Imafuku Aya, Suwabe Tatsuya, Hasegawa Eiko, Mise Koki, Sumida Keiichi, Hiramatsu Rikako, Yamanouchi Masayuki, Hayami Noriko, Hoshino Junichi, Sawa Naoki, Oohashi Kenichi, Fujii Takashi, Okubo Minoru, Takaichi Kenmei, Oga Tatsuhide, Ubara Yoshifumi
Nephrology Center, Toranomon Hospital, Japan.
Intern Med. 2013;52(14):1611-6. doi: 10.2169/internalmedicine.52.0271. Epub 2013 Jul 15.
A 56-year-old Japanese man developed a cerebral hemorrhage and was diagnosed with plasma cell-type multicentric Castleman's disease (MCD) based on the findings of an inguinal lymph node biopsy in addition to clinical findings, including hypergammaglobulinemia, anemia and elevation of the levels of CRP and serum IL-6. Although a renal biopsy showed nephrosclerosis, the levels of serum lipids and apolipoprotein were low. Following the initiation of treatment with anti-interleukin-6 receptor antibodies, the hypergammaglobulinemia, anemia, CRP level and serum lipid profile improved. However, inflammation due to overproduction of IL-6 persisted, and atherosclerotic vascular events occurred as critical complications, even though the serum levels of lipids were very low.
一名56岁的日本男性发生脑出血，除临床症状（包括高球蛋白血症、贫血以及CRP和血清IL-6水平升高）外，根据腹股沟淋巴结活检结果被诊断为浆细胞型多中心Castleman病（MCD）。尽管肾活检显示为肾硬化，但血清脂质和载脂蛋白水平较低。在用抗白细胞介素-6受体抗体治疗后，高球蛋白血症、贫血、CRP水平和血清脂质谱均有所改善。然而，由于IL-6过度产生导致的炎症持续存在，即使血清脂质水平非常低，动脉粥样硬化性血管事件仍作为严重并发症发生。
