Case Reports
Sunday, October 13, 2024
12:45 PM–02:15 PM
Abstract
Introduction: Langerhans' Cell Histiocytosis (LCH) is a rare disorder characterized by the abnormal proliferation of Langerhans cells. While methotrexate is a commonly used treatment for LCH, its use is often associated with adverse effects, particularly mucositis and fatigue. This case report highlights the potential benefit of incorporating folic acid supplementation into LCH treatment protocols involving methotrexate to mitigate these side effects and improve patient outcomes.
Case: A 62-year-old female with multifocal LCH involving the skin was treated with mercaptopurine and methotrexate. Despite showing a partial response in her skin lesions, she experienced severe mucositis and fatigue, likely exacerbated by the absence of folic acid supplementation. Her treatment regimen was reassessed, and folic acid 1mg daily was added, which significantly alleviated her symptoms.
Discussion: This case underscores the interplay between treatment efficacy and side effect management in LCH. While methotrexate is an effective treatment option, its use without folic acid supplementation contrasts with established oncological guidelines, where folic acid is routinely prescribed to mitigate methotrexate-induced adverse effects. The addition of folic acid in this case resulted in significant symptom relief, suggesting a potential benefit in updating LCH treatment protocols to include folic acid supplementation alongside methotrexate therapy.
Conclusion: This case report generates the hypothesis that incorporating folic acid supplementation into LCH treatment protocols involving methotrexate therapy could improve patient quality of life and treatment outcomes by balancing efficacy with symptom management. Further research is warranted to investigate the potential benefits of this approach in a larger LCH patient population. Ultimately, this case highlights the importance of holistic treatment strategies and the need to reevaluate and update existing protocols for rare disorders like LCH based on clinical experience and emerging evidence.
Presenting Author
Madeline Yuzwa Pharm.D. CandidateNortheast Ohio Medical University
Authors
Frankie Benavides Pharm.D. Candidate
Northeast Ohio Medical University