Abstract
Diseases in childhood have an impact on growth. The influence of Langerhans cell histiocytosis (LCH) on growth has never been studied well. Recently a patient with LCH was treated with human growth hormone (GH) because of severe GH deficiency due to LCH involvement of both the hypothalamus and pituitary. This led us to review our charts from 1971 onward for evaluation of the growth patterns in patients with LCH. Here the long-term growth of 22 patients with LCH is reported, the median follow up being 7 years and 1 month. The height data were converted into standard deviation scores (SDS). At diagnosis the mean SDS of patients with isolated LCH at diagnosis was 0.04 and −0.37 in patients with disseminated LCH. Of the total group, 12 patients did not show any influence from the LCH or therapy on their growth. The remaining 10 patients reached, after a minimum of 3 years, a percentile clearly higher than that at diagnosis. However all the ten above mentioned patients, either isolated or disseminated LCH, had a lesion in the facial side of the skull.
Conclusion
GH deficiency is not a common manifestation of LCH in childhood and GH provocation tests are only indicated when there is a poor or decelerating growth rate. In our patients the number of organs involved and/or the treatment modality did not influence the growth in all but one.
Similar content being viewed by others
Abbreviations
- GH :
-
growth hormone
- hGH :
-
human growth hormone
- LCH :
-
Langerhans cell histiocytosis
References
Braunstein GD, Kohler PO (1981) Endocrine manifestations of histiocytosis. Am J Pediatr Hematol Oncol 3:67–75
Braunstein GD, Raiti S, Hansen JW, Kohler PO (1975) Response of growthretarded patients with Hand-Schüller-Christian disease to growth hormone therapy. N Engl J Med 292:332–333
Broadbent V, Pritchard J, Davies EG, Levinsky RJ, Heaf D, Atherton DJ, Pincott JR, Tucker S (1984) Spontaneous remission of multi-system histiocytosis X. Lancet 1:253–254
Brown P, Gajdusek DC, Gibbs CJ, Asher DM (1985) Potential epidemic of Creutzfeldt-Jakob disease from human growth hormone therapy. N Engl J Med 313:728–731
Corbeel L, Eggermonnt E, Desmyter J, De Vos R, De Wolf-Peeter C, Cobbaert C, Eykens A (1988) Spontaneous healing of Langerhans cell histiocytosis (histiocytosis X). Eur J Pediatr 148:32–33
Dean HJ, Bishop A, Winter JSD (1986) Growth hormone deficiency in patients with histiocytosis X. J Pediatr 109:615–618
Egeler RM, Nesbit ME (1992) Current concepts and treatment of Langerhans cell histiocytosis. In: Voûte PA, et al, (eds) Cancer in children. Springer Berlin Heidelberg New York, pp 162–173
Hokken-Koelega ACS, Van Doorn JWD, Hählen K, Stijnen T, De Muinck Keizer-Schrama SMPF, Drop SLS (1993) Long-term effects of treatment for acute lymphoblastic leukemia with and without cranial irradiation on growth and puberty: a comparative study. Pediatr Res 33:577–582
Keeling JW, Harries JT (1973) Intestinal malabsorption in infants with histiocytosis X. Arch Dis Child 48:350–354
Latorre H, Kenney FM, Lahey ME, Drash A (1974) Short stature and growth hormone deficiency in histiocytosis X. J Pediatr 85:813–816
Powell-Jackson J, Kennedy P, Whitcombe EM, Weller RO, Preece MA, Newsom-Davis J (1985) Creutzfeldt-Jakob disease after administration of human growth hormone. Lancet I: 244–246
Robert H, Dubousset J, Miladi L (1987) Histiocytosis X in the juvenile spine. Spine 12:167–172
Robison LL, Nesbit ME, Sather HN, Meadows AT, Ortega JA, Hammond GD (1985) Height of children successfully treated for acute lymphoblastic leukemia: a report from the Late Effects Study Committee of Children's Cancer Study Group. Med Pediatr Oncol 13:14–21
Roede MJ, Van Wieringen JC (1985) Growth diagrams 1980. Netherlands third nation-wide survey. Tijdschr Soc Geneesk 63:1–34
Author information
Authors and Affiliations
Additional information
Both authors made equal contributions to this work and are listed in alphabetical order
Rights and permissions
About this article
Cite this article
van den Hoek, A.C.J., Karstens, A., Egeler, R.M. et al. Growth of children with Langerhans cell histiocytosis. Eur J Pediatr 154, 822–825 (1995). https://doi.org/10.1007/BF01959790
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01959790