[Central nervous system disorders secondary to histiocytoses: neurodegeneration with potential for improvement].

Q4 Medicine Clinical Neurology Pub Date : 2024-02-23 Epub Date: 2024-01-27 DOI:10.5692/clinicalneurol.cn-001899
Akira Morimoto, Kenichi Sakamoto, Ko Kudo, Yoko Shioda
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Abstract

Histiocytoses, including Langerhans cell histiocytosis (LCH) and Erdheim-Chester disease (ECD), are inflammatory myeloid tumors in which monocyte lineage cells aggregate in various organs, causing tissue damage. Most of these tumors harbor oncogenic mutations in mitogen-activated protein kinase (MAPK) pathway genes, typified by BRAFV600E. Some patients with LCH develop bilateral symmetrical cerebellar lesions and brain atrophy several years after diagnosis when the initial symptoms disappear, leading to cerebellar ataxia and higher cerebral dysfunction. A similar neurological disorder has also been reported in ECD. This neurological disorder can be improved with MAPK inhibitors. When patients with this neurological disorder are identified among neurodegeneration of unknown etiology or histiocytosis patients and treated early with MAPK inhibitors, the disorder can be reversible.

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[组织细胞病继发的中枢神经系统疾病:有改善潜力的神经变性]。
组织细胞增生症,包括朗格汉斯细胞组织细胞增生症(Langerhans cell histiocytosis,LCH)和埃尔德海姆-切斯特病(Erdheim-Chester disease,ECD),是单核细胞系细胞在不同器官聚集并造成组织损伤的炎性髓系肿瘤。这些肿瘤大多含有丝裂原活化蛋白激酶(MAPK)通路基因的致癌突变,其中以 BRAFV600E 为典型。一些 LCH 患者在确诊数年后,最初的症状消失后出现双侧对称性小脑病变和脑萎缩,导致小脑共济失调和高级脑功能障碍。在 ECD 中也有类似神经紊乱的报道。MAPK 抑制剂可改善这种神经紊乱。如果能在病因不明的神经变性或组织细胞增生症患者中发现这种神经紊乱的患者,并尽早使用 MAPK 抑制剂进行治疗,这种紊乱是可以逆转的。
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来源期刊
Clinical Neurology
Clinical Neurology Medicine-Neurology (clinical)
CiteScore
0.30
自引率
0.00%
发文量
147
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