mercaptopurine and Orbital-Diseases

Topics: Antigens, CD1; Biomarkers; Child; Diagnosis, Differential; Edema; Female; Histiocytosis, Langerhans-Cell; Humans; Immunosuppressive Agents; Magnetic Resonance Imaging; Mercaptopurine; Orbital Diseases; S100 Proteins; Tomography, X-Ray Computed

To describe the systemic treatment of recurrent eosinophilic granuloma.. Case report and review of Langerhans cell histiocytosis.. A 9-year-old boy had painful, right upper eyelid swelling. A computed tomography scan showed a right superolateral orbital mass with evidence of bony erosion. Frozen section evaluation was consistent with eosinophilic granuloma. Biopsy and curettage were performed. Systemic work-up was negative for extraorbital disease. Recurrence of the orbital mass 6 weeks after surgery was confirmed by magnetic resonance imaging (MRI). Four weeks after treatment with prednisone and vinblastine, MRI showed a marked decrease in the size of the orbital lesion. Additional treatment with 6-mercaptopurine and methotrexate was initiated, and MRI 6 months later showed complete resolution of the lesion.. The treatment of recurrent eosinophilic granuloma is challenging. The goal is to effectively cure the lesion with minimal short-term and long-term side effects. Systemic steroids, vinca alkaloids, antimetabolites, and antifols are preferred because they have less toxicity and mutagenicity. Combination chemotherapy used in conjunction with treatment by a pediatric hematologist/oncologist appears to be an effective method of treating recurrent disease.

Topics: Antineoplastic Combined Chemotherapy Protocols; Child; Drug Therapy, Combination; Eosinophilic Granuloma; Glucocorticoids; Humans; Magnetic Resonance Imaging; Male; Mercaptopurine; Orbital Diseases; Prednisone; Recurrence; Vinblastine; X-Rays

Langerhans cell histiocytosis (LCH) is an enigmatic disease usually occurring in children. Tumor lysis syndrome (TLS) is a clinical syndrome associated with severe metabolic derangement and oliguric acute renal failure. In this report, we present the clinical course of an infant with advanced LCH who had TLS develop after chemotherapy. Treatment with continuous arteriovenous hemofiltration resulted in effective control of serum uric acid, potassium, creatinine, phosphorus, and blood urea nitrogen levels in the blood.

Topics: Acute Kidney Injury; Allopurinol; Antineoplastic Combined Chemotherapy Protocols; Biomarkers; Blood Transfusion; Combined Modality Therapy; Disease Progression; Etoposide; Fatal Outcome; Female; Fluid Therapy; Hemofiltration; Histiocytosis, Langerhans-Cell; Humans; Infant; L-Lactate Dehydrogenase; Lymph Nodes; Mercaptopurine; Multiple Organ Failure; Neck; Orbital Diseases; Prednisolone; Sodium Bicarbonate; Temporal Bone; Tumor Lysis Syndrome; Uric Acid; Vinblastine; Vincristine