Nursing Interventions for Langerhans Cell Histiocytosis Patients

Abstract

A rare disorder that resembles cancer is known as Langerhans cell histiocytosis (LCH). It results from an excessive number of immature Langerhans cells in the body. These cells belong to a category of immune cells named histiocytes. These cells can damage tissue, bone, and organs when they proliferate and can even result in cancers. Langerhans cell histiocytosis can manifest universally. Most of the time, it occurs in the bones and skin cells. Besides, organs like the lungs, liver, brain, and spleen, as well as lymph nodes and bone marrow, can get compromised. The disorder was confirmed with histopathological examination and positive immunostaining for CD1a, S100, langerin (CD207), biopsy, and PET scan and may require sequencing of DNA to detect the gene mutations in Langerhans cells. Imminent treatment should be a possible combination of chemotherapeutic medications. It is an oral medication that prevents specific gene alterations that lead to Langerhans cell histiocytosis. Adverse effects of chemotherapy are not brought through this gene inhibitor therapy. Case Report: A 2.5-year-old male child came to the hospital with complaints of swelling over the neck and discharge from both ears. Neck swelling is progressively increasing in size, but is not associated with pain, tenderness, skin changes, and pus discharge with a foul smell. It was associated with intermittent low-grade fever, cold and cough and the child was admitted to the hospital and initially diagnosed with multiple cervical lymphadenopathy. On the day of admission, all other investigations such as a bone marrow smear, USG neck, a Biopsy of the right cervical lymph node, and PET CT were done. The reports showed variable-sized cysts involving both lungs' upper and lower lobes, showed an infiltrative and poorly defined high-grade malignant neoplasm composed of large cells with grooved nuclei, granular chromatin, prominent nucleoli, high mitotic rate with signs of Langerhans cell histiocytosis and child was diagnosed with LCH. The patient was treated with corticosteroids and chemotherapy. Discussion: The case report has heightened the knowledge and competence of the nurses in implementing comprehensive and priority-based care. The information of Langerhans cell histiocytosis is essential to recognize and treat LCH in its early phases. One needs a thorough understanding of the condition. Through this case report, nurses are better equipped to educate patients and their families and to confidently deliver complete nursing care. Conclusion: A rare condition with varied disease presentations, Langerhans cell histiocytosis (LCH) is linked to a high rate of morbidity and mortality. It is imperative to identify clinical symptoms and risk factors and to administer appropriate treatment to minimize mortality and long-term problems related to the condition.