[HHV-8-positive Castleman's disease with rapidly progressing multiorgan failure mimicking TAFRO syndrome]

A 60-year-old man was admitted to our hospital with multiple organ failure complicated by disseminated intravascular coagulation. He presented with thrombocytopenia, pleural effusion, ascites, high fever, and renal impairment, suggesting TAFRO syndrome. In addition to administering prednisolone, dialysis and mechanical ventilation were initiated for severe renal and respiratory insufficiencies, respectively. However, he died 5 days after admission. An autopsy was performed, resulting in the diagnosis of human herpesvirus (HHV)-8-positive plasma cell-type Castleman's disease. Furthermore, HHV-8 was detected in the vascular endothelium and lymph nodes on immunohistochemical study. His rapidly deteriorating clinical course with the lack of serum hypergammaglobulinemia is atypical for Castleman's disease. Therefore, HHV-8 may have incited the disorder's aggressive behavior, causing TAFRO syndrome.