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Erdheim-Chester disease: an unusual presentation of an uncommon disease.
[erdheim-chester disease]
Erdheim-
Chester
disease
(
ECD
)
is
a
rare
,
non-
Langerhans
cell
histiocytosis
with
classic
radiographic
findings
of
patchy
or
diffuse
osteosclerosis
predominantly
involving
the
long
bones
in
a
bilaterally
symmetrical
pattern
.
A
49
-
year
-old
woman
presented
with
diffuse
lymphadenopathy
,
painful
skin
lesions
,
and
constitutional
symptoms
.
Recent
history
was
significant
for
a
nontraumatic
fracture
of
the
tibia
3
weeks
prior
to
admission
.
Physical
examination
and
laboratory
studies
were
notable
for
lower
extremity
pain
and
swelling
,
nodular
lesions
on
the
skin
,
and
normocytic
,
normochromic
anemia
.
Plain
radiographs
showed
a
lytic
pattern
of
destruction
with
a
superimposed
fracture
in
the
left
proximal
tibia
.
MRI
showed
focal
bone
marrow
replacement
extending
from
the
subchondral
bone
to
the
tibial
diaphysis
.
Excisional
lymph
node
and
skin
biopsies
of
the
lesions
demonstrated
a
CD-
68
positive
,
S-
100
variable
,
and
CD
1
a-negative
histiocytic
cell
proliferation
filling
the
dermis
and
completely
replacing
the
sampled
lymph
node
with
an
accompanying
chronic
inflammatory
infiltrate
and
fibrosis
,
pathognomonic
for
ECD
.
We
report
an
unusual
case
of
ECD
presenting
initially
as
diffuse
,
painful
lymphadenopathy
,
and
subsequently
demonstrating
a
lytic
lesion
of
the
tibia
underlying
a
nontraumatic
fracture
.
Diseases
Validation
Diseases presenting
"pain"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
aniridia
aromatase deficiency
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital diaphragmatic hernia
congenital toxoplasmosis
cushing syndrome
cutaneous mastocytosis
cystinuria
dedifferentiated liposarcoma
dentin dysplasia
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
familial mediterranean fever
focal myositis
hirschsprung disease
hodgkin lymphoma, classical
holt-oram syndrome
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
malignant atrophic papulosis
neuralgic amyotrophy
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
pleomorphic liposarcoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
scrub typhus
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
trochlear dysplasia
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
wolf-hirschhorn syndrome
This symptom has already been validated