To the Editor.—
We have read with
interest the article by Guardia et al, in
the Archives, entitled "Early Pleural
Effusion in Histiocytosis X" (139:934-936,1979). We had a similar case with
recurrent pleural effusion, which
turned our attention to a different
aspect of the effusion.
Report of a Case.—
A 59-year-old man
with adult-onset diabetes mellitus was
first seen in January 1974, with nonketotic
hyperosmolar coma and diabetes insipidus
of undetermined cause. In March 1976, he
had chronic otitis media and recurrent
ulcerative lesions of the buccal mucosa.
Biopsy of the lesions disclosed typical histopathologic changes of histiocytosis X.
Hepatomegaly and multiple bone lesions
involving the lower extremities, pelvis, and
right frontoparietal area of the skull were
noted. Chest roentgenograms were normal.
A bone marrow biopsy specimen was compatible with histiocytosis X. In March 1978,
the patient manifested increasing shortness of breath, pedal edema, and proptosis
of the right eye. Chest roentgenograms
showed cardiomegaly and bilateral
Winkler CF, Yam LT. Pleural Effusion in Histiocytosis X. Arch Intern Med. 1980;140(7):988. doi:10.1001/archinte.1980.00040020988031
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