Langerhans Cell Histiocytosis: A Rare Differential Diagnosis for Child Abuse-A Case Report With A Forensic Standpoint

There are various forms of child abuse-physical, sexual, psychological and starvation. The physical form being more common, presents with clinical findings such as bruises, multiple fractures of varying ages, subdural haemorrhages, retinal haemorrhages, abdominal injuries etc. Some naturally occurring diseases also have external features similar to those mentioned above. We present a case of a 13yr old male child, who was admitted with a head injury after an alleged history of fall in his school. Bruises of varying ages were present all over the body along with signs of abdominal injury, following which, a suspicion of child abuse was made. The blood coagulation profile was well within normal limits. However, following the death of the child, the autopsy findings, together with the previous medical history of the child, established it to be a known case of Langerhans cell histiocytosis. The present case report stresses on establishing a case of child abuse with utmost precision and expertise and also the need to exclude all the possible non-traumatic etiologies which mimic child abuse.