Correct!
3. Smoking cessation
Evaluation of treatment in LHC is difficult because spontaneous remissions can occur. Glucocorticoids are often empirically given which seem to help with systemic symptoms and radiographically (2). Vincristine is sometimes added. LHC is predominately a disease of smokers and smoking cessation seems to help. There are multiple reports of improvement with smoking cessation (3,4). Interestingly, patients with LHC seem to have difficulty quitting smoking.
Lung transplantation has been performed in both children and adults with LCH. Recurrence of disease does occur in the allograft at a high rate (20% in one series) (3). LCH has also been associated with malignancy in several reports. Given the small numbers of transplants and the reported outcomes to date, lung transplantation remains an appropriate therapeutic option for patients with advance disease due to LCH.
Our patient was followed and seems stable. He did quit cigarette smoking with the aid of Nicorette gum which he still uses. Patients with LCH often do not quit smoking, although when they do, their disease often stabilizes or improves. His marijuana smoking might contribute to his lack of improvement.
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