Search

Objective – Langerhans cell histiocytosis is a rare disease characterized by monoclonal proliferation and infiltration of organs by large mononuclear cells. Here we report a case of Langerhans cell histiocytosis with non-classic perianal presentation and diabetes insipidus. Case report – A 10-year-old male patient diagnosed with central diabetes insipidus was referred to us with the complaints of abdominal pain, bloody stool, and an irregular ulceration on the bilateral perianal region. With the suspicion of inflammatory bowel disease the patient underwent colonoscopy and the result was normal. Due to the prior diagnosis of central diabetes insipidus the lesion was thought to be histiocytosis. A biopsy was performed and histological findings were consistent with Langerhans cell histiocytosis. Conclusion – Perianal involvement is an unusual presentation for Langerhans cell histiocytosis. In the case of suspicion of nonspecific ulceration of this area, the precise diagnosis should be made by histological means.

Abusive head trauma is a serious form of child abuse and mostly seen in infants below the age of two years as a result of a strong shaking by the caregiver who aims to stop the infant's crying. Characteristic symptoms include subdural hematomas, encephalopathy, retinal hemorrhages and fractures of the long bones. When physically examined, there are generally no externally visible signs. For this reason, it can be underdiagnosed, if it is not considered in the differential diagnosis. When the information provided from the parents is inconsistent and contradictory with the clinical picture of the patient, this form of abuse must be suspected and retinal hemorrhages should be searched. In this article, two patients who were admitted to our emergency department and diagnosed with physical child abuse are reported. One of these patients had a history of minor head trauma after falling down from the sofa and the other one had a history of breathlessness and loss of consciousness as a result of excessive crying.