Erdheim-Chester Disease Involving the Central Nervous System with Latent Toxoplasmosis

Tomoya Wadayama; Mikito Shimizu; Ikko Kimura; Kousuke Baba; Goichi Beck; Seiichi Nagano; Ryo Morita; Hidenori Nakagawa; Michinori Shirano; Tetsushi Goto; Kazumi Norose; Kenji Hikosaka; Shigeo Murayama; Hideki Mochizuki

doi:10.2169/internalmedicine.8564-21

CASE REPORTS

Erdheim-Chester Disease Involving the Central Nervous System with Latent Toxoplasmosis

Tomoya Wadayama, Mikito Shimizu, Ikko Kimura, Kousuke Baba, Goichi Beck, Seiichi Nagano, Ryo Morita, Hidenori Nakagawa, Michinori Shirano, Tetsushi Goto, Kazumi Norose, Kenji Hikosaka, Shigeo Murayama, Hideki Mochizuki

Author information

Tomoya Wadayama
Department of Neurology, Osaka University Graduate School of Medicine, Japan
Mikito Shimizu
Department of Neurology, Osaka University Graduate School of Medicine, Japan
Ikko Kimura
Graduate School of Frontier Biosciences, Osaka University, Japan
Kousuke Baba
Department of Neurology, Osaka University Graduate School of Medicine, Japan
Goichi Beck
Department of Neurology, Osaka University Graduate School of Medicine, Japan
Seiichi Nagano
Department of Neurology, Osaka University Graduate School of Medicine, Japan
Ryo Morita
Department of Infectious Diseases, Osaka City General Hospital, Japan
Hidenori Nakagawa
Department of Infectious Diseases, Osaka City General Hospital, Japan
Michinori Shirano
Department of Infectious Diseases, Osaka City General Hospital, Japan
Tetsushi Goto
Department of Infectious Diseases, Osaka City General Hospital, Japan
Kazumi Norose
Department of Infection and Host Defense, Graduate School of Medicine, Chiba University, Japan
Kenji Hikosaka
Department of Infection and Host Defense, Graduate School of Medicine, Chiba University, Japan
Shigeo Murayama
Department of Neurology, Osaka University Graduate School of Medicine, Japan
Hideki Mochizuki
Department of Neurology, Osaka University Graduate School of Medicine, Japan

Keywords: neuro-oncology, histiocytosis, Erdheim-Chester disease, toxoplasmosis, Toxoplasma nested polymerase chain reaction

JOURNAL OPEN ACCESS

2022 Volume 61 Issue 17 Pages 2661-2666

DOI https://doi.org/10.2169/internalmedicine.8564-21

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Abstract

Erdheim-Chester disease (ECD) is a rare, non-Langerhans cell histiocytosis characterized by the infiltration of foamy histiocytes into multiple organs. We herein report a case of ECD with central nervous system (CNS) involvement in a 63-year-old man who also presented a positive result for Toxoplasma gondii nested polymerase chain reaction testing of cerebrospinal fluid. Since anti-Toxoplasma treatment proved completely ineffective, we presumed latent infection of the CNS with T. gondii. This case suggests the difficulty of distinguishing ECD with CNS involvement from toxoplasmic encephalitis and the possibility of a relationship between the pathogeneses of ECD and infection with T. gondii.

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