title: Multicentric reticulohistiocytosis (MRH): case report with review of literature between 1991 and 2014 with in depth analysis of various treatment regimens and outcomes.
abstract: Multicentric reticulohistiocytosis is a rare disease affecting skin and joints primarily and rarely other organs. We present a case report of this disease and an extensive review of the literature. We reviewed the data between 1991 and 2014 and extracted 52 individual cases. Only articles in English were chosen after checking for relevance. The articles were studies and data was extracted into excel spread sheets and later used to compute such variables like frequency, mean and percentage of distribution of various clinical manifestations. The treatments used in these articles were critically analyzed and graded for their relative efficacy for skin and joint manifestations. The grades were 0 = worse, 1 = no benefit/condition remained same, 2 = improvement without resolution, and 3 = resolution. This article also reports the demographic, clinical, laboratory and pathological data from the reviewed articles. Authors attempted to discuss the findings of this review in depth to help manage this condition and proposed a treatment algorithm to help clinicians approach this rare and challenging disease.
authors.affiliation: Division of Rheumatology, Department of Medicine, Indiana University School of Medicine, 1120 West Michigan Street, Room CL 370, Indianapolis, IN 46202 USA.
authors.forename: Saad
authors.initials: S
authors.lastname: Tariq
authors.affiliation: Division of Rheumatology, Department of Medicine, Indiana University School of Medicine, 1120 West Michigan Street, Room CL 370, Indianapolis, IN 46202 USA.
authors.forename: Steven T
authors.initials: ST
authors.lastname: Hugenberg
authors.affiliation: Dermatopathology Division, Department of Pathology, Indiana School of Medicine, Indianapolis, IN USA.
authors.forename: Stefanie A
authors.initials: SA
authors.lastname: Hirano-Ali
authors.affiliation: Department of Histopathology, AFIP (Armed Forces Institute of Pathology) , Rawalpindi, Pakistan.
authors.forename: Hassan
authors.initials: H
authors.lastname: Tariq
keywords: Arthritis; Autoimmune disease; Immunosuppressive medications; Skin disease