{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:29:10Z","timestamp":1791250150417,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2005,7,26]],"date-time":"2005-07-26T00:00:00Z","timestamp":1122336000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2006,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Diabetes insipidus (DI) is the most frequent central nervous system (CNS)\u2010related permanent consequence in Langerhans cell histiocytosis (LCH), which mostly requires life\u2010long hormone replacement therapy. In an attempt to define the population at risk for DI, 1,741 patients with LCH registered on the trials DALHX 83 and DALHX 90, LCH I and LCH II were studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall 212 of 1,741 patients (12%) was reported to have DI. In 102 of 1,741 patients (6%) DI was present at diagnosis of LCH. One thousand one hundred eighty three of 1,539 patients without DI at diagnosis had follow up information. One hundred ten of these (9%) later developed DI. The risk of developing DI was 20% at 15 years after diagnosis. Multisystem disease patients at diagnosis carried a 4.6\u2010fold risk for DI compared to single system patients. Craniofacial lesions, in particular in the \u201cear,\u201d \u201ceye,\u201d and oral region were associated with a significantly increased risk for DI (relative hazard rate, RHR 1.7), independent of the extent of disease. No influence of the duration of therapy could be determined, but the duration of initial disease activity (RHR 1.5) and the occurrence of reactivations (RHR 3.5) significantly increased the risk for DI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with multisystem disease and craniofacial involvement at diagnosis, in particular of the \u201cear,\u201d \u201ceye,\u201d and the oral region carry a significantly increased risk to develop DI during their course. This risk is augmented when the disease remains active for a longer period or reactivates. \u00a9 2005 Wiley\u2010Liss, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.20425","type":"journal-article","created":{"date-parts":[[2005,7,26]],"date-time":"2005-07-26T19:29:35Z","timestamp":1122406175000},"page":"228-233","source":"Crossref","is-referenced-by-count":264,"title":["Risk factors for diabetes insipidus in langerhans cell histiocytosis"],"prefix":"10.1002","volume":"46","author":[{"given":"N.","family":"Grois","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"P\u00f6tschger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Prosch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Minkov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Arico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Braier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u2010I.","family":"Henter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Janka\u2010Schaub","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Ladisch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Ritter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Steiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Unger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Gadner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the DALHX\u2010 and LCH I and II Study Committee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,12,20]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(57)90115-8"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.52.6.433"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.2950210405"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1996.14.7.2073"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.75.1.17"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1080\/088800199276921"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2003.12.030"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20021"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198910263211704"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.2950240407"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-911X(199704)28:4<289::AID-MPO8>3.0.CO;2-E"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-911X(199707)29:1<36::AID-MPO7>3.0.CO;2-T"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.85.4.6501"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(92)90006-4"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-200307000-00017"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20003"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.2000.01125.x"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-030907"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.2950230203"},{"key":"e_1_2_6_21_2","first-page":"880","article-title":"MR imaging presentation of intracranial disease associated with Langerhans cell histiocytosis","volume":"25","author":"Prayer D","year":"2004","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.2950230207"},{"key":"e_1_2_6_23_2","unstructured":"LCH Study Group of the Histiocyte Society.LCH II \u2010 Treatment Protocol of the Second International Study for Langerhans Cell Histiocytosis. 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