Rapidly progressive renal failure associated with angiofollicular lymph node hyperplasia.

Area of Science:

• Nephrology
• Hematology
• Oncology

Background:

• Castleman's disease, a rare lymphoproliferative disorder, is typically associated with systemic symptoms.
• Renal involvement in Castleman's disease is uncommon and poorly understood.
• Rapidly progressive renal failure is a severe complication that requires prompt diagnosis and management.

Observation:

• A case of rapidly progressive renal failure was observed in a patient with Castleman's disease.
• Renal biopsy findings included crescentic glomerulonephritis and marked tubulointerstitial nephritis.
• These specific renal lesions had not been previously reported in association with Castleman's disease.

Findings:

• The patient presented with severe kidney injury necessitating hemodialysis.
• Treatment with corticosteroids effectively managed the systemic aspects of Castleman's disease.
• Significant recovery of renal function was achieved, allowing discontinuation of hemodialysis.

Implications:

• This case highlights a novel association between Castleman's disease and specific glomerulonephritis and tubulointerstitial nephritis.
• Early recognition and treatment of renal manifestations may improve outcomes in Castleman's disease patients.
• Corticosteroid therapy shows potential in managing renal dysfunction in this context.