Association between Ischemic Stroke and Erdheim-Chester Disease: A Case Report and Review of Literature

J Stroke Cerebrovasc Dis. 2017 Aug;26(8):e153-e155. doi: 10.1016/j.jstrokecerebrovasdis.2017.04.029. Epub 2017 Jun 13.

Abstract

Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis characterized by a xanthogranulomatous infiltration of tissues by spumous histiocytes. Neurological involvement is frequent, but ischemic strokes have been exceptionally described. We report the case of a 68-year-old woman who presented with an acute ischemic stroke associated with a multisystemic disorder including insipidus diabetes, infiltration of the aorta and the carotid arteries, perirenal infiltration, aortitis, and lytic bone lesions. The surgical biopsy of a lumbar vertebra revealed an infiltration of spumous macrophages consistent with ECD. Many ischemic symptoms can occur in ECD. Ischemic strokes, infrequently reported, might be caused by perivascular infiltration and adventitial fibrosis of the supra-aortic trunks or intracranial arteries.

Keywords: Erdheim–Chester disease; coated aorta; hairy kidney; ischemic stroke; non–Langerhans cell histiocytosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Anti-Inflammatory Agents / therapeutic use
  • Cerebral Angiography / methods
  • Erdheim-Chester Disease / complications*
  • Erdheim-Chester Disease / diagnosis
  • Erdheim-Chester Disease / drug therapy
  • Erdheim-Chester Disease / genetics
  • Fatal Outcome
  • Female
  • Genetic Predisposition to Disease
  • Humans
  • Infarction, Middle Cerebral Artery / diagnostic imaging
  • Infarction, Middle Cerebral Artery / etiology*
  • Interleukin 1 Receptor Antagonist Protein / therapeutic use
  • Magnetic Resonance Angiography
  • Mutation
  • Proto-Oncogene Proteins B-raf / genetics
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Interleukin 1 Receptor Antagonist Protein
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf