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Satoh K, Okuyama M, Nakae H. Potential risks of cell-free concentrated ascites reinfusion therapy in TAFRO syndrome patient. Ther Apher Dial 2024; 28:477-478. [PMID: 38316625 DOI: 10.1111/1744-9987.14109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/22/2023] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Affiliation(s)
- Kasumi Satoh
- Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, Akita, Japan
| | - Manabu Okuyama
- Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, Akita, Japan
| | - Hajime Nakae
- Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, Akita, Japan
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2
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Lopez M, Kainthla R, Lazarte S, Chen W, Nijhawan AE, Knights S. Outcomes in Kaposi's sarcoma-associated herpesvirus -associated primary effusion lymphoma and multicentric Castleman's disease in patients with human immunodeficiency virus (HIV) in a safety-net hospital system. Eur J Haematol 2024; 112:723-730. [PMID: 38155405 DOI: 10.1111/ejh.14163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/13/2023] [Accepted: 12/13/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVE To describe cases of Kaposi's sarcoma-associated herpesvirus (KSHV)-associated multicentric Castleman's disease (MCD) and primary effusion lymphoma (PEL) in patients with HIV from a large, safety-net hospital system in Dallas, Texas, USA. METHODS We conducted a retrospective review of patients with HIV-associated PEL and/or MCD. RESULTS Twelve patients with PEL and 10 patients with MCD were identified. All patients were male and 17 of 20 were men who have sex with men; 66.7% of PEL patients and 50% of MCD patients had concurrent KS at the time of diagnosis; 42% of patients with PEL and 20% of patients with MCD died during the follow-up period. We noted improved survival in our cohort compared to previous studies, particularly in our PEL patients with a median survival of 11.4 months compared to 3-6-month median survival historically. Median follow-up time for MCD patients was 17.5 months. This improved survival is despite suboptimal antiretroviral therapy (ART) adherence at diagnosis, with only 50% of patients on ART at the time of MCD/PEL diagnosis. CONCLUSION These data highlight the importance of early recognition of PEL and MCD, and the larger-scale efforts needed to better understand the pathogenetic drivers of clinical outcomes in patients affected by KSHV-related diseases.
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Affiliation(s)
- Melanie Lopez
- Department of Undergraduate Medical Education, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Radhika Kainthla
- Division of Hematology and Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Parkland Health, Dallas, Texas, USA
| | - Susana Lazarte
- Parkland Health, Dallas, Texas, USA
- Division of Infectious Diseases and Geographic Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Weina Chen
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ank E Nijhawan
- Parkland Health, Dallas, Texas, USA
- Division of Infectious Diseases and Geographic Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Sheena Knights
- Parkland Health, Dallas, Texas, USA
- Division of Infectious Diseases and Geographic Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Zhang Y, Li CY, Li Z, Chen W. Unicentric Castleman's disease in the parotid gland associated with psoriasis: a case report. J Med Case Rep 2024; 18:140. [PMID: 38566262 PMCID: PMC10988862 DOI: 10.1186/s13256-024-04468-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/20/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Castleman's disease is a rare lymphoproliferative disorder that is often misdiagnosed because of its untypical clinical or imaging features except for a painless mass. Besides, it is also difficult to cure Castleman's disease due to its unclear pathogenesis. CASE PRESENTATION We present a Castleman's disease case with diagnostic significance regarding a 54-year-old Chinese male who has a painless mass in his left parotid gland for 18 months with a 30-years history of autoimmune disease psoriasis. Computed tomography scan showed a high-density nodule with clear boundaries in the left parotid and multiple enlarged lymph nodes in the left submandibular and neck region. General checkup, the extremely elevated serum interleukin-6 and lymph node biopsy in the left submandibular region gave us an initial suspicion of Castleman's disease. Then the patient underwent a left superficial parotidectomy. Based on histopathologic analysis, we made a certain diagnosis of Castleman's disease and gave corresponding treatments. In 18 months of follow-up, the patient showed no evidence of recurrence, with the level of serum interleukin-6 decreased. CONCLUSIONS Clinicians should be aware of the possibility of Castleman's disease when faced with masses or enlarged lymph nodes in the parotid gland to avoid misdiagnosis, especially in patients with autoimmune diseases and elevated serum interleukin-6.
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Affiliation(s)
- Ying Zhang
- Department of Stomatology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, 305 East Zhongshan Road, Nanjing, 210012, Jiangsu, China
| | - Chong-Yang Li
- Department of Stomatology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, 305 East Zhongshan Road, Nanjing, 210012, Jiangsu, China
| | - Zhi Li
- Department of Stomatology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, 305 East Zhongshan Road, Nanjing, 210012, Jiangsu, China
| | - Wei Chen
- Department of Stomatology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, 305 East Zhongshan Road, Nanjing, 210012, Jiangsu, China.
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4
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Xue C, Hu X, Yang B, Zhang L, Mao Z. Peritoneal dialysis is feasible for TAFRO syndrome with acute kidney injury and refractory ascites: A case report. Clin Nephrol 2024; 101:203-206. [PMID: 38126197 DOI: 10.5414/cn111255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2024] [Indexed: 12/23/2023] Open
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Appell LE, Mack JM, Farrar JE, Roper SN, Savage MR, Pandey S, Crary SE. Acquired Hemophilia: A Rare Complication of Pediatric Idiopathic Multicentric Castleman Disease. Pediatrics 2024; 153:e2023063168. [PMID: 38511235 DOI: 10.1542/peds.2023-063168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 03/22/2024] Open
Abstract
Acquired hemophilia is caused by acquired autoantibodies to 1 of the factors of the coagulation cascade, usually factor VIII or IX, and is an exceedingly rare phenomenon in children. The finding of an acquired factor VIII inhibitor in a pediatric patient with idiopathic multicentric Castleman disease has never been reported. Patients with acquired hemophilia can have life-threatening bleeds that are refractory to blood product support, requiring bypassing agents to manage bleeding symptoms. We present the novel finding of acquired hemophilia resulting from an autoantibody to factor VIII in a pediatric patient with idiopathic multicentric Castleman disease and discuss the optimal management of bleeding in a patient with acquired hemophilia.
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Affiliation(s)
- Lauren E Appell
- Department of Pediatrics, Division of Pediatric Hematology/Oncology
- Arkansas Children's Hospital, Little Rock Arkansas
| | - Joana M Mack
- Department of Pediatrics, Division of Pediatric Hematology/Oncology
- Arkansas Children's Hospital, Little Rock Arkansas
| | - Jason E Farrar
- Department of Pediatrics, Division of Pediatric Hematology/Oncology
- Arkansas Children's Hospital, Little Rock Arkansas
| | - Sydney N Roper
- College of Medicine
- Department of Medicine & Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Matthew R Savage
- College of Medicine
- Department of Family Medicine, Baptist Health-University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Soumya Pandey
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Shelley E Crary
- Department of Pediatrics, Division of Pediatric Hematology/Oncology
- Arkansas Children's Hospital, Little Rock Arkansas
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Orzel J, Dewberry L, Holman C, Sato Y, Shelton J, Edwards A. Urologic Presentation of Unicentric Pediatric Castleman Disease in the Setting of Acute Renal Colic. Urology 2024; 186:162-165. [PMID: 38408492 DOI: 10.1016/j.urology.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 02/13/2024] [Indexed: 02/28/2024]
Abstract
An 11-year-old otherwise healthy female presented with renal colic and during computed tomography imaging evaluation, she was found to have a right distal ureteral stone with associated hydroureteronephrosis, medially deviated ureter, and 4-cm solid retroperitoneal mass. The mass was palpable on physical exam and was further categorized with magnetic resonance imaging, ultrasound, and laboratory testing. A multidisciplinary team approach, including pediatric surgery, radiology, oncology, and urology, led to the patient undergoing a right retrograde pyelogram, ureteroscopy with stent placement, and laparoscopic excision of retroperitoneal mass. Her pathology revealed lymphoid hyperplasia with histologic features of Castleman disease.
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Affiliation(s)
- Joanna Orzel
- University of Iowa Hospitals and Clinics, Department of Urology, Iowa City, IA.
| | - Lindel Dewberry
- University of Iowa Hospitals and Clinics, Division of Pediatric Surgery, Iowa City, IA
| | - Carol Holman
- University of Iowa Hospitals and Clinics, Department of Pathology, Iowa City, IA
| | - Yutaka Sato
- University of Iowa Hospitals and Clinics, Department of Radiology, Iowa City, IA
| | - Julia Shelton
- University of Iowa Hospitals and Clinics, Division of Pediatric Surgery, Iowa City, IA
| | - Angelena Edwards
- University of Iowa Hospitals and Clinics, Department of Urology, Iowa City, IA
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Chang LC, Fu PA, Wang SH, Chang KC, Hsu YT. Kaposi sarcoma herpesvirus/human herpesvirus 8-positive diffuse large B-cell lymphoma characterized by malignant ascites: A case report. Pathol Res Pract 2024; 255:155185. [PMID: 38342036 DOI: 10.1016/j.prp.2024.155185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/13/2024]
Abstract
Herein, we report a rare case of Kaposi sarcoma herpesvirus/human herpesvirus 8 (KSHV/HHV8)-positive diffuse large B-cell lymphoma (DLBCL), which is characterized by malignant ascites and complex karyotypes. A 72-year-old male patient who tested negative for human immunodeficiency virus presented with thrombocytopenia and lymphadenopathies. He was diagnosed with KSHV/HHV8-associated multicentric Castleman disease (MCD). After three years, he developed progressive lymphadenopathies and massive ascites. The lymphoma cells in the ascitic fluid presented with characteristic immunophenotype and monoclonality, which support the diagnosis of KSHV/HHV8-positive DLBCL. Lymphadenopathies and massive splenomegaly are common manifestations of KSHV/HHV8-positive DLBCL. Nevertheless, peritoneal involvement, as observed in this case, is a rare presentation. This emphasizes the diagnostic complexities of KSHV/HHV8-associated lymphoproliferative disorders. Within the context of preexisting KSHV/HHV8-associated multicentric Castleman disease, the differential diagnosis of this disorder can be challenging.
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Affiliation(s)
- Li-Chang Chang
- Division of Hematology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
| | - Pei-An Fu
- Division of Hematology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
| | - Shu-Hsien Wang
- Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
| | - Kung-Chao Chang
- Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
| | - Ya-Ting Hsu
- Division of Hematology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan.
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Chabchoub I, Salah RB, Kallel R, Snoussi M, Frikha F, Marzouk S, Boudawara TS, Bahloul Z. Clinical features and outcomes in patients with human immunodeficiency virus-negative, Castleman's disease: a single medical center study in Tunisia. Rom J Intern Med 2024; 62:20-32. [PMID: 37948573 DOI: 10.2478/rjim-2023-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION Castleman's disease (CD), known as angiofollicular lymph node hyperplasia, is an uncommon condition. The two most common histological subtypes are hyaline vascular and plasma cell. We performed a retrospective analysis to define the clinic-pathological features and survival of CD, which is quite rare focusing on the particularities of our series with a review of the recent literature. METHODS This is a retrospective study conducted in the department of internal medicine of Hedi Chaker hospital in Sfax, Tunisia over 25 years. The disease was histologically confirmed in all patients. For each file, we collected a set of data by filling in a pre-designed form. RESULTS 18 patients were included. There were 8 men and 10 women with a mean age of 42.8 years. CD was monocentric in 5 cases (28%) and multicentric in 13 cases (72%). Clinically, peripheral adenopathy was present in 77.7% of patients and deep adenopathy in 72.2%. Systemic signs were found in 13 patients, including general condition (4.4%), fever (16.6%), serositis (27.7%), and skin involvement (33.3%). A biological inflammatory syndrome accompanied the clinical picture in 66% of patients. Abnormalities in the blood count were found in 12 cases (66%), with anemia in 11 cases, thrombocytosis in 3 cases, and hypereosinophilia in 3 cases. Cutaneous Kaposi's sarcoma was associated with Castleman's disease in 2 cases, Hodgkin's lymphoma, angioimmunoblastic T-cell lymphoma, and lymph node T-cell lymphoma were found in 1 case respectively. 3 of the patients had associated connective tissue diseases such as Sjögren's syndrome in 2 cases and rheumatoid arthritis in 1 case. HHV8 serology was positive in 1 case with a multicentric plasma cell form. Histologically, the plasma cell form represented 50% of cases, hyaline-vascular (39% of cases), and mixed (11% of cases). Therapeutically, high-dose corticosteroid therapy was initiated in 13 cases. As a second-line treatment, MOPP chemotherapy was used in 1 case due to transformation into Hodgkin's lymphoma, and biotherapy (rituximab) was used in 2 cases in the multicentric form. Surgical removal of superficial adenopathy was performed in 2 patients with monocentric CD. CONCLUSION : Castleman's disease (CD) is a non-malignant lymphoproliferation of localized or multicentric form with a wide and heterogeneous clinical spectrum. Diagnosis can be difficult due to the lack of clinical and radiological specificity. Management depends on the clinical form involving surgical and/or medical management.
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Affiliation(s)
- Imen Chabchoub
- Internal Medicine department, Hedi Chaker Hopsital, University of Sfax, Faculty of Medicine 3029 Sfax, Tunisia
| | - Raida Ben Salah
- Internal Medicine department, Hedi Chaker Hopsital, University of Sfax, Faculty of Medicine 3029 Sfax, Tunisia
| | - Rim Kallel
- Anatomopathology laboratory, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Mouna Snoussi
- Internal Medicine department, Hedi Chaker Hopsital, University of Sfax, Faculty of Medicine 3029 Sfax, Tunisia
| | - Feten Frikha
- Internal Medicine department, Hedi Chaker Hopsital, University of Sfax, Faculty of Medicine 3029 Sfax, Tunisia
| | - Sameh Marzouk
- Internal Medicine department, Hedi Chaker Hopsital, University of Sfax, Faculty of Medicine 3029 Sfax, Tunisia
| | | | - Zouhir Bahloul
- Internal Medicine department, Hedi Chaker Hopsital, University of Sfax, Faculty of Medicine 3029 Sfax, Tunisia
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Wang S, Wang R, Shang P, Zhu X, Chen X, Zhang G, Wang M. Whole-Exome Sequencing Reveals the Genomic Profile and IL6ST Variants as a Prognostic Biomarker of Paraneoplastic Pemphigus-Associated Unicentric Castleman Disease. J Invest Dermatol 2024; 144:585-592.e1. [PMID: 37839777 DOI: 10.1016/j.jid.2023.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/27/2023] [Accepted: 07/29/2023] [Indexed: 10/17/2023]
Abstract
Unicentric Castleman disease (UCD) is a rare lymphoproliferative disorder. Paraneoplastic pemphigus (PNP) is a major complication associated with poor UCD prognosis. However, the genomic profiles and prognostic biomarkers of PNP-associated UCD remain unclear. In this study, we performed whole-exome sequencing analysis for 28 matched tumor-normal pairs and 9 tumor-only samples to define the genomic landscape of Chinese patients with PNP-associated UCD. An integrative analysis was performed to identify somatic variants, the mutational signatures, and key pathways in tumors. Besides, we analyzed the relationship among mutated genes, clinical characteristics, and prognosis. Sixty-one somatic mutant genes were identified in >1 patient with PNP-associated UCD. Specifically, IL6ST and PDGFRB were the most frequently mutated genes (32%), followed by DPP6 (18%) and MUC4 (18%). Signaling molecules and interactions, cellular processes, and signal transduction pathways were enriched. Furthermore, we found that poor overall survival was related to IL6ST variants (P = .02). Finally, we classified PNP-associated UCD into 4 genomic subgroups: IL6ST, PDGFRB, IL6ST-PDGFRB, and an unknown subgroup. In summary, we defined the molecular profile of PNP-associated UCD and identified a potential molecular biomarker for predicting prognosis, which may provide therapeutic targets for treating this severe disorder.
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Affiliation(s)
- Sai Wang
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China; National Clinical Research Center for Skin and Immune Diseases, Beijing, China; Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China; National Medical Products Administration Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - Rui Wang
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China; National Clinical Research Center for Skin and Immune Diseases, Beijing, China; Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China; National Medical Products Administration Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - Panpan Shang
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China; National Clinical Research Center for Skin and Immune Diseases, Beijing, China; Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China; National Medical Products Administration Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - Xuejun Zhu
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China; National Clinical Research Center for Skin and Immune Diseases, Beijing, China; Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China; National Medical Products Administration Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - Xixue Chen
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China; National Clinical Research Center for Skin and Immune Diseases, Beijing, China; Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China; National Medical Products Administration Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - Guohong Zhang
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China; National Clinical Research Center for Skin and Immune Diseases, Beijing, China; Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China; National Medical Products Administration Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - Mingyue Wang
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China; National Clinical Research Center for Skin and Immune Diseases, Beijing, China; Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China; National Medical Products Administration Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China.
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Takada I, Amemiya R, Ono S, Kou K, Morishita Y, Ikeda N, Furukawa K. A Rare Case of Chest Wall Castleman's Disease with Calcification. Ann Thorac Cardiovasc Surg 2023; 29:319-322. [PMID: 35545524 PMCID: PMC10767661 DOI: 10.5761/atcs.cr.22-00026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/06/2022] [Indexed: 11/16/2022] Open
Abstract
Castleman's disease with calcification of the chest wall is very rare, and there have been few reports of such cases to date. A 57-year-old woman was referred to our hospital for a tumor with calcification on her left lateral chest wall, which was detected on chest computed tomography. Findings of her chest magnetic resonance imaging suggested schwannoma or a solitary fibrous tumor, and therefore, we performed surgery for diagnostic and therapeutic purposes. Pathologically, the tumor with calcification was diagnosed as Castleman's disease of the hyaline-vascular type. After the surgery, the patient has had no obvious symptoms and continues to undergo regular follow-up examinations.
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Affiliation(s)
- Ikki Takada
- Department of Thoracic Surgery, Tokyo Medical University Ibaraki Medical Center, Ami-machi, Ibaraki, Japan
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Ryosuke Amemiya
- Department of Thoracic Surgery, Tokyo Medical University Ibaraki Medical Center, Ami-machi, Ibaraki, Japan
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Shotaro Ono
- Department of Thoracic Surgery, Tokyo Medical University Ibaraki Medical Center, Ami-machi, Ibaraki, Japan
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Keni Kou
- Department of Diagnostic Pathology Division, Tokyo Medical University Ibaraki Medical Center, Ami-machi, Ibaraki, Japan
| | - Yukio Morishita
- Department of Diagnostic Pathology Division, Tokyo Medical University Ibaraki Medical Center, Ami-machi, Ibaraki, Japan
| | - Norihiko Ikeda
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kinya Furukawa
- Department of Thoracic Surgery, Tokyo Medical University Ibaraki Medical Center, Ami-machi, Ibaraki, Japan
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Tashakori M, Beckman AK. Circulating plasmablastic cells in a patient with HHV-8-associated multicentric Castleman disease and Kaposi sarcoma. Blood 2023; 142:2124. [PMID: 38095919 DOI: 10.1182/blood.2023022364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
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12
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Zhu Q, Wang S. Castleman disease of plasma cell type accompanied with bronchiolitis obliterans: a case report and review of the literature. J Med Case Rep 2023; 17:539. [PMID: 38082371 PMCID: PMC10714532 DOI: 10.1186/s13256-023-04285-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Castleman disease, also known as giant lymph node hyperplasia or angiofollicular lymph node hyperplasia, is a highly heterogeneous clinicopathological entity that belongs to the family lymphoproliferative disorders. Castleman disease accompanied by bronchiolitis obliterans is uncommon and often poses a great diagnostic challenge, which is easily confused with respiratory diseases and impeding the correct diagnosis and treatment. The main aim in presenting such rare case studies is to raise awareness and expand the diagnostic horizon of clinicians for appropriate management. CASE PRESENTATION Here, we present a 69-year-old Chinese male who was admitted to our hospital due to right chest pain for 6 months, accompanied by cough, expectoration, and fever. Laboratory examinations revealed elevated immunoglobulin G and C-reactive protein, and normal serum levels of tumor markers and interleukin-6. Computed tomography scan detected diffuse bronchial wall thickening and patchy area of air trapping consistent with small airway disease. Pulmonary function test showed mild small airway obstructive ventilation dysfunction and moderate decrease in diffusion capacity. The pathological result of the right axillary lymph node was consistent with the plasma cell type Castleman disease. According to the above examinations, the patient was finally diagnosed with the plasma cell type Castleman disease accompanied with bronchiolitis obliterans. He received immunosuppressive medication after surgery and has been followed up for 11 months. Now the patient is currently in stable condition without recurrence. CONCLUSION Castleman disease is a rare lymphoproliferative disorder with a variety of symptoms. At present, the treatment of Castleman disease accompanied with bronchiolitis obliterans is mostly based on experiences or previous case reports, and there is no standard treatment. Here, we report an uncommon case of Castleman disease accompanied with bronchiolitis obliterans in which the patient received immunosuppressive medication after surgery and has been followed up for 11 months without experiencing a recurrence, which may deepen and extend our understanding of this disease.
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Affiliation(s)
- Qingyuan Zhu
- Department of Respiratory Diseases, Quzhou TCM Hospital at the Junction of Four Provinces Affiliated to Zhejiang Chinese Medical University, Quzhou, 324002, Zhejiang Province, China
| | - Shuiyou Wang
- Department of Respiratory Diseases, Quzhou TCM Hospital at the Junction of Four Provinces Affiliated to Zhejiang Chinese Medical University, Quzhou, 324002, Zhejiang Province, China.
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13
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Hatta BWM, Syafiqah S, Rasheed M, Vegagonzalez M, Leong WB, Bashir A. Idiopathic multicentric Castleman disease and its rare association with peripheral neuropathy and stroke. Clin Med (Lond) 2023; 23:1. [PMID: 38182226 PMCID: PMC11046664 DOI: 10.7861/clinmed.23-6-s1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
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14
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Ma X, Li J, Fan L, Jiang H, Shi G, Ge D, Shi X. Systemic lupus erythematosus combined with Castleman disease and secondary paraneoplastic pemphigus: a case report. Pediatr Rheumatol Online J 2023; 21:126. [PMID: 37858241 PMCID: PMC10588252 DOI: 10.1186/s12969-023-00871-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/30/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND The literature describes a case of systemic lupus erythematosus (SLE) complicated with Castleman's disease (CD) and secondary paraneoplastic pemphigus (PNP). CASE PRESENTATION A 12-year-old female presented with a neck mass, rash, arthralgia, and skin and mouth ulceration for 5 years were admitted. All blood cells were low. Multiple autoantibodies associated with SLE were positive. The pathology of the neck mass revealed the classical manifestations of CD. She was treated with prednisone, hydroxychloroquine, leflunomide, thalidomide, and dressings. Pathological examination of the skin revealed PNP. The neck mass was removed and continued to take antirheumatic drugs. At subsequent follow-up, the patient's disease status was stable and the skin mucosal lesion did not recur. CONCLUSION The case of simultaneous SLE, CD, and PNP in children was rarely reported, and the correct diagnosis of the disease will help to take timely treatment.
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Affiliation(s)
- Xin Ma
- Department of Rheumatology and Immunology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, No,24 Jinghua Road, Luoyang, China
| | - Jiyuan Li
- Department of Thoracic Surgery, The First Affiliated Hospital, and College of Clinicalcal Medicine of Henan University of Science and Technology, No,24 Jinghua Road, Luoyang, China
| | - Linlin Fan
- Department of Rheumatology and Immunology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, No,24 Jinghua Road, Luoyang, China
| | - Hongwei Jiang
- Henan Key Laboratory of Rare Diseases, Endocrinology and Metabolism Center, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, No,24 Jinghua Road, Luoyang, China
| | - Gaishao Shi
- Department of Rheumatology and Immunology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, No,24 Jinghua Road, Luoyang, China
| | - Dongfeng Ge
- Department of Pathology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, No,24 Jinghua Road, Luoyang, China
| | - Xiaofei Shi
- Department of Rheumatology and Immunology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, No,24 Jinghua Road, Luoyang, China.
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15
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Peng Q, Wu F, Shi Y, Wang J, Zhai Z, Wang Z. Idiopathic multicentric castleman's disease mimicking immunoglobulin G4-related disease responding well to Bortezomib: a case report. BMC Nephrol 2023; 24:290. [PMID: 37784011 PMCID: PMC10546740 DOI: 10.1186/s12882-023-03335-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/18/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Castleman's disease (CD) is a rare disease that has clinical and pathological similarities to lymphoma and is characterized by a high frequency of associated immunological dysfunction. ImmunoglobulinG4-related disease (IgG4-RD) is a collection of systemic disorders that affect numerous organs and are also referred to as IgG4-associated sclerosing diseases. CD and IgG4-RD are difficult to separate because they may manifest similar commin clinical features. CASE PRESENTATION This case describes a 53-year-old female who, during routine medical check-up, exhibited a progressive increase in serum globulin levels and a simultaneous worsening of anemia symptoms, raising concern for a clonal plasma cell disease such as myeloma. However, bone marrow punctures did not reveal any abnormal plasma cells. Also, serum and urine immunofixation electrophoresis demonstrated no abnormal monoclonal protein bands. In addition, several laboratory findings excluded chronic liver disease, chronic infections caused by bacteria or viruses. Later, we found elevated serum IgG4 levels (10,700 mg/L), and identified multiple enlarged lymph nodes throughout the patient's body. Axillary lymph node aspiration revealed no abnormal lymphocytes, ruling out the possibility of lymphoma. Pathological morphology of the axillary lymph revealed a large number of plasma cells in the lymphatic follicles. In addition, there was a reduction in lymphatic follicle size and apoptosis of the germinal centres. Immunohistochemistry revealed IgG4+/IgG + in > 40% of cells, and more than 100 IgG4 + cells per high powered field (HPF) of specimen. As of now, finding strongly suggested IgG4-RD. This patient was treated with glucocorticoids and various immunosuppressive drugs, such as prednisone, cyclosporine, methotrexate, cyclophosphamide, mycophenolate mofetil, azathioprine and hydroxychloroquine. Unfortunately, the patient did not recover. Ultimately, idiopathic multicentric Castleman disease (iMCD) was diagnosed in relation to the patient's clinical presentation and laboratory tests, and after combination chemotherapy (VCD: Bortezomib, Cyclophosphamide and Dexamethasone), durable remission was achieved without serious adverse effects. During the follow-up period of one year and ten months, the patient remained stable. CONCLUSION The diagnosis of Castleman must be distinguished from other disorders such as IgG4-RD, malignant lymphoma, reactive hyperplasia of various lymph nodes (mostly caused by viral infections), plasmacytoma, advanced HIV and rheumatic diseases. Besides observing systemic symptoms, laboratory tests such as immunoglobulin levels, complement levels, interleukin levels, and C-reactive protein levels should also be performed in order to determine a diagnosis.
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Affiliation(s)
- Qian Peng
- Department of Hematology/Hematological Lab, Second Hospital of Anhui Medical University, Hefei, 230601, China
| | - Fan Wu
- Department of Hematology/Hematological Lab, Second Hospital of Anhui Medical University, Hefei, 230601, China
| | - Yuting Shi
- Department of Radiology, Second Hospital of Anhui Medical University, Hefei, 230601, China
| | - Juan Wang
- Department of Hematology/Hematological Lab, Second Hospital of Anhui Medical University, Hefei, 230601, China
| | - Zhimin Zhai
- Department of Hematology/Hematological Lab, Second Hospital of Anhui Medical University, Hefei, 230601, China
| | - Zhitao Wang
- Department of Hematology/Hematological Lab, Second Hospital of Anhui Medical University, Hefei, 230601, China.
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16
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Rasmussen C, Gérard L, Fadlallah J, Corvilain E, Galicier L, Meignin V, Oksenhendler E, Boutboul D. Higher rate of progression in HIV- than in HIV+ patients after rituximab for HHV8+ multicentric Castleman disease. Blood Adv 2023; 7:5663-5669. [PMID: 37288720 PMCID: PMC10546345 DOI: 10.1182/bloodadvances.2023010316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/16/2023] [Accepted: 05/29/2023] [Indexed: 06/09/2023] Open
Abstract
Rituximab has revolutionized the treatment of Kaposi sarcoma-associated herpesvirus/human herpesvirus 8-associated multicentric Castleman disease (HHV8+ MCD), converting a rapidly fatal illness into a relapsing disease. HHV8+ MCD mainly affects patients with HIV infection but can also be observed in patients without HIV infection. We retrospectively analyzed a cohort of 99 patients (73 who tested HIV+ and 26 who tested HIV-), with HHV8+ MCD treated with rituximab-based therapy. Baseline characteristics were similar in patients who had HIV- and HIV+ results, although those who tested HIV- were older (65 vs 42 years) and presented less frequently with Kaposi sarcoma (15% vs 40%). Ninety-five patients (70 HIV+ and 25 HIV-) achieved complete remission (CR) after rituximab-based therapy. After a median follow-up of 51 months, 36 patients (12 HIV- and 24 HIV+) experienced disease progression. The 5-year progression-free survival (PFS) was 54%. The 5-year PFS was lower in HIV- patients than in HIV+ patients : 26% and 62%, respectively (P = .02). A multivariate prognostic factors analysis including time-dependent covariates revealed that HIV- status, reoccurrence of HHV8 DNA >3 log copies per mL, and serum C-reactive protein (CRP) >20 mg/mL were independently associated with an increased risk of progression after rituximab-induced CR (P = .001; P = .01; and P = .01, respectively). The lower rate of progression observed in the population with HIV+ results despite a longer follow-up period might have resulted from the possible immune restoration upon antiretroviral therapy. HHV8 viral load and serum CRP monitoring after rituximab therapy provide information on the progression risk and may help in the decision to resume specific therapy.
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Affiliation(s)
- Camille Rasmussen
- Department of Clinical Immunology, Hôpital Saint-Louis, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Laurence Gérard
- Department of Clinical Immunology, Hôpital Saint-Louis, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Jehane Fadlallah
- Department of Clinical Immunology, Hôpital Saint-Louis, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Emilie Corvilain
- Department of Clinical Immunology, Hôpital Saint-Louis, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Lionel Galicier
- Department of Clinical Immunology, Hôpital Saint-Louis, Assistance Publique–Hôpitaux de Paris, Paris, France
- National Reference Center for Castleman Disease, Paris, France
| | - Véronique Meignin
- Department of Pathology, Hôpital Saint-Louis, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Eric Oksenhendler
- Department of Clinical Immunology, Hôpital Saint-Louis, Assistance Publique–Hôpitaux de Paris, Paris, France
- National Reference Center for Castleman Disease, Paris, France
- Université de Paris, Paris, France
| | - David Boutboul
- Department of Clinical Immunology, Hôpital Saint-Louis, Assistance Publique–Hôpitaux de Paris, Paris, France
- National Reference Center for Castleman Disease, Paris, France
- Université de Paris, Paris, France
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17
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Lucas F, O'Keefe TE, Banks N, Bledsoe J, Kim AS, Sadigh S. Old links revisited: Co-occurring thymoma and Castleman disease. Am J Hematol 2023; 98:1497-1498. [PMID: 36794925 DOI: 10.1002/ajh.26885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023]
Affiliation(s)
- Fabienne Lucas
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Thomas E O'Keefe
- Department of Pathology, Saint Elizabeth's Medical Center, Boston, Massachusetts, USA
| | - Nadia Banks
- Department of Pathology, Saint Elizabeth's Medical Center, Boston, Massachusetts, USA
| | - Jacob Bledsoe
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Pathology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Annette S Kim
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Sam Sadigh
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
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18
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Huang L, Zheng X, Huang X, Wang L, Fang X, He G, Tang M, Shi H, Cai H. Alveolar Hemorrhage in Idiopathic Multicentric Castleman's Disease. Am J Respir Crit Care Med 2023; 208:613-615. [PMID: 36883944 PMCID: PMC10492250 DOI: 10.1164/rccm.202204-0780im] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 03/06/2023] [Indexed: 03/09/2023] Open
Affiliation(s)
| | | | | | | | | | | | | | - Huixian Shi
- Department of Radiology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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19
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Plano F, Mancuso S, Camarda GM, Butera MG, Sucato G, Alecci G, Florena AM, Perrone S, Siragusa SM. A Multicentric Castleman Disease Associated with Mixed Warm and Cold Antibody-Mediated AHA Responsive to Siltuximab. Chemotherapy 2023; 69:35-39. [PMID: 37634492 DOI: 10.1159/000533235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 07/21/2023] [Indexed: 08/29/2023]
Abstract
Castleman disease is non-clonal lymphoproliferative disorders defined by hypertrophy of lymph nodes. The multicentric form (MCD), in which multiple lymph node stations are involved, is not associated with HHV8 infection, but considered idiopathic, although IL-6 appears to play a central role in its pathogenesis. Here, we report the case of a patient who presented with mixed autoimmune hemolytic anemia (AIHA) and adenopathy that was very challenging to diagnose due to very low values of hemoglobin and refractoriness of obtaining any improvement of AIHA with standard first and second lines of therapy (steroids, rituximab, immunoglobulin, erythropoietin, and cyclosporine). When we safely proceeded to lymph node biopsy, a diagnosis of MCD was established. This permitted the treatment with siltuximab, an anti-IL-6 monoclonal antibody. After only 1 week, hemoglobin raised and he was discharged. After 1 year, he was still in remission. This case underlines the challenges in diagnosis of MCD, and the first case of response to siltuximab after the failure of rituximab to relieve mixed AIHA.
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Affiliation(s)
- Federica Plano
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Salvatrice Mancuso
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Giulia Maria Camarda
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Maria Giulia Butera
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Giuseppe Sucato
- Hematology Division, University Hospital Policlinico "Paolo Giaccone,", Palermo, Italy
| | - Giuseppe Alecci
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Ada Maria Florena
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Salvatore Perrone
- Hematology Division, University Hospital Policlinico "Paolo Giaccone,", Palermo, Italy
| | - Sergio Mario Siragusa
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
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20
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Nakayama Y, Mizuno H, Sawa N, Suwabe T, Yamanouchi M, Ikuma D, Hasegawa E, Hoshino J, Sekine A, Oba Y, Kono K, Kinowaki K, Ohashi K, Suzuki K, Sato Y, Shimizu A, Yamaguchi Y, Ubara Y. Adolescent-onset TAFRO Syndrome with Malignant Nephrosclerosis-like Lesions. Intern Med 2023; 62:2223-2229. [PMID: 36517029 PMCID: PMC10465276 DOI: 10.2169/internalmedicine.0529-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/30/2022] [Indexed: 12/15/2022] Open
Abstract
A 16-year-old Japanese girl developed a fever, thrombocytopenia, and renal dysfunction. Treatment was started with steroids, but cervical lymphadenopathy and ascites developed. A lymph node biopsy indicated TAFRO syndrome. The patient's renal function deteriorated, and dialysis was started. Refractory hypertension and subsequent encephalopathy developed. Treatment was started with an anti-IL-6 receptor antibody and an anti-CD20 monoclonal antibody. A kidney biopsy showed malignant nephrosclerosis-like microangiopathy and glomerular collapse due to narrowing of the small arteries. The majority of TAFRO syndrome cases are adult-onset, with glomerular microangiopathy. To our knowledge, this is the first report of adolescent-onset TAFRO syndrome presenting with malignant nephrosclerosis-like lesions associated with hypertension.
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Affiliation(s)
- Yuki Nakayama
- Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Kajigaya, Japan
| | - Hiroki Mizuno
- Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Kajigaya, Japan
| | - Naoki Sawa
- Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Kajigaya, Japan
| | - Tatsuya Suwabe
- Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Kajigaya, Japan
| | - Masayuki Yamanouchi
- Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Kajigaya, Japan
| | - Daisuke Ikuma
- Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Kajigaya, Japan
| | - Eiko Hasegawa
- Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Kajigaya, Japan
| | - Junichi Hoshino
- Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Kajigaya, Japan
| | - Akinari Sekine
- Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Kajigaya, Japan
| | - Yuki Oba
- Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Kajigaya, Japan
| | - Kei Kono
- Department of Pathology, Toranomon Hospital Kajigaya, Japan
| | | | - Kenichi Ohashi
- Department of Pathology, Toranomon Hospital Kajigaya, Japan
- Department of Human Pathology, Tokyo Medical Dental University, Japan
| | - Kodai Suzuki
- Department of General Internal Medicine, Saitama Medical University, Japan
| | - Yasuharu Sato
- Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Japan
| | - Akira Shimizu
- Department of Analytic Human Pathology, Nippon Medical School, Japan
| | | | - Yoshifumi Ubara
- Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Kajigaya, Japan
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21
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Zhou J, Zhang L, Liu X, Zhang M, Li J, Zhang W. Evolution of Pulmonary Involvement in Idiopathic Multicentric Castleman Disease-Not Otherwise Specified: From Nodules to Cysts or Consolidation. Chest 2023; 164:418-428. [PMID: 36963752 DOI: 10.1016/j.chest.2023.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 02/01/2023] [Accepted: 03/15/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND Previous studies about multicentric Castleman disease-associated pulmonary manifestations have been limited by small cohorts and not following the Castleman Disease Collaborative Network classification criteria of multicentric Castleman disease. The pulmonary manifestations in idiopathic multicentric Castleman disease-not otherwise specified (iMCD-NOS), a distinct clinical phenotype in the classification criteria, have not been reported. RESEARCH QUESTION Which pulmonary abnormalities in iMCD-NOS are advanced manifestations and which are reversible after effective treatment? STUDY DESIGN AND METHODS Patients diagnosed with iMCD-NOS with pulmonary involvement were enrolled. The baseline CT scan was evaluated for the presence and anatomic locations of pulmonary abnormalities. Patients were further divided into different subgroups according to baseline CT scan manifestations. Follow-up CT scan was reviewed to assess the changes in pulmonary lesions among patients without and with treatment. RESULTS Of 162 patients with iMCD-NOS, 58 individuals (35.8%) with pulmonary involvement were identified. Pulmonary manifestations included nodules (96.6%), cysts (65.5%), consolidation (22.4%), interstitial thickening (50.0%-87.9%), and ground-glass opacities (55.2%). Patients (n = 58) were further classified into nodule (n = 15), cyst (n = 33), and consolidation (n = 10) subgroups. Patients in the consolidation (median, 67 months) and cyst (median, 23 months) subgroups had a longer duration of symptoms before the baseline CT examination than those in the nodule subgroup (median, 12 months) (P = .016). During follow-up, the evolution of pulmonary lesions from nodules to cysts was observed in two patients without treatment. After treatment, pulmonary lesions, except for cysts, improved in most patients. Moreover, nodules or cysts progressed into consolidation in two patients. INTERPRETATION Pulmonary involvement is not rare in iMCD-NOS. Chest CT scan examination is very essential in finding potential pulmonary abnormalities. Pulmonary manifestations follow a unique pattern with evolution from nodules to cysts or consolidation, the latter of which can also form in cystic areas. Timely diagnosis of pulmonary involvement is crucial because of possible reversibility after treatment.
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Affiliation(s)
- Jiamin Zhou
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lu Zhang
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xueqing Liu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Miaoyan Zhang
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian Li
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Weihong Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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22
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Duminuco A, Romano A, Sabattini E, Villari L, Del Fabro V, Elia F, Palumbo GA, Di Raimondo F, Conticello C. Multicentric Castleman Disease and Concurrent Hematological Disorders: The Occurrence of Plasmacytoma and the Hypotheses Arising from Literature Review. Acta Haematol 2023; 146:331-337. [PMID: 37068478 DOI: 10.1159/000530601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/03/2023] [Indexed: 04/19/2023]
Abstract
The concomitant presence of Castleman disease (CD) with other hematological pathology is an event described in the literature with increasing frequency, able to modify the diagnostic and curative approach in such patients. Very few studies in the literature describe the association of CD with concomitant neoplastic diseases; the most frequent are Kaposi's sarcomas (especially in HIV and human herpes virus-8-positive patients) and lymphoproliferative disorders, such as lymphomas. Instead, since the association with plasma cell diseases such as multiple myeloma and plasmacytoma is infrequent, there is a lack of literature. This manuscript aimed to revise the literature by describing a rare case of CD and plasmacytoma and attempting to explain the underlying triggering mechanisms.
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Affiliation(s)
- Andrea Duminuco
- Division of Hematology with BMT, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy
| | - Alessandra Romano
- Division of Hematology with BMT, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy
- Department of Scienze Mediche Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, Catania, Italy
| | - Elena Sabattini
- Haematopathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Loredana Villari
- Hematopathology Unit, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy
| | - Vittorio Del Fabro
- Division of Hematology with BMT, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy
| | - Federica Elia
- Division of Hematology with BMT, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy
| | - Giuseppe A Palumbo
- Division of Hematology with BMT, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy
- Department of Scienze Mediche Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, Catania, Italy
| | - Francesco Di Raimondo
- Division of Hematology with BMT, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy
| | - Concetta Conticello
- Division of Hematology with BMT, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy
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23
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Temmoku J, Sasajima T, Kuroda T, Sumichika Y, Saito K, Yoshida S, Matsumoto H, Fujita Y, Matsuoka N, Asano T, Sato S, Yamada T, Hashimoto Y, Migita K. Rapid Clinical Improvement of Multicentric Castleman Disease (MCD) with Renal Involvement Following Treatment with Tocilizumab: AA Amyloidosis as a Possible Renal Involvement of MCD. TOHOKU J EXP MED 2023; 259:285-291. [PMID: 36653160 DOI: 10.1620/tjem.2023.j003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Castleman disease (CD) is a lymphoproliferative disorder that manifests as hypergammaglobulinemia and severe inflammation with multiorgan involvement. However, renal involvement has been infrequently described in CD. We present a case of a 63-year-old Japanese male patient with multicentric CD (MCD) in whom kidney involvement, including impaired renal function and massive proteinuria, is present. He had a 2-year history of inflammatory arthritis and was referred to our clinic with newly developed proteinuria, renal dysfunction, and elevated levels of acute-phase proteins. Abdominal computed tomography scan revealed hepatosplenomegaly, including mesenteric and inguinal lymph node enlargements. The patient underwent inguinal lymph node resection. Excisional biopsy of the inguinal lymph node showed multiple lymphoid follicles and expansion of interfollicular areas by marked plasmacytosis consistent with mixed type CD. The patient was diagnosed with human herpes virus 8-negative MCD according to the international diagnostic criteria for CD. Diagnostic renal biopsy was not performed following the medical viewpoint. Tocilizumab (TCZ) treatment was highly effective in reducing proteinuria and stabilizing renal function, as well as improving other clinical symptoms. The patient responded to TCZ treatment, and the renal involvement was rapidly improved. Our preliminary immunohistochemical analysis indicated AA amyloid deposits in urinary epithelial cells suggesting a possible renal involvement of AA amyloidosis. TCZ could potentially be one of the therapeutic options in patients with MCD with renal involvement.
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Affiliation(s)
- Jumpei Temmoku
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | | | - Takeshi Kuroda
- Department of Rheumatology and Nephrology, Niigata University Graduate School of Medical and Dental Sciences
| | - Yuya Sumichika
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | - Kenji Saito
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | - Shuhei Yoshida
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | - Haruki Matsumoto
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | - Yuya Fujita
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | - Naoki Matsuoka
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | - Tomoyuki Asano
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | - Shuzo Sato
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | - Toshiyuki Yamada
- Department of Clinical Laboratory Medicine, Jichi Medical University
| | - Yuko Hashimoto
- Department of Pathology, Fukushima Medical University School of Medicine
| | - Kiyoshi Migita
- Department of Rheumatology, Fukushima Medical University School of Medicine
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Togitani K, Ogasawara F, Arakawa Y, Sugimura N, Miyazaki R, Kojima K. Psoas and Mediastinal Abscesses during Intravenous Tocilizumab Treatment in Multicentric Castleman Disease. Intern Med 2023; 62:449-452. [PMID: 35732449 PMCID: PMC9970794 DOI: 10.2169/internalmedicine.9519-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Tocilizumab has been used to treat idiopathic multicentric Castleman disease (iMCD). As tocilizumab prevents interleukin-6 from exerting pro-inflammatory effects, there is some concern about a delayed diagnosis of severe infections during tocilizumab treatment. Although serious infections during tocilizumab therapy have been previously described in patients with rheumatoid arthritis, they have not been reported in iMCD. We herein report a case of disseminated Staphylococcus aureus infection after a superficial skin wound followed by psoas and mediastinal abscesses with pyogenic spondylodiscitis in an iMCD patient with diabetes. Physicians should be alert for the occurrence of disseminated S. aureus infection after even minor skin injury during tocilizumab therapy.
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Affiliation(s)
- Kazuto Togitani
- Department of Hematology, Kochi Medical School, Kochi University, Japan
| | - Fumiya Ogasawara
- Department of Hematology, Kochi Medical School, Kochi University, Japan
| | - Yu Arakawa
- Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University, Japan
| | - Natsuki Sugimura
- Department of Orthopedic Surgery, Kochi Medical School, Kochi University, Japan
| | - Ryohei Miyazaki
- Department of Thoracic Surgery, Kochi Medical School, Kochi University, Japan
| | - Kensuke Kojima
- Department of Hematology, Kochi Medical School, Kochi University, Japan
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25
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Sonoda K, Kaneko U, Hiura M, Kinoshita Y, Umezu H, Ito S, Saitoh A, Imai C. Short stature as an initial presenting presentation of unicentric Castleman disease in a child: A case report with long-term follow-up and a literature review. Mod Rheumatol Case Rep 2023; 7:261-266. [PMID: 35536586 DOI: 10.1093/mrcr/rxac034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/02/2022] [Accepted: 04/11/2022] [Indexed: 06/14/2023]
Abstract
Short stature is a common clinical condition in paediatric outpatient clinics and is associated with various clinical conditions, ranging from normal variants to severe diseases. Short stature is known to be caused by chronic inflammatory conditions, in which over-produced inflammatory cytokines are reported to be involved in growth suppression. Castleman disease is a rare lymphoproliferative disorder known as a chronic inflammatory disease with overproduction of interleukin 6, which often causes systemic symptoms such as fever, fatigue, weight loss, and night sweats. Here, we report the case of a 10-year-old female diagnosed with unicentric Castleman disease, who presented with short stature as the sole clinical sign but lacked typical systemic symptoms of Castleman disease. An elevated serum C-reactive protein level led us to suspect a chronic inflammatory condition, and we found an intra-abdominal tumour that was histopathologically confirmed as Castleman disease. The tumour removal resulted in a steady catch-up in her height in the six years following the surgery. We also present a brief review of relevant literature on paediatric cases of Castleman disease associated with growth impairment. Clinicians should be aware that chronic inflammatory conditions can cause growth impairment, which may be a key clinical manifestation of such conditions.
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Affiliation(s)
- Kaori Sonoda
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department of Pediatrics, Niigata Medical-Care Cooperative, Kido Hospital, Niigata, Japan
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Utako Kaneko
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Makoto Hiura
- Department of Pediatrics, Niigata Medical-Care Cooperative, Kido Hospital, Niigata, Japan
| | - Yoshiaki Kinoshita
- Department of Pediatric Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hajime Umezu
- Division of Pathology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Shuichi Ito
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Akihiko Saitoh
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Chihaya Imai
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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26
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Kakutani T, Nunokawa T, Chinen N, Tamai Y. Treatment-resistant idiopathic multicentric Castleman disease with thrombocytopenia, anasarca, fever, reticulin fibrosis, renal dysfunction, and organomegaly managed with Janus kinase inhibitors: A case report. Medicine (Baltimore) 2022; 101:e32200. [PMID: 36482523 PMCID: PMC9726379 DOI: 10.1097/md.0000000000032200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
RATIONALE Thrombocytopenia, anasarca, fever, reticulin fibrosis, renal dysfunction, and organomegaly (TAFRO) syndrome are nonmalignant but life-threatening systemic inflammatory disorders. However, many patients are refractory to treatment, resulting in significant morbidity and mortality. Additionally, established treatment options are unavailable. Therefore, we present 2 cases of adults with the iMCD-TAFRO syndrome refractory to initial treatment but responded to Janus kinase (JAK) inhibitors with ruxolitinib. The report reveals that these rare adult cases of the refractory and treatment-resistant iMCD-TAFRO syndrome can be treated using JAK inhibitors. PATIENT CONCERNS Case 1 is a 36-year-old previously healthy male patient who presented with fever and general fatigue for 2 weeks. Case 2 is a 42-year-old previously healthy female patient who presented with fever and general fatigue. DIAGNOSIS The diagnosis met the 2015 criteria for TAFRO syndrome, as determined by All Japan TAFRO Syndrome Research Group in the Research Program for Intractable Disease by the Ministry of Health, Labor and Welfare (MHLW) Japan. INTERVENTIONS Treatment with tocilizumab and several immunosuppressants were ineffective. So, we performed ruxolitinib. OUTCOMES Each patient received ruxolitinib, the general condition improved, and CRP levels decreased. LESSONS These cases showed that ruxolitinib was effective for treatment-resistant/ refractory TAFRO syndrome. Further prospective studies are needed on using ruxolitinib with a small number of cases.
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Affiliation(s)
- Takuya Kakutani
- Division of Rheumatology, Shonan Kamakura General Hospital, Kanagawa, Japan
- * Correspondence: Takuya Kakutani, Division of Rheumatology, Shonan Kamakura General Hospital, 1370-1 Okamoto, Fujisawa city, Kanagawa 247-8533, Japan (e-mail: )
| | | | - Naofumi Chinen
- Division of Rheumatology, Tama Nambu Chiiki Hospital, Tokyo, Japan
| | - Yotaro Tamai
- Division of Hematology, Shonan Kamakura General Hospital, Kanagawa, Japan
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27
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Hansen ME, Mangusan R, Lurain K, Odeny T, George J, Lu C, Manion M, Widell A, Ekwede I, Whitby D, Gulley JL, Kadri SS, Elinoff JM, Barochia A, Torabi-Parizi P, Uldrick TS, Yarchoan R, Ramaswami R. Characteristics of patients admitted to the ICU with Kaposi sarcoma herpesvirus-associated diseases. AIDS 2022; 36:1969-1978. [PMID: 35848586 PMCID: PMC9617765 DOI: 10.1097/qad.0000000000003333] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE There are four conditions caused by Kaposi sarcoma herpesvirus (KSHV): Kaposi sarcoma, KSHV-associated multicentric Castleman disease (MCD), primary effusion lymphoma (PEL), and KSHV inflammatory cytokine syndrome (KICS). These KSHV-associated disorders (KADs) often occur in people with HIV and can lead to multiorgan dysfunction requiring admission to the ICU. However, little is known about patient outcomes in this setting. METHODS A retrospective study of patients with KADs admitted to the ICU between 2010 and 2021 was conducted, examining KAD admission diagnoses, HIV characteristics, selected cytokine profiles, and ICU interventions. Primary outcomes were 60-day and median overall survival from ICU admission to death from any cause. RESULTS Forty-seven patients (all but one with HIV coinfection) were included. At ICU admission, 44 patients (94%) were on antiretroviral therapy with a median CD4 + count of 88 cells/μl and HIV viral load of 23 copies/ml. The most common presentation was respiratory failure alone (19%) or with hypotension (17%). Twenty-two (47%) patients had presumed KICS (with or without Kaposi sarcoma) at admission and an additional KAD was diagnosed in 36% of these patients. IL-6 levels did not vary across KAD subtype. Twenty (43%) patients received KAD-directed therapy in the ICU. Sixty-day survival was 70% and median overall survival was 9 months. CONCLUSION The majority of patients with HIV and KADs admitted to the ICU had well controlled HIV. Additional KAD were diagnosed during ICU admission in a proportion of patients who presented with presumed KICS. Critical illness did not preclude a subset of patients from receiving KAD-directed therapy in the ICU.
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Affiliation(s)
- Megan E Hansen
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
| | - Ralph Mangusan
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
| | - Kathryn Lurain
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
| | - Thomas Odeny
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
| | - Jomy George
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
| | - Crystal Lu
- Pharmacy Department, Clinical Center, National Institutes of Health
| | - Maura Manion
- HIV Pathogenesis Section, Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases
| | - Anaida Widell
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
| | - Irene Ekwede
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory
| | - James L Gulley
- Center for Immuno-oncology, Center for Cancer Research, National Cancer Institute
| | | | | | - Amisha Barochia
- Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Thomas S Uldrick
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
| | - Robert Yarchoan
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
| | - Ramya Ramaswami
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
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28
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Suzuki H, Sano T, Shimasaki Y, Yamaguchi M, Ide T, Arinaga-Hino T, Kuwahara R, Amano K, Oshima K, Nagafuji K, Ida H, Koga H, Torimura T. TAFRO Syndrome That Responded to Prednisolone-only Treatment: Evaluating Changes in IL-6. Intern Med 2022; 61:2967-2972. [PMID: 35228431 PMCID: PMC9593160 DOI: 10.2169/internalmedicine.9160-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Thrombocytopenia, anasarca, fever, reticulin fibrosis, and organomegaly (TAFRO) syndrome is a systemic inflammatory disorder characterized by the above-mentioned symptoms. Because of the similarity in phenotypes between TAFRO syndrome and decompensated liver cirrhosis, an accurate diagnosis is often difficult. We herein report a 62-year-old Japanese patient with TAFRO syndrome who was misdiagnosed with intractable ascites associated with liver cirrhosis. Improvement of symptoms after treatment with prednisolone was associated with interleukin-6 rather than C-reactive protein. The pathogenesis of TAFRO syndrome, which has similar clinical manifestations to liver cirrhosis, remains unclear, and our findings may help elucidate the concept of this condition.
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Affiliation(s)
- Hiroyuki Suzuki
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Tomoya Sano
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Japan
| | | | - Maki Yamaguchi
- Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Tatsuya Ide
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Teruko Arinaga-Hino
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Reiichiro Kuwahara
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Keisuke Amano
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Koichi Oshima
- Department of Pathology, Kurume University School of Medicine, Japan
| | - Koji Nagafuji
- Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Hiroaki Ida
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Hironori Koga
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Takuji Torimura
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Japan
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29
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Lurain K, Yarchoan R, Ramaswami R. Immunotherapy for KSHV-associated diseases. Curr Opin Virol 2022; 55:101249. [PMID: 35803203 PMCID: PMC9464688 DOI: 10.1016/j.coviro.2022.101249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 05/31/2022] [Accepted: 06/08/2022] [Indexed: 11/18/2022]
Abstract
Kaposi sarcoma herpesvirus (KSHV)-associated diseases (Kaposi sarcoma, multicentric Castleman disease, primary effusion lymphoma, and KSHV inflammatory cytokine syndrome) are associated with immune suppression and dysregulation and loss of KSHV-specific immunity. These diseases are most frequent in people living with HIV as well as those with primary or iatrogenic immune deficiencies. KSHV itself can modulate the immune system via viral homologs of host cytokines or downregulation of immune-surface markers altering host immune surveillance. These factors make KSHV-associated diseases prime targets for immunotherapy approaches. Several agents have been studied or are under investigation in KSHV-associated diseases, including monoclonal antibodies, immunomodulatory agents, and therapeutic cytokines. Here, we review the role of immunotherapies in KSHV-associated diseases.
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Affiliation(s)
- Kathryn Lurain
- HIV & AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
| | - Robert Yarchoan
- HIV & AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Ramya Ramaswami
- HIV & AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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30
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Campbell CM, Owen DR, Montazeripouragha A, McCormick I, Fajgenbaum DC, Chen LYC. Idiopathic multicentric Castleman disease with arteriolar endotheliopathy and secondary haemophagocytosis. Lancet Haematol 2022; 9:e546. [PMID: 35772433 PMCID: PMC9624448 DOI: 10.1016/s2352-3026(22)00037-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/04/2022] [Accepted: 01/21/2022] [Indexed: 06/15/2023]
Affiliation(s)
| | - Daniel R Owen
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Iain McCormick
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - David C Fajgenbaum
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Luke Y C Chen
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
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31
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You RL, Wen YB, Wang J, Ma J, Chen LM, Li XM. [Nephrotic Syndrome Caused by AA Amyloidosis Secondary to Unicentric Castleman's Disease:Report of One Case]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2022; 44:540-544. [PMID: 35791957 DOI: 10.3881/j.issn.1000-503x.14104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
AA amyloidosis is a rare systemic complication caused commonly by chronic inflammatory arthritis,periodic fever disease,vasculitis,tumors,etc.Castleman's disease is an uncommon cause of AA amyloidosis.Here,we reported a case of unicentric Castleman's disease-induced AA amyloidosis with nephrotic syndrome as the main manifestation.The laboratory examination showed elevated levels of inflammatory indicators.We summarized the clinical manifestations,diagnosis,and therapy of this case,aiming to facilitate the management of patients with unknown reasons of renal amyloidosis.
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Affiliation(s)
- Rui-Lian You
- Department of Nephrology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
| | - Yu-Bing Wen
- Department of Nephrology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
| | - Jing Wang
- Department of Pathology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
| | - Jie Ma
- Department of Nephrology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
| | - Li-Meng Chen
- Department of Nephrology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
| | - Xue-Mei Li
- Department of Nephrology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
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32
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Liu SZ, Zhou X, Wang YP, Liu Y. Osteosclerosis in Castleman's disease. QJM 2022; 115:171-172. [PMID: 35088859 DOI: 10.1093/qjmed/hcac013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S-Z Liu
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 1 Shuaifu Yuan, Beijing 100730, China
| | - X Zhou
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 1 Shuaifu Yuan, Beijing 100730, China
| | - Y-P Wang
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 1 Shuaifu Yuan, Beijing 100730, China
| | - Y Liu
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 1 Shuaifu Yuan, Beijing 100730, China
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 1 Shuaifu Yuan, Beijing 100730, China
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33
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Abstract
TAFRO syndrome is a systemic inflammatory disorder resembling multicentric Castleman disease; it is characterized by thrombocytopenia, anasarca, a fever, reticulin fibrosis, and organomegaly. Involvement of the adrenal glands, including adrenal infarction, hemorrhaging, and adrenomegaly, has recently been reported in several cases and been considered a characteristic early-stage symptom. We herein report a case of TAFRO syndrome initially presenting with bilateral adrenal infarctions and review the literature on TAFRO syndrome related to adrenal involvement. This case suggests that adrenal abnormalities as an early clinical feature of TAFRO syndrome may be useful for the early diagnosis.
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Affiliation(s)
- Shun Yonezaki
- Department of Internal Medicine, Mito Kyodo General Hospital, University of Tsukuba, Japan
| | - Kazuya Nagasaki
- Department of Internal Medicine, Mito Kyodo General Hospital, University of Tsukuba, Japan
| | - Hiroyuki Yamaguchi
- Department of Internal Medicine, Mito Kyodo General Hospital, University of Tsukuba, Japan
| | - Hiroyuki Kobayashi
- Department of Internal Medicine, Mito Kyodo General Hospital, University of Tsukuba, Japan
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34
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Zhou K, Urquhart E, Hui C. The white tree: arborising calcification indicating Castleman disease. Abdom Radiol (NY) 2022; 47:1202-1204. [PMID: 35037078 DOI: 10.1007/s00261-021-03388-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/12/2021] [Accepted: 12/13/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Kevin Zhou
- Monash Health Imaging, Monash Medical Centre, Monash University, 246 Clayton Road, Clayton, VIC, 3168, Australia
| | - Evan Urquhart
- Monash Health Imaging, Monash Medical Centre, Monash University, 246 Clayton Road, Clayton, VIC, 3168, Australia.
| | - Cathryn Hui
- Monash Health Imaging, Monash Medical Centre, Monash University, 246 Clayton Road, Clayton, VIC, 3168, Australia
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35
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Sugawara E, Sato T, Amasaki Y, Katsumata K. Successful treatment with tocilizumab for refractory anemia and slowly progressive renal glomerulosclerosis in multicentric Castleman disease: A case report. Medicine (Baltimore) 2022; 101:e28941. [PMID: 35212301 PMCID: PMC8878775 DOI: 10.1097/md.0000000000028941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 02/09/2022] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Multicentric Castleman disease (MCD) is a rare lymphoproliferative disorder accompanied by systemic symptoms characterized by polyclonal hypergammaglobulinemia and chronic inflammation due to overexpression of interleukin-6. Histological heterogeneity of renal involvement in MCD has been described, although the number of reports is limited. Tocilizumab, a humanized anti-interleukin-6 receptor antibody, has been reported to be effective for MCD. PATENT CONCERNS A 64-year-old man experienced refractory anemia and slowly progressive renal dysfunction with proteinuria, accompanied by persistent inflammation for 11 years. DIAGNOSIS Two renal biopsies were obtained. The first biopsy performed 7 years before admission revealed non-specific interstitial inflammation, whereas the second biopsy demonstrated global sclerosis in most glomeruli and interstitial fibrosis. The patient had multiple lymphadenopathies. Cervical lymph node biopsy histological findings were compatible with plasma cell type Castleman disease. The patient had no evidence of human hepatitis virus-8 infection. INTERVENTION The patient was treated with 60 mg/d prednisolone followed by 8 mg/kg intravenous tocilizumab every 2 weeks. OUTCOME His anemia significantly improved, as well as a marked reduction in proteinuria and stabilization of renal function. He did not experience renal function during the 2-years follow-up period. LESSONS The heterogeneity of the renal manifestations of MCD sometimes makes early diagnosis difficult. We need to interpret the histological findings of the renal biopsy carefully. For advanced-stage renal diseases, tocilizumab might be an effective treatment strategy for MCD.
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Affiliation(s)
- Eri Sugawara
- Department of Rheumatology, Tonan Hospital, Sapporo, Japan
| | - Taiki Sato
- Department of Rheumatology, Tonan Hospital, Sapporo, Japan
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36
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Kondo J, Arinuma Y, Matsueda Y, Hasegawa Y, Muramatsu T, Kanayama Y, Hoshiyama T, Tono T, Tanaka S, Oku K, Yamaoka K. A Patient with Castleman's Disease Initially Manifesting Symmetrical Synovitis with Pitting Edema. Mod Rheumatol Case Rep 2022; 6:309-313. [PMID: 35092673 DOI: 10.1093/mrcr/rxac003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/21/2021] [Accepted: 12/31/2021] [Indexed: 11/13/2022]
Abstract
Castleman's disease (CD), especially multicentric CD (MCD) has been known to manifest a variety of clinical features such as fatigue, anemia, fever and hypergammaglobulinemia. Here, we report a 72-year-old female patient who had complicated severe synovitis, as an initial manifestation of the disease, lastly diagnosed as MCD. Initially, she had been diagnosed as remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome because of bilateral leg pitting edema with significant c-reactive protein and matrix metalloproteinase-3 elevation but no disease-specific autoantibodies. Promptly, corticosteroid (CS) and additionally weekly methotrexate (MTX) was introduced, but her leg edema and inflammatory findings did not adequately come to be a remission. A lymph node biopsy from the groin region was performed because multiple lymph node swelling in ultrasound examination appeared even after introducing treatments, which revealed mixed-type CD. Multiple lymphadenopathies were observed in the axilla and inguinal region, finally, we diagnosed her as idiopathic MCD and introduced tocilizumab (TCZ) which significantly improved leg edema as well as inflammatory findings. As is shown in this case, manifestations included in RS3PE syndrome could be one of the clinical phenotypes in MCD, which should be considered as a differential diagnosis of MCD.
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Affiliation(s)
- Junichi Kondo
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
| | - Yoshiyuki Arinuma
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
| | - Yu Matsueda
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
| | - Yasuhiro Hasegawa
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
| | - Takumi Muramatsu
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
| | - Yoshiro Kanayama
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
| | - Takayuki Hoshiyama
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
| | - Toshihiro Tono
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
| | - Sumiaki Tanaka
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
| | - Kenji Oku
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
| | - Kunihiro Yamaoka
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
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Chou PR, Tsai KB, Chang CW, Lin TY, Kuo YR. Concurrence of Marjolin's Ulcer in the Lower Limb in a Patient with Idiopathic Multicentric Castleman Disease: A Case Report. Medicina (Kaunas) 2022; 58:medicina58010071. [PMID: 35056379 PMCID: PMC8780264 DOI: 10.3390/medicina58010071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/30/2021] [Accepted: 12/31/2021] [Indexed: 11/16/2022]
Abstract
Idiopathic multicentric Castleman disease (iMCD) is characterized by the benign proliferation of lymphoid cells in multiple regions. However, the co-occurrence of epithelial malignancy and idiopathic multicentric Castleman disease (iMCD) is rarely reported. Herein, we present a case of iMCD mimicking lymph nodal metastasis of Marjolin’s ulcer in the lower extremity. A 53-year-old male presented with an unhealed chronic ulcer on the left lower leg and foot accompanied by an enlarged mass in the left inguinal region. Intralesional biopsy was performed, and pathological examination showed squamous cell carcinoma (SCC). Imaged studies revealed left calcaneus bone invasion, and lymph nodal metastasis was suspected by the cancer TNM staging of T4N2M0 pre-operatively. The patient received below-knee amputation and lymph node dissection; intraoperative histological examination showed no lymphatic nodal malignancy and diagnosed the patient as having iMCD with lymphadenopathy. The patient recovered uneventfully and was referred to a hematologist for further treatment.
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Affiliation(s)
- Ping-Ruey Chou
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Kun-Bow Tsai
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Chao-Wei Chang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-W.C.); (T.-Y.L.)
| | - Tzu-Yu Lin
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-W.C.); (T.-Y.L.)
| | - Yur-Ren Kuo
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-W.C.); (T.-Y.L.)
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Biological Sciences, National Sun Yat-sen University, Kaohsiung 807, Taiwan
- SingHealth Duke-NUS Musculoskeletal Sciences Academic Clinical Programme, Singapore 168753, Singapore
- Correspondence:
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Dunn R, Jariwal R, Venter F, Mishra S, Bhandohal J, Cobos E, Heidari A. HHV-8-Associated Multicentric Castleman Disease, a Diagnostic Challenge in a Patient With Acquired Immunodeficiency Syndrome and Fever. J Investig Med High Impact Case Rep 2022; 10:23247096221097526. [PMID: 35549932 PMCID: PMC9109171 DOI: 10.1177/23247096221097526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/30/2022] [Accepted: 04/11/2022] [Indexed: 11/29/2022] Open
Abstract
Patients with acquired immunodeficiency syndrome (AIDS) are at an increased susceptibility to pathogens and associated malignancies which can present with a unique constellation of symptoms. In this article, we describe a case of Castleman disease in a patient with AIDS, nonadherent with antiretroviral therapy (ART), who presented with fevers, constant abdominal pain, nausea, and vomiting. After an extensive work up, a lymph node biopsy confirmed a diagnosis of human herpesvirus-8 (HHV-8)-associated multicentric Castleman disease. Patients presenting with AIDS and fever have broad differential diagnoses; therefore, reaching a diagnosis as rare as Castleman disease can be challenging. HHV-8 has a propensity to CD20 positive B cells, which allows rituximab to be an effect treatment.
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Affiliation(s)
- Robert Dunn
- Department of Medicine, Kern Medical UCLA, Bakersfield, CA, USA
| | - Roopam Jariwal
- Department of Medicine, Kern Medical UCLA, Bakersfield, CA, USA
| | | | - Shikha Mishra
- Department of Medicine, Kern Medical UCLA, Bakersfield, CA, USA
| | | | - Everado Cobos
- Department of Medicine, Kern Medical UCLA, Bakersfield, CA, USA
| | - Arash Heidari
- Department of Medicine, Division of Infectious Diseases, Kern Medical UCLA, Bakersfield, CA, USA
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Banza MI, Kapessa ND, Shutsha NT, Omole PW, N’dwala YTB, Kasanga TK, Nafatalewa DK, Katambwa PM. Abcès mésentérique du au Chryseobacterium meningosepticum révélant la maladie de Castleman à localisation mésentérique chez un jeune adulte immunocompétent. Pan Afr Med J 2022; 41:99. [PMID: 35465379 PMCID: PMC8994466 DOI: 10.11604/pamj.2022.41.99.19121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 02/16/2020] [Indexed: 11/21/2022] Open
Abstract
Un abcès mésentérique causé par le Chryseobacterium meningosepticum est une entité clinique extrêmement rare, le plus souvent retrouvé sur un terrain d´immunodéficience et la maladie de Castleman peut être révélée par un abcès mésentérique. Nous présentons le cas d´un patient de 23 ans admis pour péritonite aiguë généralisée évoluant depuis 2 semaines. L´échographie abdominale montrait une masse hypoéchogène dans les anses grêles sans donner des plus amples détails. A la laparotomie, du pus avait été retrouvé dans la grande cavité et un abcès mésentérique présent dans le mésentère jéjunal à 35 cm de l´angle de Treitz sans aucune ouverture de l´anse en regard mais également une adénopathie mésentérique en regard de l´abcès. La pyoculture a isolé le Chryseobacterium meningosepticum et l´adénopathie mésentérique enlevée a montré à l´analyse histologique des anomalies structurales évoquant le type vascularisation hyalinisée de la maladie de Castleman. Le traitement a consisté en une incision et drainage de l´abcès avec résection de la coque et un nettoyage de la cavité abdominale au sérum physiologique. La Ciprofloxacine était le seul antibiotique sensible au Chryseobacterium meningosepticum. Les suites post-opératoires étaient simples avec sortie du patient au 10e jour post-opératoire. Un suivi clinique et paraclinique du patient pendant 12 mois n´a objectivé aucune autre adénopathie ni aucune récidive. Le but de cette publication est de présenter un cas extrêmement rare associant un abcès mésentérique à Chryseobacterium meningosepticum et une maladie de Castleman unicentrique à localisation mésentérique chez un immunocompétent ainsi que les modalités de cette prise en charge.
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Affiliation(s)
- Manix Ilunga Banza
- Département de Chirurgie des Cliniques universitaires de Lubumbashi, Université de Lubumbashi, Haut Katanga, Lubumbashi République Démocratique du Congo
- Corresponding author: Manix Ilunga Banza, Département de Chirurgie des Cliniques universitaires de Lubumbashi, Université de Lubumbashi, Haut Katanga, Lubumbashi République Démocratique du Congo.
| | - Nathalie Dinganga Kapessa
- Département de Chirurgie des Cliniques universitaires de Lubumbashi, Université de Lubumbashi, Haut Katanga, Lubumbashi République Démocratique du Congo
| | - Néron Tapenge Shutsha
- Département de Chirurgie des Cliniques universitaires de Lubumbashi, Université de Lubumbashi, Haut Katanga, Lubumbashi République Démocratique du Congo
| | - Pius Wonga Omole
- Département de Chirurgie des Cliniques universitaires de Lubumbashi, Université de Lubumbashi, Haut Katanga, Lubumbashi République Démocratique du Congo
| | - Yannick Tietie Ben N’dwala
- Département de Chirurgie des Cliniques universitaires de Lubumbashi, Université de Lubumbashi, Haut Katanga, Lubumbashi République Démocratique du Congo
| | - Trésor Kibangula Kasanga
- Département de Chirurgie des Cliniques universitaires de Lubumbashi, Université de Lubumbashi, Haut Katanga, Lubumbashi République Démocratique du Congo
| | - Dimitri Kanyanda Nafatalewa
- Département de Chirurgie des Cliniques universitaires de Lubumbashi, Université de Lubumbashi, Haut Katanga, Lubumbashi République Démocratique du Congo
| | - Prince Muteba Katambwa
- Département de Chirurgie des Cliniques universitaires de Lubumbashi, Université de Lubumbashi, Haut Katanga, Lubumbashi République Démocratique du Congo
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Horino T, Kashio T, Inotani S, Ishihara M, Ichii O. Membranous Nephropathy Associated With Multicentric Castleman Disease-Efficacy of Interleukin 6 Antibody for Nephrotic Syndrome. J Clin Rheumatol 2022; 28:e1-e2. [PMID: 34897198 DOI: 10.1097/rhu.0000000000001810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Taro Horino
- From the Departments of Endocrinology, Metabolism, and Nephrology
| | - Takeshi Kashio
- From the Departments of Endocrinology, Metabolism, and Nephrology
| | - Satoshi Inotani
- From the Departments of Endocrinology, Metabolism, and Nephrology
| | | | - Osamu Ichii
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
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Arakawa A, Iizuka M, Matsuda S, Matsubara E, Yamazaki H, Yoshikawa N, Tanaka H, Yoshizawa T. Aseptic Meningitis-retention Syndrome Associated with Tocilizumab in a Patient with Idiopathic Multicentric Castleman Disease. Intern Med 2021; 60:3995-3998. [PMID: 34219105 PMCID: PMC8758442 DOI: 10.2169/internalmedicine.6938-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This is the first report of tocilizumab-associated meningitis-retention syndrome in a patient with idiopathic multicentric Castleman disease. A 57-year-old man presented with headache, nuchal rigidity, impaired consciousness, pyramidal tract signs and urinary retention. A cerebrospinal fluid examination revealed increased cell counts and protein levels. These symptoms were improved by intravenous methylprednisolone. Tocilizumab-associated meningoencephalitis has been reported in patients with rheumatoid arthritis and juvenile idiopathic arthritis but not with multicentric Castleman disease. This case presents evidence of the increased probability of meningitis as a neurological complication of tocilizumab administration.
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Affiliation(s)
- Akira Arakawa
- Department of Neurology, NTT Medical Center Tokyo, Japan
| | - Masaki Iizuka
- Department of Neurology, NTT Medical Center Tokyo, Japan
| | | | - Erika Matsubara
- Department of Rheumatology and Allergy, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Japan
| | - Hiroki Yamazaki
- Department of Rheumatology and Allergy, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Japan
| | - Noritada Yoshikawa
- Department of Rheumatology and Allergy, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Japan
| | - Hirotoshi Tanaka
- Department of Rheumatology and Allergy, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Japan
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Yamazaki Y, Yoshida Y, Shimizu M, Kobayashi T, Tojima H, Sato K, Kakizaki S, Handa H, Yokoo H, Uraoka T. An Autopsy Case of Multicentric Castleman Disease Presenting with Severe Jaundice. Intern Med 2021; 60:3615-3620. [PMID: 34092729 PMCID: PMC8666219 DOI: 10.2169/internalmedicine.6835-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A 70-year-old man with multicentric Castleman disease (MCD) was admitted to our hospital with jaundice and ascites. Elevations in his bilirubin and interleukin-6 levels were noted, and computed tomography revealed hepatic atrophy and portal vein and bile duct disorders. Steroid therapy was started for MCD, but he died of hepatic failure. An autopsy revealed that the MCD activity was mild, but advanced fibrosis and cholestasis were observed in the liver. Mild infiltration of interleukin-6-positive plasma cells was noted in the highly fibrotic area of the liver. Although rare, liver and biliary tract damage may be also considered organ disorders of MCD.
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Affiliation(s)
- Yuichi Yamazaki
- ¹Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Japan
| | - Yuka Yoshida
- ²Department of Human Pathology, Gunma University Graduate School of Medicine, Japan
| | - Megumi Shimizu
- ¹Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Japan
| | - Takeshi Kobayashi
- ¹Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Japan
| | - Hiroki Tojima
- ¹Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Japan
| | - Ken Sato
- ¹Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Japan
| | - Satoru Kakizaki
- ¹Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Japan
- ³Department of Clinical Research, National Hospital Organization Takasaki General Medical Center, Japan
| | - Hiroshi Handa
- ⁴Department of Hematology, Gunma University Graduate School of Medicine, Japan
| | - Hideaki Yokoo
- ²Department of Human Pathology, Gunma University Graduate School of Medicine, Japan
| | - Toshio Uraoka
- ¹Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Japan
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Tu KH, Fan PY, Chen TD, Chuang WY, Wu CY, Ku CL, Tian YC, Yang CW, Fang JT, Yang HY. TAFRO Syndrome with Renal Thrombotic Microangiopathy: Insights into the Molecular Mechanism and Treatment Opportunities. Int J Mol Sci 2021; 22:ijms22126286. [PMID: 34208103 PMCID: PMC8230834 DOI: 10.3390/ijms22126286] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/12/2021] [Accepted: 05/19/2021] [Indexed: 01/02/2023] Open
Abstract
TAFRO syndrome is an extremely rare form of idiopathic MCD, characterized by thrombocytopenia, anasarca, fever, reticulin fibrosis on bone marrow biopsy, and organomegaly. Like idiopathic MCD, renal involvement is also a common presentation in patients with TAFRO syndrome. Furthermore, membranoproliferative glomerulonephritis (MPGN)-like injury and thrombotic microangiopathy (TMA) are the most reported histopathologic findings of renal biopsy. Several molecular mechanisms have been previously postulated in order to explain the TAFRO syndrome symptoms, including abnormal production of interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), etc. The role of these cytokines in renal injury, however, is not well understood. The aim of this review article is to summarize the latest knowledge of molecular mechanisms behind the TAFRO syndrome and their potential role in renal damage.
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Affiliation(s)
- Kun-Hua Tu
- Kidney Research Center, Department of Nephrology, Chang-Gung Memorial Hospital, Taoyuan 333, Taiwan; (K.-H.T.); (P.-Y.F.); (Y.-C.T.); (C.-W.Y.); (J.-T.F.)
- Transplantation Immunology Lab, Chang-Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Pei-Yi Fan
- Kidney Research Center, Department of Nephrology, Chang-Gung Memorial Hospital, Taoyuan 333, Taiwan; (K.-H.T.); (P.-Y.F.); (Y.-C.T.); (C.-W.Y.); (J.-T.F.)
| | - Tai-Di Chen
- Department of Pathology, Chang-Gung Memorial Hospital, Taoyuan 333, Taiwan; (T.-D.C.); (W.-Y.C.)
| | - Wen-Yu Chuang
- Department of Pathology, Chang-Gung Memorial Hospital, Taoyuan 333, Taiwan; (T.-D.C.); (W.-Y.C.)
- College of Medicine, Chang-Gang University, Taoyuan 333, Taiwan;
| | - Chao-Yi Wu
- Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang-Gung Memorial Hospital, Taoyuan 333, Taiwan;
| | - Cheng-Lung Ku
- College of Medicine, Chang-Gang University, Taoyuan 333, Taiwan;
| | - Ya-Chung Tian
- Kidney Research Center, Department of Nephrology, Chang-Gung Memorial Hospital, Taoyuan 333, Taiwan; (K.-H.T.); (P.-Y.F.); (Y.-C.T.); (C.-W.Y.); (J.-T.F.)
- Transplantation Immunology Lab, Chang-Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Chih-Wei Yang
- Kidney Research Center, Department of Nephrology, Chang-Gung Memorial Hospital, Taoyuan 333, Taiwan; (K.-H.T.); (P.-Y.F.); (Y.-C.T.); (C.-W.Y.); (J.-T.F.)
- College of Medicine, Chang-Gang University, Taoyuan 333, Taiwan;
| | - Ji-Tseng Fang
- Kidney Research Center, Department of Nephrology, Chang-Gung Memorial Hospital, Taoyuan 333, Taiwan; (K.-H.T.); (P.-Y.F.); (Y.-C.T.); (C.-W.Y.); (J.-T.F.)
- College of Medicine, Chang-Gang University, Taoyuan 333, Taiwan;
| | - Huang-Yu Yang
- Kidney Research Center, Department of Nephrology, Chang-Gung Memorial Hospital, Taoyuan 333, Taiwan; (K.-H.T.); (P.-Y.F.); (Y.-C.T.); (C.-W.Y.); (J.-T.F.)
- Transplantation Immunology Lab, Chang-Gung Memorial Hospital, Taoyuan 333, Taiwan
- Advanced Immunology Lab, Chang-Gung Memorial Hospital, Taoyuan 333, Taiwan
- Correspondence: ; Tel.: +886-3328-1200-8181
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Abstract
TAFRO syndrome and POEMS syndrome are lymphoproliferative disorders with elevated interleukin-6 and vascular endothelial growth factor (VEGF) levels; however, their underlying pathogenic mechanisms remain unclear. Similarities have been reported in the pathological findings of the lymph nodes of TAFRO syndrome, Multicentric Castleman disease (MCD), and some cases of POEMS syndrome. However, there is no consensus on the relationship among them. We encountered a case of lymphoproliferative disorder that presented with manifestations of both TAFRO syndrome and POEMS syndrome. This case may be a subtype of idiopathic MCD and will be very important for establishing the disease concept of TAFRO syndrome and POEMS syndrome.
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Affiliation(s)
- Sho Shibata
- Department of Hematology, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
| | - Sumie Tabata
- Department of Hematology, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
| | - Hajime Morita
- Department of Nephrology, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
| | - Tomomi Endo
- Department of Nephrology, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
| | - Naoto Kawasaki
- Department of Hematology, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
| | - Yoshio Okamoto
- Department of Hematology, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
| | - Shojiro Inano
- Department of Hematology, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
| | - Yoko Takiuchi
- Department of Hematology, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
| | - Akiko Fukunaga
- Department of Hematology, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
| | - Toshiyuki Kitano
- Department of Hematology, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
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Gwiti P, Melegh Z, Johnston S, Sutak J. Paraneoplastic pemphigus caused by pre-existing stroma-rich variant of Castleman disease: from a pathologist's point of view. BMJ Case Rep 2021; 14:e241374. [PMID: 33975839 PMCID: PMC8118026 DOI: 10.1136/bcr-2020-241374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2021] [Indexed: 11/04/2022] Open
Abstract
A young woman presented with mucocutaneous blisters and ulcerating lesions, and was diagnosed with erythrodermic pemphigus complicated by bronchiolitis obliterans. Her clinical condition did not improve on immunosuppressive therapy. She had a history of an asymptomatic retroperitoneal mass, presumed to be a dermoid cyst, followed up clinically. Due to the pre-existing nature of the retroperitoneal mass, the paraneoplastic nature of the pemphigus was initially not recognised, but after a multidisciplinary team meeting a biopsy was performed. Histology revealed a rare stroma-rich variant of Castleman disease with a prominent stroma demonstrating a myoid phenotype. Resection of the retroperitoneal tumour resulted in resolution of the cutaneous blisters. This emphasises the importance to consider paraneoplastic disease in treatment-resistant pemphigus as surgical removal of the tumour forms the mainstay of therapy. The differential diagnosis should include Castleman disease and careful evaluation of histology is essential with the awareness of this rare stroma-rich variant.
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Affiliation(s)
- Paida Gwiti
- Department of Cellular Pathology, Peterborough City Hospital, Peterborough, Cambridgeshire, UK
| | - Zsombor Melegh
- Centre for Medical Education, University of Bristol, Bristol, UK
- Department of Cellular Pathology, North Bristol NHS Trust, Westbury on Trym, UK
| | - Sarah Johnston
- Department of Immunology, North Bristol NHS Trust, Westbury on Trym, Bristol, UK
| | - Judit Sutak
- Department of Cellular Pathology, North Bristol NHS Trust, Westbury on Trym, UK
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Liu FF, Hall V, Cronin KM, Nair AP, Mclean CA, Hoy JF. 'Peeling back the onion layers': the challenge of HIV-associated multicentric Castleman's disease. AIDS 2021; 35:159-161. [PMID: 33273187 DOI: 10.1097/qad.0000000000002705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Faye F Liu
- Department of Infectious Diseases, The Alfred, Melbourne
| | - Victoria Hall
- Department of Infectious Diseases, The Alfred, Melbourne
| | - Katie M Cronin
- Department of Infectious Diseases, Austin Health, Heidelberg
| | - Anish P Nair
- Border Medical Oncology and Haematology, East Albury
- Albury Wodonga Health, Albury
| | - Catriona A Mclean
- Department of Anatomical Pathology, The Alfred, Melbourne
- Monash University, Clayton, Australia
| | - Jennifer F Hoy
- Department of Infectious Diseases, The Alfred, Melbourne
- Monash University, Clayton, Australia
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Demirkan FG, Doğan S, Kalyoncu Uçar A, Sönmez HE, Aktay Ayaz N. Systemic lupus erythematosus complicated with Castleman disease: a case-based review. Rheumatol Int 2020; 41:475-479. [PMID: 32797278 DOI: 10.1007/s00296-020-04684-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/09/2020] [Indexed: 11/26/2022]
Abstract
Systemic lupus erythematosus (SLE) is a complex, chronic, multi-systemic autoimmune disease, characterized by miscellaneous clinical findings. Castleman disease (CD) is a rare lymphoproliferative disorder that may present with systemic symptoms. Herein, a SLE case complicated with CD is reported by comparing her clinical findings with previously reported patients. We reviewed the literature regarding cases of "Castleman disease" and "Systemic lupus erythematosus" by searching medical journal databases in MEDLINE, EMBASE, Scopus, and Web of Science. A case of a 16-year-old girl with SLE who had intraabdominal lymphadenopathy detected both by ultrasonography and abdominal magnetic resonance imaging is presented. The excision of the lymph node was performed by pediatric surgeons. Histopathological examination was compatible with CD. Hydroxychloroquine and steroid treatments were started after the operation. She achieved remission in 3 months. In the literature research, we found 10 articles describing 17 patients. To our best of knowledge, the presented case was the third pediatric case in the literature with SLE and coexistent CD. This case report and literature review suggests that CD should be considered while evaluating and following patients with autoimmune diseases.
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Affiliation(s)
- Fatma Gül Demirkan
- Department of Pediatric Rheumatology, University of Health Sciences, Kanuni Sultan Süleyman Research and Training Hospital, Istanbul, Turkey
| | - Sümeyra Doğan
- Department of Pediatric Radiology, University of Health Sciences, Kanuni Sultan Süleyman Research and Training Hospital, Istanbul, Turkey
| | - Ayşe Kalyoncu Uçar
- Department of Pediatric Radiology, University of Health Sciences, Kanuni Sultan Süleyman Research and Training Hospital, Istanbul, Turkey
| | - Hafize Emine Sönmez
- Department of Pediatric Rheumatology, University of Health Sciences, Kanuni Sultan Süleyman Research and Training Hospital, Istanbul, Turkey
| | - Nuray Aktay Ayaz
- Department of Pediatric Rheumatology, Istanbul University, Faculty of Medicine, Fatih, Istanbul, Turkey.
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Furutera N, Fukunaga N, Okita J, Suzuki T, Suenaga Y, Oyama Y, Aoki K, Fukuda A, Nakata T, Uesugi N, Daa T, Hisano S, Shibata H. Two cases of idiopathic multicentric Castleman disease with nephrotic syndrome treated with tocilizumab. CEN Case Rep 2020; 10:35-41. [PMID: 32715375 DOI: 10.1007/s13730-020-00511-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 07/14/2020] [Indexed: 01/11/2023] Open
Abstract
We report two cases of idiopathic multicentric Castleman disease (iMCD) with nephrotic syndrome (NS) treated with tocilizumab. Case 1 was a 58-year-old man diagnosed with iMCD prior to the onset of NS. Renal biopsy revealed membranous nephropathy, which was considered to be secondary membranous nephropathy associated with iMCD. Case 2 was a 49-year-old woman diagnosed with iMCD prior to NS. Renal biopsy revealed renal amyloidosis positive for Congo red staining and amyloid A protein immunostaining. In both the cases, the proteinuria improved after the initiation of glucocorticoid and tocilizumab therapy. Tocilizumab may be a good therapeutic choice for iMCD with NS.
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Affiliation(s)
- Norihiro Furutera
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hsama-machi Yufu, Oita, 879-5593, Japan
| | - Naoya Fukunaga
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hsama-machi Yufu, Oita, 879-5593, Japan.
| | - Jun Okita
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hsama-machi Yufu, Oita, 879-5593, Japan
| | - Tomoko Suzuki
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hsama-machi Yufu, Oita, 879-5593, Japan
| | - Yuko Suenaga
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hsama-machi Yufu, Oita, 879-5593, Japan
| | - Yuzo Oyama
- Department of Diagnostic Pathology, Faculty of Medicine, Oita University, Oita, Japan
| | - Kohei Aoki
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hsama-machi Yufu, Oita, 879-5593, Japan
| | - Akihiro Fukuda
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hsama-machi Yufu, Oita, 879-5593, Japan
| | - Takeshi Nakata
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hsama-machi Yufu, Oita, 879-5593, Japan
| | - Noriko Uesugi
- Department of Pathology, Faculty of Medicine, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Tsutomu Daa
- Department of Diagnostic Pathology, Faculty of Medicine, Oita University, Oita, Japan
| | - Satoshi Hisano
- Department of Pathology, Faculty of Medicine, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Hirotaka Shibata
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hsama-machi Yufu, Oita, 879-5593, Japan
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Zhou YX, Ji Y, Wu S. A CARE-compliant article: Unicentric Castleman disease presenting as a retroperitoneal mass of the upper edge of the pancreas: A case report. Medicine (Baltimore) 2020; 99:e19515. [PMID: 32176100 PMCID: PMC7440106 DOI: 10.1097/md.0000000000019515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 12/27/2019] [Accepted: 02/11/2020] [Indexed: 02/05/2023] Open
Abstract
RATIONALE Castleman disease (CD) is a rare lymphoproliferative disease with a poorly understood etiology. The occurrence of CD in the abdominal cavity is very rare, especially in the retroperitoneal peripancreatic region. PATIENT CONCERNS A 33-year-old woman was referred to our department on March 1, 2018 for a detailed physical examination due to retroperitoneal peripancreatic lymph node enlargement over 15 days. DIAGNOSIS Enhanced magnetic resonance imaging of the epigastrium showed the mass with abundant blood supply is located between the liver and the stomach in the upper margin of the pancreas. Postoperative pathological examination revealed CD, type of unicentric Castleman disease. INTERVENTIONS We performed an open surgery on this patient and completely removed the mass. There was no postoperative radiochemotherapy. OUTCOMES The patient was followed-up for more than 12 months after the operation and showed good recovery. LESSONS CD is a rare disorder that is hard to diagnose early and complete resection of the tumor is still the most effective treatment.
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Affiliation(s)
- You-Xin Zhou
- Department of General Surgery, People Hospital of Jingjiang
| | - Yong Ji
- Department of General Surgery, People Hospital of Jingjiang
| | - Sheng Wu
- Department of Pathology, People Hospital of Jingjiang, YangZhou University Medical Academy, Jingjiang, Taizhou, China
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Volkow-Fernández P, Lome-Maldonado C, Quintero-Buenrostro H, Islas-Muñoz B, Cornejo-Juárez P. HIV-associated multicentric Castleman disease: a report of 19 cases at an oncology institution. Int J STD AIDS 2020; 31:318-325. [PMID: 32089093 DOI: 10.1177/0956462420905277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The aim of this study is to describe the clinical characteristics and outcome of multicentric Castleman disease (MCD) in HIV-infected patients at an oncological referral center in Mexico. Clinical records at the HIV-AIDS clinic of all patients diagnosed with MCD from 1994 to 2018 were reviewed. There were 19 patients, mean age was 31.3 ± 8.4 years, and 17 (89.5%) were males. Fifteen patients (79%) had also Kaposi sarcoma (KS). Main clinical characteristics were multiple lymphadenopathy (95%), systemic symptoms (63%), and hepatosplenomegaly (50%). Computed tomography scan and 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography showed multiple lymphadenopathy, inversion of the liver:spleen uptake ratio, with an increase in SUVmax (5.7). The histopathology report described plasma cells in 58%, mixed type in 26%, and hyaline vascular in 16%. Eleven patients (57.9%) received different chemotherapy regimens. Seven patients died (36.8%): four related to MCD progression or chemotherapy complications, median survival was eight months. For those patients who survived, median, follow-up was 28 months (p < 0.001). The incidence of MCD in people living with HIV is probably underestimated. In patients with lymphadenopathy, B symptoms, deranged inflammatory markers, and/or disseminated KS, a biopsy of an enlarged lymph node is warranted, and the histology should be reviewed by an experienced pathologist.
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Affiliation(s)
- P Volkow-Fernández
- Infectious Diseases Department, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - C Lome-Maldonado
- Pathology Department, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - H Quintero-Buenrostro
- Pathology Department, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - B Islas-Muñoz
- Infectious Diseases Department, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - P Cornejo-Juárez
- Infectious Diseases Department, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
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