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[Cardiovascular involvement in Erdheim-Chester syndrome: clinical and therapeutic implications].
[erdheim-chester disease]
Erdheim-
Chester
disease
(
ECD
)
is
a
rare
form
of
non-
Langerhans
'
cell
histiocytosis
of
unknown
etiology
and
its
incidence
is
constantly
increasing
.
ECD
is
characterized
by
a
xantomatous
or
xanthogranulomatous
infiltration
of
various
tissues
by
foamy
histiocytes
surrounded
by
fibrosis
.
ECD
is
characterized
by
multi-organ
involvement
and
is
generally
associated
with
a
poor
prognosis
with
a
median
survival
of
32
months
after
diagnosis
.
Cardiovascular
involvement
concerns
mainly
the
thoraco-
abdominal
aorta
and
pericardium
.
Less
frequently
,
infiltration
affects
the
myocardial
tissue
,
especially
the
right
atrium
,
and
the
valvular
endocardium
.
Recently
,
the
involvement
of
the
vena
cava
has
also
been
described
.
The
diagnosis
of
ECD
is
made
by
the
identification
of
foamy
histiocytes
CD
68
positive
and
CD
1
a
/
S
100
negative
embedded
in
a
polymorphic
inflammatory
tissue
on
biopsy
.
Despite
the
adoption
of
several
therapeutic
strategies
until
now
prognosis
has
remained
poor
.
Interferon-α
can
be
considered
the
first
line
therapy
,
but
its
effects
on
central
nervous
system
and
cardiovascular
localization
have
been
shown
to
be
often
poor
.
In
this
context
a
combined
treatment
with
the
anti-
TNFα
monoclonal
antibody
infliximab
and
methotrexate
seems
to
be
effective
and
well
tolerated
.
Diseases
Validation
Diseases presenting
"now prognosis"
symptom
erdheim-chester disease
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