Disseminated langerhans cell histiocytosis presenting as decompensated childhood cirrhosis

Childhood cirrhosis is a rare disease of multifactorial etiopathogenesis. One of the rare underlying causes is Langerhans cell histiocytosis (LCH). The multifocal multisystemic variant of LCH can rarely involve the hepatobiliary system. Indirect and direct forms of hepatobiliary involvement are known. Early diagnosis of underlying liver involvement in cases of LCH is crucial to prevent decompensation and ameliorate prognosis post-liver transplantation. This is a case of an 18-month-old male child who developed cutaneous lesions in the early infancy. He was brought to clinical attention due to progressively increasing abdominal girth. His laboratory, clinical and radiological examination suggested multisystem pathology, subsequently confirmed on biopsy as LCH with predominant involvement of hepatobiliary, pulmonary, and integumentary systems. Unfortunately, he succumbed within a week of diagnosis.