Predictive Model for Idiopathic Multicentric Castleman Disease Supporting Treatment Decisions

Exploring castleman disease in a cohort of hispanic patients: a recognition to its histopathology

Castleman disease is a clinicopathological entity that shares features with hematological, rheumatological, and infectious diseases, making accurate diagnosis essential. The objective of this study is to characterize the clinical and pathological characteristics of CD in a Mexican cohort. A retrospective study was conducted on adult Mexican patients diagnosed with unicentric (UCD) and multicentric (MCD) Castleman disease from 1985 to 2023. Clinical and histopathological characteristics typical of UCD and MCD were observed. POEMS-associated MCD showed a higher relapse rate. The mixed histopathological variant was more prevalent in MCD. Immunohistochemical expression of VEGF-A was elevated in all CD cases. A multidisciplinary diagnostic approach is crucial for accurately categorizing CD. The mixed histopathological variant was more common than previously reported, especially in MCD. Further studies are needed to validate VEGF-A as a biomarker for CD.

[Castleman's disease, pathophysiology, advances in diagnosis and treatment]

Castleman's disease (CD) encompasses a heterogeneous set of reactive lymphoproliferative processes that share well-defined histologic features. CD is considered a rare or minority disease. The incidence of CD is not fully known, although it is estimated at less than 1 per 100,000 inhabitants. It has a bimodal distribution (30-40 years and then 60-80 years). The incidence is similar in both sexes, although the unicentric variant seems to have a slight predominance in women with a 2:1 ratio. CD is classified into a hyalinovascular form (this being the most frequent) and a plasmocellular form, related to the HIV and VHH-8 viruses, which together with other autoimmune mechanisms develop hyperproduction of interleukin-6 (IL-6) by B lymphocytes. There are different lines of treatment, where the use of anti IL-6 stands out, being siltuximab the most used as orphan drug in this pathology.