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[Castleman disease].

Gerardo A Belletti1, Verónica Savio, Daniel Minoldo

  • 1Servicio de Clínica Médica del Hospital Italiano Cba.

Revista De La Facultad De Ciencias Medicas (Cordoba, Argentina)
|October 11, 2005
PubMed
Summary
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Multicentric Castleman disease is a rare condition presenting with systemic symptoms and lymphadenopathy. Prompt diagnosis and corticosteroid treatment led to a significant clinical and biochemical response in this patient.

Area of Science:

  • Internal Medicine
  • Hematology
  • Oncology

Background:

  • Multicentric Castleman disease (MCD) is a rare lymphoproliferative disorder with significant systemic manifestations.
  • It often presents with constitutional symptoms, lymphadenopathy, and laboratory abnormalities, mimicking other conditions.

Observation:

  • A 66-year-old female presented with a year of asthenia, arthralgias, skin lesions, anemia, and elevated inflammatory markers.
  • Physical examination revealed significant weight loss, anorexia, adenopathy, and altered consciousness.
  • Biopsies confirmed a hyperplastic lymphoid process and neutrophilic vasculitis.

Findings:

  • The patient was diagnosed with Multicentric Castleman disease after excluding other etiologies.
  • Initial treatment with high-dose corticosteroids (1 mg/kg) resulted in a rapid and remarkable clinical and biochemical improvement.

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  • Disease relapse occurred upon steroid withdrawal, necessitating re-initiation of corticosteroid therapy with a favorable outcome.

    • Implications:

    • MCD, though rare, should be considered in the differential diagnosis of patients with severe systemic illness, lymphadenopathy, and responsiveness to steroids.
    • Corticosteroid therapy is a crucial treatment modality for MCD, offering significant symptom control and disease management.
    • This case highlights the importance of early recognition and appropriate management of MCD for improved patient outcomes.