Systemic lupus erythematosus mimicking idiopathic multicentric Castleman disease: A diagnostic dilemma

Area of Science:

• Immunology
• Rheumatology
• Hematology

Background:

• Castleman disease is a rare lymphoproliferative disorder that can present with diverse clinical manifestations.
• It often mimics other conditions, including autoimmune diseases and malignancies, complicating diagnosis.
• Systemic lupus erythematosus (SLE) shares overlapping clinical and laboratory features with Castleman disease, creating a diagnostic challenge.

Observation:

• A young female patient initially presented with symptoms suggestive of idiopathic multicentric Castleman disease.
• Subsequently, she developed antinuclear antibody (ANA) positivity and met the diagnostic criteria for SLE.
• This presentation underscores the diagnostic complexity when these two conditions overlap.

Findings:

• The patient's initial presentation mimicked Castleman disease, but the subsequent development of ANA positivity indicated SLE.
• Treatment initiated for systemic lupus erythematosus led to a significant clinical and biochemical improvement.
• This suggests that in certain overlapping cases, SLE treatment may be effective.

Implications:

• This case highlights the importance of considering SLE in patients with Castleman disease-like symptoms, especially with serological evidence.
• Accurate differentiation and timely diagnosis are crucial for effective management of these overlapping conditions.
• Further research may elucidate sharedpathogenic mechanisms between Castleman disease and SLE.