Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Akita, Japan.
Am J Med Sci. 2010 May;339(5):486-90. doi: 10.1097/MAJ.0b013e3181da4321.
A 35-year-old Japanese man developed systemic lymphadenopathy during the course of immunosuppressive therapy for IgA nephropathy associated with cutaneous nodules, polyclonal hypergammaglobulinemia, and persistent increased serum C-reactive protein of unknown cause. Lymph node examination showed the plasmacytic type of Castleman disease (CD). A skin biopsy showed specific pathologic findings of CD cutaneous involvement. Considering the involvement of interleukin-6 in CD, we treated the patient with humanized anti-interleukin-6 receptor antibody. Thereafter, his symptoms and abnormal laboratory findings were improved. Cutaneous CD has rarely been described in Asian population, and renal complications in CD are uncommon and heterogeneous. To our knowledge, this is the first case of IgA nephropathy associated with multicentric CD with cutaneous involvement.
一位 35 岁的日本男性在接受免疫抑制治疗 IgA 肾病相关的皮肤结节、多克隆高丙种球蛋白血症和持续性不明原因的血清 C 反应蛋白升高期间出现全身淋巴结病。淋巴结检查显示为浆细胞型 Castleman 病（CD）。皮肤活检显示 CD 皮肤受累的特定病理发现。鉴于白细胞介素-6 在 CD 中的作用，我们用抗人白细胞介素-6 受体抗体治疗该患者。此后，他的症状和异常实验室发现得到改善。皮肤 CD 在亚洲人群中很少被描述，CD 的肾脏并发症罕见且表现多样。据我们所知，这是首例伴有皮肤受累的多中心 CD 相关 IgA 肾病。
