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W4312536235 abstract "Going back to the clinical pictures, it becomes apparent that the nonlipoid reticulo-endothelioses are acute diseases, with fever, high sedimentation rate, poor general condition, and wretched prognosis. The principal signs are enlargement of lymph nodes, lesions in the bone marrow, splenomegaly, anemia, and purpura. In certain of these cases, a definite infection can be shown as the etiologic factor. In others, no specific infection can be discovered, nor is there any proof that such infection is present in all cases. It is therefore advisable to put all such cases in a separate group, and keep an open mind as to etiologic possibilities. Hand-Schüller-Christian disease, on the other hand, is a complaint with a more chronic course, an insidious onset, often localized in one or more sites, and, less frequently, appearing as a generalized reaction. Even when a general reaction can be demonstrated, such a reaction does not result in fully formed foam cells everywhere, and the clinical picture is most often conditioned by the lesions in one or several sites. Obviously, the symptomatology changes accordingly. Hypercholesteremia is not necessarily present in these cases. An excess of cholesterol in the blood is rather a sign of a disturbed lipid metabolism; this disturbance can be present in any pronounced interference with the function of the reticulo-endothelial system. Formation of foam cells depends on a specific dysfunction in the cells, and this dysfunction can be demonstrated in vitro. The eosinophilic granuloma, finally, is a local reaction, appearing in one or several sites within the skeletal system; it is accompanied by a strong admixture of eosinophilic granulocytes in a typical conglomeration. Clinically, its onset is fairly acute, it develops swiftly, and heals spontaneously. Local swelling and tenderness often appear over the site of one or another of the lesions; this is not the case with the other two types of reticuloses described here. The general condition is never affected, and the prognosis is always good. All three forms are diseases of the reticulo-endothelial system. Until more is known about them, we must assume the existence of a family relationship, but more than that, it seems to me, has neither been proved nor even plausibly postulated. In the presence of different clinical pictures, with dissimilar courses and prognoses, one can do no more than classify clinical-pathologic diagnoses. This method at least offers the possibility of prognosis—perhaps, with the passage of time, of treatment as well—and provides a more solid starting point for etiologic research. The less clearly defined cases are less suitable as a basis for research." @default.
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W4312536235 date "1949-01-01" @default.
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W4312536235 title "The Reticulo-endothelioses in Children" @default.
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W4312536235 doi "https://doi.org/10.1016/s0065-3101(22)00812-x" @default.
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