Bilateral Renal Colic as an Initial Presentation of Erdheim-Chester Disease

Erdheim-Chester disease (ECD) is a rare non-Langerhans cells histiocytosis characterized by multiorgan involvement, with renal-ECD documented in over one-third of patients. Renal disease is generally asymptomatic, rarely causing hydronephrosis and kidney impairment. In addition, the diverse clinical...

Full description

Saved in:
Bibliographic Details
Main Authors: Julien Sarkis, Fady Haddad, Sarah Nasr, Elie Hanna, Ahmad Mroueh, Elie Nemr
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Case Reports in Urology
Online Access:http://dx.doi.org/10.1155/2019/4670376
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832564074640048128
author Julien Sarkis
Fady Haddad
Sarah Nasr
Elie Hanna
Ahmad Mroueh
Elie Nemr
author_facet Julien Sarkis
Fady Haddad
Sarah Nasr
Elie Hanna
Ahmad Mroueh
Elie Nemr
author_sort Julien Sarkis
collection DOAJ
description Erdheim-Chester disease (ECD) is a rare non-Langerhans cells histiocytosis characterized by multiorgan involvement, with renal-ECD documented in over one-third of patients. Renal disease is generally asymptomatic, rarely causing hydronephrosis and kidney impairment. In addition, the diverse clinical picture of Erdheim-Chester disease arises slowly with sequential manifestations. We present a rare case of a 75-year-old woman on long-term treatment for panhypopituitarism and steroid therapy for vasculitis, presenting to the emergency department with bilateral renal colic and acute kidney injury. Abdominopelvic CT scan revealed renal infiltration with signs of retroperitoneal fibrosis and hydronephrosis. Kidney CT-guided biopsy and 18-fluorodeoxyglucose (FDG) positron emission tomography whole body scan as well as the history of hypopituitarism and vasculitis confirmed the diagnosis of Erdheim-Chester disease. Proper therapy with interferon-α was started. This case describes the multifaced manifestation of this disease and the difficulty to establish the diagnosis, as well as the pivotal role that a urologist can play in its management.
format Article
id doaj-art-a5a6adce400448188ceb3af7e7ed9a3c
institution Kabale University
issn 2090-696X
2090-6978
language English
publishDate 2019-01-01
publisher Wiley
record_format Article
series Case Reports in Urology
spelling doaj-art-a5a6adce400448188ceb3af7e7ed9a3c2025-02-03T01:11:49ZengWileyCase Reports in Urology2090-696X2090-69782019-01-01201910.1155/2019/46703764670376Bilateral Renal Colic as an Initial Presentation of Erdheim-Chester DiseaseJulien Sarkis0Fady Haddad1Sarah Nasr2Elie Hanna3Ahmad Mroueh4Elie Nemr5Department of Urology, Hôtel-Dieu de France, Beirut, LebanonDepartment of Internal Medicine, Hôtel-Dieu de France, Beirut, LebanonDepartment of Pathology, Hôtel-Dieu de France, Beirut, LebanonDepartment of Urology, Hôtel-Dieu de France, Beirut, LebanonDepartment of Nephrology, Hôtel-Dieu de France, Beirut, LebanonDepartment of Urology, Hôtel-Dieu de France, Beirut, LebanonErdheim-Chester disease (ECD) is a rare non-Langerhans cells histiocytosis characterized by multiorgan involvement, with renal-ECD documented in over one-third of patients. Renal disease is generally asymptomatic, rarely causing hydronephrosis and kidney impairment. In addition, the diverse clinical picture of Erdheim-Chester disease arises slowly with sequential manifestations. We present a rare case of a 75-year-old woman on long-term treatment for panhypopituitarism and steroid therapy for vasculitis, presenting to the emergency department with bilateral renal colic and acute kidney injury. Abdominopelvic CT scan revealed renal infiltration with signs of retroperitoneal fibrosis and hydronephrosis. Kidney CT-guided biopsy and 18-fluorodeoxyglucose (FDG) positron emission tomography whole body scan as well as the history of hypopituitarism and vasculitis confirmed the diagnosis of Erdheim-Chester disease. Proper therapy with interferon-α was started. This case describes the multifaced manifestation of this disease and the difficulty to establish the diagnosis, as well as the pivotal role that a urologist can play in its management.http://dx.doi.org/10.1155/2019/4670376
spellingShingle Julien Sarkis
Fady Haddad
Sarah Nasr
Elie Hanna
Ahmad Mroueh
Elie Nemr
Bilateral Renal Colic as an Initial Presentation of Erdheim-Chester Disease
Case Reports in Urology
title Bilateral Renal Colic as an Initial Presentation of Erdheim-Chester Disease
title_full Bilateral Renal Colic as an Initial Presentation of Erdheim-Chester Disease
title_fullStr Bilateral Renal Colic as an Initial Presentation of Erdheim-Chester Disease
title_full_unstemmed Bilateral Renal Colic as an Initial Presentation of Erdheim-Chester Disease
title_short Bilateral Renal Colic as an Initial Presentation of Erdheim-Chester Disease
title_sort bilateral renal colic as an initial presentation of erdheim chester disease
url http://dx.doi.org/10.1155/2019/4670376
work_keys_str_mv AT juliensarkis bilateralrenalcolicasaninitialpresentationoferdheimchesterdisease
AT fadyhaddad bilateralrenalcolicasaninitialpresentationoferdheimchesterdisease
AT sarahnasr bilateralrenalcolicasaninitialpresentationoferdheimchesterdisease
AT eliehanna bilateralrenalcolicasaninitialpresentationoferdheimchesterdisease
AT ahmadmroueh bilateralrenalcolicasaninitialpresentationoferdheimchesterdisease
AT elienemr bilateralrenalcolicasaninitialpresentationoferdheimchesterdisease