Which specialist consultations are beneficial to patients with Langerhans cell histiocytosis (LCH)?

Updated: Jun 12, 2020
  • Author: Christopher R Shea, MD; Chief Editor: William D James, MD  more...
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Answer

Referral to an orthopedic surgeon has important diagnostic and management implications when bone lesions are present.

An otolaryngologist may aid in the treatment of otitis media caused by destruction of the temporal and mastoid bones.

Consultation with an ophthalmologist is suggested for a vision check and an assessment of the need for decompression in patients with proptosis.

Consultation with a dentist is indicated if loose teeth result from infiltration of the mandibles.

Referral to an endocrinologist may help in the design of treatment of the endocrine abnormalities.

Long-term hearing loss can cause significant morbidity, owing to ear involvement by Langerhans cell histiocytosis (LCH), as well as to the use of other medications (ie, aminoglycosides) as adjuncts to chemotherapy. It has been proposed that all LCH patients with ear involvement have regular audiometry and CT/MRI of the petrous temporal bones, as well as long-term follow up with an audiologist to monitor for hearing loss. [58]


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