Multicentric Castleman’s disease associated with IgA vasculitis (Henoch-Schönlein purpura) responding well to tocilizumab: a case report
| Autor: | Masayuki Yamanouchi, Kenmei Takaichi, Noriko Hayami, Nobukazu Hayashi, Tatsuya Suwabe, Masahiro Kawada, Hiroki Mizuno, Toshiharu Ueno, Yoshifumi Ubara, Aya Imafuku, Rikako Hiramatsu, Akinari Sekine, Takeshi Fujii, Naoki Sawa, Eiko Hasegawa, Yoichi Oshima, Junichi Hoshino, Junko Yabuuchi |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Axillary Lymph Node Biopsy medicine.medical_specialty Pathology Henoch-Schonlein purpura IgA Vasculitis Antibodies Monoclonal Humanized Gastroenterology 030207 dermatology & venereal diseases 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Tocilizumab Rheumatology immune system diseases hemic and lymphatic diseases Internal medicine Humans Medicine medicine.diagnostic_test business.industry Castleman Disease Hypergammaglobulinemia General Medicine medicine.disease Purpura Treatment Outcome IgA vasculitis chemistry 030220 oncology & carcinogenesis Skin biopsy medicine.symptom business Immunosuppressive Agents |
| Zdroj: | Clinical Rheumatology. 36:729-733 |
| ISSN: | 1434-9949 0770-3198 |
| Popis: | A 41-year-old man was referred to our hospital for the evaluation of hypergammaglobulinemia (IgG 2898 mg/dL and IgA 587 mg/dL), inflammation (CRP 6.7 mg/dL and serum interleukin-6 (IL-6) 15.1 ng/L), and anemia (Hb 10.9 mg/dL). Castleman's disease (CD) was diagnosed by axillary lymph node biopsy. Five months later, painful purpura (multiple palpable 5 mm lesions) developed on his legs, gradually spreading to the upper limbs, thighs, and trunk, accompanied by arthralgia of the wrists, ankles, and knees. Skin biopsy revealed leukocytoclastic vasculitis with IgA deposits in dermal vessels. Accordingly, IgA vasculitis (Henoch-Schönlein purpura) was diagnosed. Tocilizumab (an anti-IL-6 receptor antibody) was administered intravenously at 8 mg/kg and treatment was repeated at monthly intervals. His purpura and clinical findings specific to CD improved rapidly. CD is well known to cause various skin lesions. The findings in this case indicate that overproduction of IL-6 contributes to IgA vasculitis (Henoch-Schönlein purpura) as well as to the pathogenesis of CD. |
| Databáze: | OpenAIRE |
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