Langerhans cell histiocytosis in children with refractory diarrhea and hypoalbuminemia as the initial presentation: two cases report and literature review

Langerhans cell histiocytosis (LCH) with involvement of the gastrointestinal tract is rare and lack of clinical experience. We describe two cases who initially presented with chronic diarrhea, hypoproteinemia, and intermittent fever. These cases suggest that refractory diarrhea accompanied by recurrent hypoalbuminemia, especially with abdominal rash, LCH should be considered. Then gastrointestinal endoscopy, pathology and PET-CT detection need to be perfected for the definitive diagnosis. It might be helpful for the early recognition of the gastrointestinal tract involvement in LCH.