Castleman Disease and Renal Amyloidosis

I. Kazes; G. Deray; C. Jacobs

doi:10.7326/0003-4819-122-5-199503010-00024

Letters |1 March 1995

Castleman Disease and Renal Amyloidosis

I. Kazes; G. Deray; C. Jacobs

Article, Author, and Disclosure Information

TO THE EDITOR:

Giant lymph node hyperplasia was initially described by Castleman and colleagues [1] in 1956 as a solitary mediastinal lesion. Since then, isolated cases of this rare disease have been reported in other sites [2] and have been described under two clinicopathologic variants: the hyaline vascular type and the plasma cell type. Systemic manifestations such as fever, anemia, increased erythrocyte sedimentation rate, and hypergammaglobulinemia frequently accompany the plasma cell variant and subside after the lesion is removed [3]. We describe a patient successfully treated with surgery alone for Castleman disease associated with renal amyloidosis.

A 48-year-old woman who had had profound and chronic microcytic and hypochromic anemia since 1976 and who was unresponsive to iron therapy was hospitalized for a nephrotic syndrome. Results of a physical examination were normal. Laboratory findings were as follows: erythrocyte sedimentation rate, 105 mm/h; hemoglobin level, 5.3 g/dL; erythrocyte count, 3 × 10¹²/L; mean corpuscular volume, 63.5 microns³; reticulocyte count, 1%; platelet count, 626 000 cells/mm³; serum iron concentration, 6 µmol/L; and ferritin concentration, 402 µg/L. Acute-phase protein levels were markedly elevated. The serum creatinine level was 197 µmol/L; the serum albumin level was 24 g/L; and proteinuria was present at 18 g/d. Results of a bone marrow examination were normal. Examination of a kidney biopsy specimen showed amyloidosis of the AA type. The patient had no history of recurrent infections, chronic inflammatory diseases, autoimmune diseases, or neoplasms. No other specific diagnosis was made. A computed tomographic scan of the abdomen showed a partially calcified mesenteric mass that was lateral to the aorta and thought to represent lymphadenopathy.

FULL TEXT

PDF

Not Available

Letters |1 March 1995

Castleman Disease and Renal Amyloidosis

Content

Information For

Services

Awards and Cover

Other Resources

Follow Annals On

Letters |1 March 1995

Castleman Disease and Renal Amyloidosis

Content

Information For

Services

Awards and Cover

Other Resources

Follow Annals On

You need a subscription to this content to use this feature.