{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T07:45:04Z","timestamp":1781768704318,"version":"3.54.5"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Erdheim\u2013Chester disease (ECD) is a rare non\u2010Langerhans cell histiocytosis characterized by multisystem involvement and frequent diagnostic delay due to nonspecific clinical manifestations. We report a 42\u2010year\u2010old asymptomatic man with persistently elevated erythrocyte sedimentation rate (ESR) detected during routine laboratory evaluation. Physical examination revealed bilateral peri\u2010ocular xanthomas. Multimodal imaging demonstrated bilateral perirenal soft\u2010tissue infiltration with a characteristic \u201chairy kidney\u201d appearance on computed tomography, symmetric skeletal involvement on bone scintigraphy, and metabolically active lesions on\n                    <jats:sup>18<\/jats:sup>\n                    F\u2010FDG PET\/CT. Histopathological examination of a peri\u2010ocular xanthoma biopsy revealed CD68\u2010positive, CD1a\u2010negative foamy histiocytes, confirming the diagnosis of Erdheim\u2013Chester disease. Given the patient's oligosymptomatic presentation and absence of critical organ involvement, a watch\u2010and\u2010wait strategy with close surveillance was adopted. This case highlights the diagnostic value of subtle clinical findings, such as isolated inflammatory marker elevation and peri\u2010ocular xanthomas, and emphasizes the importance of accessible tissue biopsy combined with characteristic imaging features for early diagnosis of ECD.\n                  <\/jats:p>","DOI":"10.1002\/ccr3.71998","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T06:40:15Z","timestamp":1770187215000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Incidental Diagnosis of Erdheim\u2013Chester Disease in a 42\u2010Year\u2010Old Man With Persistent Elevated\n                    <scp>ESR<\/scp>\n                    and Peri\u2010Ocular Xanthomas: A Case Report"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-0735-4207","authenticated-orcid":false,"given":"Mohammad","family":"Rahimi","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Endocrinology and Metabolism Research Center, Vali\u2010Asr Hospital, Imam Khomeini Complex Hospital Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Ghanadan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Cancer Institute Imam Khomeini Complex Hospital  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nooshin","family":"Shirzad","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Endocrinology and Metabolism Research Center, Vali\u2010Asr Hospital, Imam Khomeini Complex Hospital Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehrnaz","family":"Doostmohammadi","sequence":"additional","affiliation":[{"name":"Department of Pathology, Cancer Institute Imam Khomeini Complex Hospital  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9305-6657","authenticated-orcid":false,"given":"Mahboobeh","family":"Hemmatabadi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Endocrinology and Metabolism Research Center, Vali\u2010Asr Hospital, Imam Khomeini Complex Hospital Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"issue":"11","key":"e_1_2_14_2_1","first-page":"e74853","article-title":"Erdheim\u2010Chester Disease: A Case Report Exploring Multisystemic Involvement","volume":"16","author":"Antunes 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