title: [Castleman's disease in patients infected with HIV].
abstract: OBJECTIVE
  Castleman's disease is a polyclonal lymphoplasmacytic and vascular proliferation prominant in lymphoid tissues. It is associated with lymph node enlargement, hepatosplenomegaly and fever. This manifestations could be secondary to hyperproduction of interleukin 6. The prognosis is poor. The opportunistic infections which are characteristic of severe HIV infection worsen the prognosis. Prolonged monochemotherapy with vinblastine or etoposide can control Castleman's disease.
  
  
  BACKGROUND
  Recent advances in human herpesvirus 8 (HHV8) knowledge and its predominance in the forms which are linked to the HIV seropositivity have partly explained the clinical manifestations of Castleman's disease. Indeed, HHV8 produce an homologous interleukin 6, the vIL-6, responsible for lymphoplasmacytic proliferation. The presence of other homologues of human cytokines produced by HHV8 could contribute to lymphoplasmacytosis and to endothelial proliferation.
  
  
  CONCLUSIONS
  Taking into account this viral origin, alpha interferon could be an alternative in forms which are less progressive. However, antiviral therapy against HHV8 or HIV and the immunitary restoration do not have any influence on the evolution of Castleman's disease, contrary to opportunistic infections.
authors.affiliation: Service de maladies infectieuses et tropicales, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75743 Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Aaron
authors.forename: O
authors.initials: O
authors.lastname: Lidove
authors.forename: J P
authors.initials: JP
authors.lastname: Viard
authors.forename: D
authors.initials: D
authors.lastname: Troisvallet
authors.forename: C
authors.initials: C
authors.lastname: Piketty
authors.forename: D
authors.initials: D
authors.lastname: Vittecoq
authors.forename: D
authors.initials: D
authors.lastname: Zucman
authors.forename: O
authors.initials: O
authors.lastname: Blétry
authors.forename: B
authors.initials: B
authors.lastname: Dupont
mesh_terms: D005871:Castleman Disease / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D015658:HIV Infections / Q000150:complications*; D006801:Humans