Arterial involvement in Erdheim-Chester disease

A retrospective cohort study

Michel Villatoro-Villar, Michael S. Bold, Kenneth J Warrington, Cynthia Crowson, Gaurav Goyal, Mithun Shah, Ronald S. Go, Matthew Koster

Research output: Contribution to journalArticle

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Abstract

Erdheim-Chester disease (ECD) is a rare histiocytosis of the "L" (Langerhans) group with multisystem involvement that can affect the large and medium-sized arteries mimicking vasculitis. Aortic involvement is common but the frequency and outcome of aortic branch vessel abnormalities are less well described.Patients with ECD were retrospectively identified. Images containing information of arterial involvement within 6 months of diagnosis were considered baseline and compared to last follow-up studies. Two physicians independently reviewed the studies to evaluate for presence of abnormalities attributable to ECD. Age and sex-adjusted logistic regression models were used to examine associations between patient characteristics and vessel involvement at baseline.Among a cohort of 64 patients with ECD, 63 had baseline imaging of vascular structures. ECD involvement of at least 1 segment of the aorta was observed in 56%. Abnormalities were also observed in aortic arch branches (26%), visceral branch arteries (40%), iliofemoral arteries (31%), coronary (5%), and pulmonary (3%) arteries. Perinephric fibrosis was strongly associated with the identification of abnormalities in the thoracic aorta (OR 4.92 [1.54, 15.75]; P = .007), abdominal aorta (OR 7.57 [2.28, 25.07]; P = .001) and visceral branch arteries (OR 6.05 [1.52, 24.03]; P = .01) but not pelvic/lower extremity arteries. Complete normalization of arterial abnormalities at follow-up was only observed in 9% or less of arterial segments involved at baseline.Aortic and aortic branch vessel abnormalities are frequently observed in patients with ECD and are often asymptomatic. Partial and/or complete resolution of arterial findings is uncommon.

Original languageEnglish (US)
Pages (from-to)e13452
JournalMedicine
Volume97
Issue number49
DOIs
StatePublished - Dec 1 2018
Externally publishedYes

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Erdheim-Chester Disease
Cohort Studies
Retrospective Studies
Arteries
Thoracic Aorta
Logistic Models
Histiocytosis
Abdominal Aorta
Vasculitis
Pulmonary Artery
Blood Vessels
Aorta
Lower Extremity
Coronary Vessels
Fibrosis
Physicians

ASJC Scopus subject areas

  • Medicine(all)

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Arterial involvement in Erdheim-Chester disease : A retrospective cohort study. / Villatoro-Villar, Michel; Bold, Michael S.; Warrington, Kenneth J; Crowson, Cynthia; Goyal, Gaurav; Shah, Mithun; Go, Ronald S.; Koster, Matthew.

In: Medicine, Vol. 97, No. 49, 01.12.2018, p. e13452.

Research output: Contribution to journalArticle

Villatoro-Villar, Michel ; Bold, Michael S. ; Warrington, Kenneth J ; Crowson, Cynthia ; Goyal, Gaurav ; Shah, Mithun ; Go, Ronald S. ; Koster, Matthew. / Arterial involvement in Erdheim-Chester disease : A retrospective cohort study. In: Medicine. 2018 ; Vol. 97, No. 49. pp. e13452.
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