[Clinical significance and relationship between traditional classification and Lavin-Osband criteria in Langerhans cell histiocytosis].
OBJECTIVE
To analyze the relationship between traditional classification and Lavin-Osband criteria on Langerhans cell histiocytosis (LCH) and to evaluate the importance of the criteria in clinical management and long-term prognosis of Lavin-Osband criteria.


METHODS
From 1992 to 2003, 25 cases of LCH were studied. All cases were divided into four types by traditional classification and graded according to Lavin-Osband criteria simultaneously. All patients were analyzed with clinical manifestation, laboratory test, diagnoses, treatment and prognosis. The case numbers distributed in different Lavin-Osband criteria were summed up, and the advantage of the criteria was analyzed.


RESULTS
The clinical manifestations according to the traditional classification (four types) overlapped mostly. The age of onset of the disease, the number of involved organs and the function of organs were all considered in the Lavin-Osband criteria, which also contained the characters of the traditional classification and could classify the cases into different severities. So Lavin-Osband criteria could predict the outcome of LCH. According to the traditional classification there were 10 cases with type I LCH, which was all graded to the criteria III and IV (100%), and there were 8 (80%) of criteria IV and none of criteria I and II. The situation was called "low type high criteria". There were 6 cases belong to LCH-II, of them 3 (50%) graded to the criteria III and 1 to the other criteria (17%), respectively. There were 4 cases with LCH-III, of them 3 (75%) graded to the criteria I and II, 1 (25%) to the criteria III and none to the criteria IV. There were 5 cases with LCH-IV, of them 4 (80%) graded to the criteria I and II, 1 (20%) to the criteria III and none to the criteria IV. This situation was called "high type low criteria".


CONCLUSIONS
The Lavin-Osband criteria seemed to be simple, clear and easy to be handled and related to the severity of the disease, which will simplify the diagnoses, help the early-treatment and judge the prognosis.
Department of Internal Medicine, The Capital Insititute of Pediatrics, Beijing 100020, China.
Li-juan
LJ
Ma
Xiao-dong
XD
Shi
Tian-you
TY
Wang
Jing
J
Chen
Rong
R
Liu
D002675:Child, Preschool; D005260:Female; D006646:Histiocytosis, Langerhans-Cell / Q000145:classification* / Q000473:pathology*; D006801:Humans; D007223:Infant; D008297:Male; D011379:Prognosis; D012720:Severity of Illness Index