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[Castleman-like presentation of systemic lupus: About a case report]
C Ferreira De Matos1, S De Almeida Chaves1, P Potin2
1Service de médecine interne, CHU de Toulouse, URM, CHU Purpan, place du Dr Baylac, TSA 40031, 31059 Toulouse cedex 9, France.
La Revue De Medecine Interne
|September 2, 2022
Summary
Castleman disease can mimic systemic lupus erythematosus (SLE). A patient with SLE presenting with "Castleman-like" features responded well to standard lupus treatment, highlighting diagnostic overlap.
Area of Science:
- Rheumatology
- Hematology
- Pathology
Background:
- Castleman disease is a rare lymphoproliferative disorder.
- It can present with symptoms overlapping those of systemic lupus erythematosus (SLE).
- SLE can rarely manifest with features suggestive of hematological malignancy, including "Castleman-like" histology.
Observation:
- A 55-year-old female with known SLE experienced weight loss, polyadenopathy, and a lupus flare.
- Investigations revealed pancytopenia, complement activation, positive anti-DNA antibodies, and hypermetabolic lymphadenopathy on PET/CT.
- Lymph node biopsy demonstrated "Castleman-like" histological features.
Findings:
- The patient achieved complete remission with corticosteroids and azathioprine, standard treatments for SLE.
- The clinical, biological, and histological findings suggested a "Castleman-like" presentation of SLE rather than concurrent Castleman disease.
Implications:
- Systemic lupus erythematosus and Castleman disease can share overlapping clinical, biological, and histological characteristics.
- Recognizing "Castleman-like" SLE is crucial to avoid unnecessary treatment intensification.
- This case underscores the importance of considering SLE in patients with apparent Castleman disease and vice versa.
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