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Renal involvement in Castleman disease

Khalil El Karoui1, Vincent Vuiblet, Daniel Dion

  • 1Department of Pathology, Hopital Europeen Georges Pompidou, AP-HP-Universite Paris Descartes, Paris, France.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|July 27, 2010
PubMed

Insights

Castleman disease (CD) frequently involves the kidneys, often presenting as small-vessel lesions (SVL). Loss of glomerular vascular endothelial growth factor (VEGF) in SVL correlates with CD activity.

Area of Science:

  • Nephrology
  • Hematology
  • Pathology

Background:

  • Castleman disease (CD), a lymphoproliferative disorder, presents with diverse symptoms.
  • Renal involvement in CD is rare, with limited case reports detailing various kidney diseases.

Purpose of the Study:

  • To investigate the patterns and characteristics of renal involvement in Castleman disease.
  • To explore the role of vascular endothelial growth factor (VEGF) in CD-associated kidney disease.

Main Methods:

  • Review of clinical and histological findings in 19 patients with CD and renal biopsies.
  • Immunolabeling of renal samples with anti-VEGF antibody.

Main Results:

  • Multicentric CD (89%) of plasma-cell or mixed type was common; 21% were HIV-associated.
  • Small-vessel lesions (SVL) were the most frequent renal pattern (60%) in HIV-negative patients.
  • Glomerular VEGF loss was observed in some SVL cases and correlated with C-reactive protein levels.

Conclusions:

  • Small-vessel lesions are the predominant renal manifestation in Castleman disease.
  • Loss of glomerular VEGF is linked to CD activity and may contribute to SVL pathogenesis.
Abstract

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