title: [Immunoblastic lymphadenopathy-like T cell lymphoma with high levels of serum interleukin-6, cold agglutinin disease, and immune thrombocytopenia].
abstract: An 88-year-old woman was admitted with generalized lymphadenopathy, anemia, and thrombocytopenia. On admission, a peripheral blood examination showed a red blood cell count of 146 x 10(6)/microliter, a hemoglobin concentration of 6.9 g/dl, and a platelet count of 5.0 x 10(4)/microliter. Blood examination detected polyclonal hypergammaglobulinemia; the results of the direct/indirect Coombs' test were positive; and an elevated cold agglutinin titer and high platelet associated IgG (PA-IgG) level indicated the existence of autoantibodies. Serum cytokine measurements disclosed an elevated level of interleukin-6 (IL-6). Immunoblastic lymphadenopathy-like T cell lymphoma was diagnosed on the basis of lymph node biopsy specimens. VP-16 and steroid therapy alleviated the patient's lymphadenopathy, anemia, thrombocytopenia, and hypergammaglobulinemia. These findings suggest that tumor cells with a T cell phenotype produced IL-6 in large quantities, thus provoking B-cell and plasmacytic histologic changes and humoral disease manifestations, including hypergammaglobulinemia.
authors.affiliation: Department of Internal Medicine, Shiraoi Town Hospital.
authors.forename: N
authors.initials: N
authors.lastname: Takayanagi
authors.forename: K
authors.initials: K
authors.lastname: Sampi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000744:Anemia, Hemolytic, Autoimmune / Q000209:etiology*; D001327:Autoimmune Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D007119:Immunoblastic Lymphadenopathy / Q000150:complications*; D015850:Interleukin-6 / Q000097:blood*; D016399:Lymphoma, T-Cell / Q000150:complications*; D013921:Thrombocytopenia / Q000209:etiology*
chemical_list: D015850:Interleukin-6