A rare differential for sinusitis and visual loss

Ann R Coll Surg Engl. 2020 Feb;102(2):e42-e44. doi: 10.1308/rcsann.2019.0130. Epub 2019 Sep 20.

Abstract

Erdheim-Chester disease is a rare infiltrative histiocytic disorder with around 800 cases being reported worldwide. Patients most commonly present with skeletal pain, but the condition has been shown to affect multiple other organs. We describe a rare presentation in which the disease infiltrated the sinuses and affected an ex-RAF pilot's vision. After extensive investigation of the elusive diagnosis, repeating of a molecular test using polymerase chain reaction analysis allowed for identification of a mutation (BRAF V600) ultimately leading to the diagnosis of Erdheim-Chester disease.

Keywords: Erdheim–Chester disease; Otolaryngology; Vision and hearing loss.

Publication types

  • Case Reports

MeSH terms

  • Blindness / etiology*
  • Blindness / therapy
  • DNA Mutational Analysis
  • Diagnosis, Differential
  • Erdheim-Chester Disease / complications
  • Erdheim-Chester Disease / diagnosis*
  • Erdheim-Chester Disease / genetics
  • Erdheim-Chester Disease / therapy
  • Ethmoid Bone / diagnostic imaging
  • Ethmoid Bone / pathology
  • Ethmoid Bone / surgery
  • Glucocorticoids / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Osteotomy
  • Pilots
  • Proto-Oncogene Proteins B-raf / genetics
  • Sinusitis / etiology*
  • Sinusitis / therapy
  • Sphenoid Bone / diagnostic imaging
  • Sphenoid Bone / pathology
  • Sphenoid Bone / surgery
  • Tomography, X-Ray Computed

Substances

  • Glucocorticoids
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf