Rosai-Dorfman disease can be limited to the lymph nodes, or affect other body systems, beyond the nodes. The majority of patients experience enlarged lymph nodes on both sides of the next. While often painless, these nodes can swell and grow rather larger. Swelling may also be reported in the lymph nodes of the groin, armpits and in the central portion of the chest. This swelling may be accompanied by fever.
In about 40 percent of patients, the disease occurs outside of the lymph nodes, affecting skin and soft tissue, nasal cavities, the eyes and eyelids, the bones, salivary glands and central nervous system. In rare instances, it affects the kidneys, lungs, liver, breast, heart, and digestive tracts.
Less frequent symptoms of RDD may include
Low blood counts: As the number of oxygen-carrying red blood cells decline, patients may develop anemia, appearing pale, tired or short of breath. A decline in platelets that normally help the blood clot may lead to easy bruising or bleeding. A decline in white blood cells puts patients at increased risk for infections that can sometimes be life threatening.
- Weight loss
- Shortness of breath
- Blockage/discharge of the nose
- Deformity of the nose (saddle-nose)
- Inflammation of the tonsils/sinuses
- Difficulty swallowing or speaking
- High-pitched breathing
- Bulging eyes, decreased vision
- Night sweats
- Decreased sensation
- Other blood abnormalities (increased sedimentation/inflammatory cell rate, abnormal protein levels)
- Joint pain
- A slow-growing, painless mass in the lymph nodes
Many adult patients with this condition have severe pain caused by bone lesions or fractures that do not heal completely with therapy. Some report pain even when no cause can be identified by an x-ray.