[A case report of TAFRO syndrome]

Area of Science:

• Hematology
• Nephrology
• Oncology

Background:

• TAFRO syndrome is a distinct subtype of idiopathic multicentric Castleman disease.
• It presents as a systemic inflammatory disease with unique clinical characteristics.
• Understanding its specific diagnostic and therapeutic approaches is crucial for clinicians.

Observation:

• Key manifestations include intermittent vaginal bleeding, fever, leg edema, anemia, thrombocytopenia, and renal dysfunction.
• Diagnostic findings revealed elevated leukocytes, C-reactive protein, and procalcitonin.
• Bone marrow biopsy showed active granulocyte proliferation, while CT indicated high FDG uptake.

Findings:

• Lymph node biopsy confirmed Castleman disease (transparent vascular type).
• Renal biopsy identified thrombotic microangiopathy with subacute tubulointerstitial nephropathy.
• Treatment with methylprednisolone and tocilizumab led to significant clinical improvement, including normalization of blood counts and renal function recovery.

Implications:

• TAFRO syndrome requires a comprehensive diagnostic approach, emphasizing lymph node and renal biopsies for accurate diagnosis and prognosis.
• Early identification and tailored treatment strategies are essential for achieving favorable clinical outcomes.
• Further research into the pathogenesis of TAFRO syndrome, particularly renal involvement, is warranted.