We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......

Hand-Schüller-Christian Disease With Occult Diabetes Insipidus

Arch Intern Med. 1965;116(1):131-137. doi:10.1001/archinte.1965.03870010133017.
Text Size: A A A
Published online

THE CLASSIFICATION of a granulomatous lesion showing reticuloendothelial hyperplasia, histiocytes with clear lipid deposits, and giant cells engulfing white and red blood cells is often dependent upon a knowledge of the clinical course of the host. Closely related histologically but with different clinical pictures are the isolated benign eosinophilic granuloma, the chronic disseminated Hand-Schiiller-Christian disease, and the generalized, usually rapidly fatal, Letterer-Siwe disease. Individuals with these granulomatous lesions described in the initial reports of Hand,1 Schuller2 and Christian 3 had a common triad of findings consisting of osteolytic defects of membranous bone (skull), diabetes insipidus, and exophthalmos. Subsequent observations on similarly afflicted individuals indicate these findings may be observed singly or in combination with additional involvement of other bones, lymph nodes, lung, skin, central nervous system, liver, spleen, and rarely other tissues.

The 88-year-old Negro woman reported herein with evidence of chronic multiple system involvement (bone, lymph


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 6

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.