Successful Treatment of a Patient with Multicentric Castleman's Disease who Presented with Thrombocytopenia, Ascites, Renal Failure and Myelofibrosis Using Tocilizumab, an Anti-Interleukin-6 Receptor Antibody

Hiroshi Kawabata; Shin-ichi Kotani; Yumi Matsumura; Tadakazu Kondo; Tatsuya Katsurada; Hironori Haga; Norimitsu Kadowaki; Akifumi Takaori-Kondo

doi:10.2169/internalmedicine.52.9482

CASE REPORTS

Successful Treatment of a Patient with Multicentric Castleman's Disease who Presented with Thrombocytopenia, Ascites, Renal Failure and Myelofibrosis Using Tocilizumab, an Anti-Interleukin-6 Receptor Antibody

Hiroshi Kawabata, Shin-ichi Kotani, Yumi Matsumura, Tadakazu Kondo, Tatsuya Katsurada, Hironori Haga, Norimitsu Kadowaki, Akifumi Takaori-Kondo

Author information

Hiroshi Kawabata
Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Japan
Shin-ichi Kotani
Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Japan
Yumi Matsumura
Department of Dermatology, Graduate School of Medicine, Kyoto University, Japan
Tadakazu Kondo
Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Japan
Tatsuya Katsurada
Department of Hematology, Ijinkai Takeda General Hospital, Japan
Hironori Haga
Department of Diagnostic Pathology, Graduate School of Medicine, Kyoto University, Japan
Norimitsu Kadowaki
Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Japan
Akifumi Takaori-Kondo
Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Japan

Keywords: Castleman's disease, systemic lupus erythematosus, interleukin-6, myelofibrosis, TAFRO syndrome

JOURNAL OPEN ACCESS

2013 Volume 52 Issue 13 Pages 1503-1507

DOI https://doi.org/10.2169/internalmedicine.52.9482

Details

Abstract

We herein describe an unusual case of multicentric Castleman's disease accompanied by thrombocytopenia, ascites, renal failure and myelofibrosis in a Japanese woman. The patient was initially diagnosed as having myelodysplastic syndrome with myelofibrosis. The general condition of the patient deteriorated rapidly; however, treatment with tocilizumab, an anti-interleukin-6 receptor antibody, together with corticosteroids dramatically improved her symptoms. The clinical features of this case were similar to those of three cases previously reported by Takai et al. (Rinsho Ketsueki, 2010, 51:320-5), which were determined to be thrombocytopenia, anasarca, fever, reticulin myelofibrosis and organomegaly (TAFRO) syndrome, a possibly distinct clinical entity.

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