at diagnosis (p = 0.039). The incidence of LCH cytopenia, fever, and diseases of the skin, liver, spleen or other organs did not differ significantly. Local treatment modality, disseminated diseases and diagnosis during the El Niño of 1997-98 were independent risk factors predicting the recurrence or progression of LCH. Our findings suggest that particular infections or other environmental factors associated with El Niño might be related to the etiology of childhood LCH.
Chen
Rong-Long
RL
Buddhist Tzu-Chi General Hospital, Tzu-Chi University, Taiwan. rongchen@mail.tcu.edu.tw
Lin
Kuo-Sin
KS
Chang
Wan-Hui
WH
Hsieh
Yuh-Lin
YL
Chen
Bow-Wen
BW
Jaing
Tang-Her
TH
Yang
Chao-Ping
CP
Hung
Iou-Jih
IJ
Peng
Ching-Tien
CT
Shu
San-Ging
SG
Lu
Meng-Yao
MY
Jou
Sheng-Tang
ST
Lin
Kai-Hsin
KH
Lin
Dong-Tsamn
DT
Lin
Ming-Tsan
MT
Chen
Jiann-Shiuh
JS
Liu
His-Che
HC
Chen
Shu-Huey
SH
Liang
Der-Cherng
DC
Chiou
Shyh-Shin
SS
Chang
Tai-Tsung
TT
Sheen
Jiunn-Ming
JM
Hsiao
Chih-Cheng
CC
Cheng
Shin-Nan
SN
Lin
Jung-Chung
JC
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002980:Climate; D005260:Female; D006646:Histiocytosis, Langerhans-Cell / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012621:Seasons; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors