Kantarci Fatma Eda Nuhoglu, Eren Rafet, Gündoğan Cihan, Huq Gülben Erdem, Doğu Mehmet Hilmi, Suyanı Elif
İstanbul Training and Research Hospital, Internal Medicine Department, Turkey.
İstanbul Training and Research Hospital, Hematology Department, Turkey.
J Infect Chemother. 2016 Jul;22(7):483-5. doi: 10.1016/j.jiac.2016.01.002. Epub 2016 Mar 2.
Multicentric Castleman disease (MCD) is a lymphoproliferative disorder characterized by systemic symptoms like recurrent lymphadenopathy, fever and hepatosplenomegaly. Human herpes virus 8 (HHV-8) can be associated with MCD whether the patient is infected with human immunodeficiency virus (HIV) or not. A 59-year-old male patient presented with fatigue, drowsiness and enlarged lymph nodes. Thoracic and abdominal computed tomography showed enlarged mediastinal, axillary, paracardiac, paraaortic, celiac, mesenteric, obturator and inguinal lymph nodes concomitant with enlarged liver and spleen. Cervical lymph node biopsy revealed HHV-8 positive plasma cell MCD. The patient's tests were negative for HIV. R-CEOP (rituximab, cyclophosphamide, etoposide, vincristin, prednisolone) and valganciclovir treatments were started simultaneously. After sixth cycle of R-CEOP, the patient achieved unconfirmed complete remission. Rituximab combined with CEOP protocol and antiviral therapy against HHV-8 might be an effective therapeutic approach without a considerable side effect for HHV-8-positive HIV-negative MCD patients.
多中心Castleman病（MCD）是一种淋巴增殖性疾病，其特征为反复出现淋巴结病、发热和肝脾肿大等全身症状。无论患者是否感染人类免疫缺陷病毒（HIV），人类疱疹病毒8型（HHV-8）都可能与MCD相关。一名59岁男性患者出现疲劳、嗜睡和淋巴结肿大。胸部和腹部计算机断层扫描显示纵隔、腋窝、心旁、主动脉旁、腹腔、肠系膜、闭孔和腹股沟淋巴结肿大，同时肝脏和脾脏肿大。颈部淋巴结活检显示HHV-8阳性浆细胞MCD。患者的HIV检测为阴性。同时开始使用R-CEOP（利妥昔单抗、环磷酰胺、依托泊苷、长春新碱、泼尼松龙）和缬更昔洛韦治疗。在R-CEOP的第六个周期后，患者实现了未经确认的完全缓解。利妥昔单抗联合CEOP方案以及针对HHV-8的抗病毒治疗可能是一种有效的治疗方法，对HHV-8阳性、HIV阴性的MCD患者没有明显副作用。
