Adrenalitis and anasarca in idiopathic multicentric Castleman's disease

A 46-year-old man presented to our hospital with abdominal pain and fever. In his medical history he reported three previous episodes of varicella zoster. On examination, he had a temperature of 38·3°C, small cervical lymph nodes, and some right upper quadrant tenderness.A CT of the patient's a...

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Veröffentlicht in:	The Lancet (British edition) 2021-05, Vol.397 (10286), p.1749-1749
Hauptverfasser:	Chen, Luke Y C, Skinnider, Brian F, Wilson, Don, Fajgenbaum, David C
Format:	Artikel
Sprache:	eng
Schlagworte:	Abdomen Abdominal Pain - diagnosis Abdominal Pain - etiology Adrenal Gland Diseases - pathology Antibodies, Monoclonal - administration & dosage Antibodies, Monoclonal - therapeutic use Antineoplastic Agents - administration & dosage Antineoplastic Agents - therapeutic use Antineoplastic Agents, Hormonal - administration & dosage Antineoplastic Agents, Hormonal - therapeutic use Ascites Azetidines - administration & dosage Azetidines - therapeutic use Biopsy Bone marrow Bone Marrow - metabolism Bone Marrow - pathology Bortezomib - administration & dosage Bortezomib - therapeutic use Case reports Castleman Disease - diagnosis Castleman Disease - drug therapy Castleman Disease - pathology Castleman's disease Creatinine Cyclosporine - administration & dosage Cyclosporine - therapeutic use Cytokines Dexamethasone - administration & dosage Dexamethasone - therapeutic use Drug Therapy, Combination Edema Edema - pathology Fever - diagnosis Fever - etiology Humans Immunosuppressive Agents - administration & dosage Immunosuppressive Agents - therapeutic use Janus Kinase Inhibitors - administration & dosage Janus Kinase Inhibitors - therapeutic use Lymph nodes Male Middle Aged Purines - administration & dosage Purines - therapeutic use Pyrazoles - administration & dosage Pyrazoles - therapeutic use Renal Insufficiency - etiology Reticulin Severe acute respiratory syndrome coronavirus 2 Sulfonamides - administration & dosage Sulfonamides - therapeutic use Thrombocytopenia Thrombocytopenia - etiology
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Zusammenfassung:	A 46-year-old man presented to our hospital with abdominal pain and fever. In his medical history he reported three previous episodes of varicella zoster. On examination, he had a temperature of 38·3°C, small cervical lymph nodes, and some right upper quadrant tenderness.A CT of the patient's abdomen showed bilateral adrenalitis (figure). Laboratory investigations showed marked cholestatic hepatitis—including a raised alkaline phosphatase (1 995 U/mL; normal 30–135).
ISSN:	0140-6736 1474-547X
DOI:	10.1016/S0140-6736(21)00674-7