{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T06:28:09Z","timestamp":1765261689683,"version":"3.46.0"},"reference-count":16,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Langerhans cell histiocytosis (LCH) is a rare neoplastic disorder involving abnormal proliferation of dendritic cells, with clinical presentations ranging from isolated lesions to life\u2010threatening multisystem involvement. This case report describes a 26\u2010month\u2010old girl who presented with progressive jaundice, fever, hepatomegaly, pruritic scalp rashes with greasy scales, and maculopapular to papulocrusted skin lesions. Laboratory findings revealed severe anemia, elevated inflammatory markers, high bilirubin levels, elevated transaminases, markedly increased GGT (Gamma\u2010Glutamyl Transferase) and ALP (Alkaline Phosphatase) levels, suggestive of cholestatic injury, along with low albumin and a reversed albumin\u2010to\u2010globulin ratio. A provisional diagnosis of high\u2010risk multisystem LCH was made, and a skin biopsy was performed, demonstrating characteristic histiocytic infiltration with immunopositivity for CD1a and S\u2010100, thereby confirming the diagnosis. She was initiated on chemotherapy with vinblastine in combination with prednisolone at a referred center and demonstrated a favorable clinical response. This case underscores the diagnostic challenges of Langerhans cell histiocytosis, particularly in resource\u2010limited settings, and highlights the importance of looking beyond common diagnoses, such as acute viral hepatitis, when the clinical presentation does not fully align. Careful recognition of systemic features, especially involvement of the liver and skin, combined with early skin biopsy and a multidisciplinary approach, is essential for timely diagnosis and effective management of rare conditions like high\u2010risk multisystem LCH.<\/jats:p>","DOI":"10.1002\/ccr3.71336","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T09:58:18Z","timestamp":1761299898000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Hepatitis: A Rare Case of Multisystem Langerhans Cell Histiocytosis in a Child"],"prefix":"10.1002","volume":"13","author":[{"given":"Dilip","family":"Neupane","sequence":"first","affiliation":[{"name":"Department of Pediatrics Kathmandu Medical College and Teaching Hospital  Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2113-5288","authenticated-orcid":false,"given":"Rishi Ram","family":"Banjade","sequence":"additional","affiliation":[{"name":"Kathmandu Medical College and Teaching Hospital  Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhiraj","family":"Joshi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kathmandu Medical College and Teaching Hospital  Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pusp Raj","family":"Awasthi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kathmandu Medical College and Teaching Hospital  Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santosh","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kathmandu Medical College and Teaching Hospital  Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,24]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1275085"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021014343"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.5114\/pdia.2017.67095"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.283075108"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.5306\/wjco.v12.i5.335"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2010.02.012"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.70141"},{"issue":"1","key":"e_1_2_13_9_1","article-title":"A Report of Pediatric Langerhans Cell Histiocytosis in a Hospital\u2010Based Study","volume":"17","author":"Nejad J. 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