title: Langerhans cell histiocytosis of the digestive tract identified on an upper gastrointestinal examination.
abstract: Langerhans cell histiocytosis (LCH) with involvement of the gastrointestinal tract is rare and typically identified in patients with systemic disease. We describe a 16-month-old girl who initially presented with bilious vomiting, failure to thrive and a rash. An upper gastrointestinal (GI) examination revealed loss of normal mucosal fold pattern and luminal narrowing within the duodenum, prompting endoscopic biopsy. Langerhans cell histiocytosis of the digestive tract was confirmed by histopathology. A skeletal survey and skin biopsy identified other systemic lesions. Although uncommon, it is important to consider LCH in the differential diagnosis for gastrointestinal symptoms of unclear origin, especially when seen with concurrent rash. Findings of gastrointestinal involvement on upper GI examination include loss of normal mucosal fold pattern and luminal narrowing in the few published case reports.
authors.affiliation: Department of Radiology, Medical College of Wisconsin, Children's Hospital of Wisconsin, P.O. Box 1997, MS 721, Milwaukee, WI, 53211-1997, USA.|Department of Radiology, St. Luke's Hospital, St. Louis, MO, USA.
authors.forename: Markus
authors.initials: M
authors.lastname: Zei
authors.affiliation: Department of Radiology, Medical College of Wisconsin, Children's Hospital of Wisconsin, P.O. Box 1997, MS 721, Milwaukee, WI, 53211-1997, USA. arthurbmeyers@yahoo.com.
authors.forename: Arthur B
authors.initials: AB
authors.lastname: Meyers
authors.affiliation: Department of Radiology, Medical College of Wisconsin, Children's Hospital of Wisconsin, P.O. Box 1997, MS 721, Milwaukee, WI, 53211-1997, USA.
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Boyd
authors.affiliation: Department of Pediatric Gastroenterology, Medical College of Wisconsin, Milwaukee, WI, USA.|Department of Pediatrics, University of Minnesota, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Larson-Nath
authors.affiliation: Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Mariko
authors.initials: M
authors.lastname: Suchi
mesh_terms: D001706:Biopsy; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000473:pathology; D006646:Histiocytosis, Langerhans-Cell / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007223:Infant
keywords: Adolescent; Duodenum; Gastrointestinal tract; Langerhans cell histiocytosis; Upper GI examination