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A comorbid case of multicentric Castleman's disease and pulmonary hyalinising granuloma successfully treated with tocilizumab and corticosteroid

Identifieur interne : 002884 ( Main/Exploration ); précédent : 002883; suivant : 002885

A comorbid case of multicentric Castleman's disease and pulmonary hyalinising granuloma successfully treated with tocilizumab and corticosteroid

Auteurs : Naoko Takeuchi [Japon] ; Toru Arai [Japon] ; Masanori Kitaichi [Japon] ; Yoshikazu Inoue [Japon]

Source :

RBID : ISTEX:06D33D687921E723E77E570AC63D390FE78EAA95

Descripteurs français

English descriptors

Abstract

A 49-year-old man with superficial lymphadenopathy presented with symptoms of low-grade fever, general fatigue and weight loss. On examination, multiple superficial lymphadenopathies and brown macules were observed on the trunk. Laboratory studies revealed an elevation of serum C reactive protein and interleukin 6 (IL-6) in addition to polyclonal hyperimmunoglobulinaemia. High-resolution CT of the chest showed bilateral multiple nodules and patchy ground-glass opacities with interstitial thickening. Biopsy of the cervical lymph node and skin biopsy showed numerous perivascular plasma cells, which were characteristic of the plasma cell type of Castleman's disease. Surgical lung biopsy showed hyalinising granuloma, which are hyalinous nodular lesions surrounded by lymphoid cells. He was diagnosed with multicentric Castleman's disease complicated by pulmonary hyalinising granulomas; his symptoms improved by treatment with tocilizumab, which is a humanised antihuman IL-6 receptor monoclonal antibody and corticosteroid. This is the first report of a comorbid case successfully treated with tocilizumab and corticosteroid.

Url:
DOI: 10.1136/bcr-2013-010233


Affiliations:


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Le document en format XML

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<term>Lung Diseases (complications)</term>
<term>Lung Diseases (diagnosis)</term>
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<term>Maladies pulmonaires (diagnostic)</term>
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<term>Humanised antihuman receptor</term>
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<term>Lymph node</term>
<term>Lymphadenopathy</term>
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<term>Macule</term>
<term>Male</term>
<term>Middle Aged</term>
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<term>Multicentric disease</term>
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<term>Node</term>
<term>Nodular lesion</term>
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<term>Opacity</term>
<term>Plasma cell type</term>
<term>Plasma cells</term>
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<term>Pulmonary hyalinizing granuloma</term>
<term>Reactive</term>
<term>Reactive protein</term>
<term>Receptor</term>
<term>Sakai</term>
<term>Surgical lung biopsy</term>
<term>Takeuchi</term>
<term>Tocilizumab</term>
<term>Tomography, X-Ray Computed</term>
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<div type="abstract">A 49-year-old man with superficial lymphadenopathy presented with symptoms of low-grade fever, general fatigue and weight loss. On examination, multiple superficial lymphadenopathies and brown macules were observed on the trunk. Laboratory studies revealed an elevation of serum C reactive protein and interleukin 6 (IL-6) in addition to polyclonal hyperimmunoglobulinaemia. High-resolution CT of the chest showed bilateral multiple nodules and patchy ground-glass opacities with interstitial thickening. Biopsy of the cervical lymph node and skin biopsy showed numerous perivascular plasma cells, which were characteristic of the plasma cell type of Castleman's disease. Surgical lung biopsy showed hyalinising granuloma, which are hyalinous nodular lesions surrounded by lymphoid cells. He was diagnosed with multicentric Castleman's disease complicated by pulmonary hyalinising granulomas; his symptoms improved by treatment with tocilizumab, which is a humanised antihuman IL-6 receptor monoclonal antibody and corticosteroid. This is the first report of a comorbid case successfully treated with tocilizumab and corticosteroid.</div>
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