Pahadiya Hans Raj, Choudhary Akanksha, Gandhi Ronak, Prajapati Gopal Raj, Lakhotia Manoj
Department of Medicine, Dr. S.N. Medical College, Jodhpur, Rajasthan, India.
Oxf Med Case Reports. 2016 Aug 29;2016(8):omw041. doi: 10.1093/omcr/omw041. eCollection 2016 Aug.
A 40-year-old male presented with a history of low-grade fever, weight loss, night sweats and breathlessness of 3 months duration. On examination, the patient had freely mobile lump in left lumbar region. The lump was surgically excised. Histological examination and immunohistochemistry of the specimen were consistent with the diagnosis of plasma cell variant of the Castleman disease. The patient had polyclonal hypergammaglobulinemia, anemia, eosinophilia and elevated interleukin (IL)-6 level. The level of IL-5 was not measured; however, the presence of eosinophilia indirectly suggests an increased IL-5 level. He obtained complete remission after resection of lump and 20 months of surgery had no signs and symptoms of diseases recurrence with normal hematological parameters. We discuss the role of IL-5 in the pathophysiology of the Castleman disease along with dysregulated overproduction of IL-6.
一名40岁男性,有持续3个月的低热、体重减轻、盗汗和呼吸急促病史。检查时,患者左腰区有可自由活动的肿块。该肿块经手术切除。标本的组织学检查和免疫组化结果与Castleman病浆细胞变异型的诊断一致。患者有多克隆高球蛋白血症、贫血、嗜酸性粒细胞增多和白细胞介素(IL)-6水平升高。未检测IL-5水平;然而,嗜酸性粒细胞增多间接提示IL-5水平升高。肿块切除后患者获得完全缓解,术后20个月无疾病复发的迹象和症状,血液学参数正常。我们讨论了IL-5在Castleman病病理生理学中的作用以及IL-6的失调过度产生。