Multicentric Castleman's disease treated with antivirals and immunosuppressants.
A patient negative for human immunodeficiency virus (HIV) developed multicentric Castleman's disease (MCD) and Kaposi's sarcoma (KS) associated with active human herpesvirus 8 (HHV-8) infection. He was treated with sequential antiviral therapy, chemotherapy, and corticosteroids. HHV-8 levels were monitored throughout the course of the patient's illness, and were found to rise on relapse. No consistent change in HHV-8 levels was found with antiviral therapy. We demonstrate that in this patient antiviral therapy was clinically ineffective, and did not alter HHV-8 levels, but that corticosteroid and combination chemotherapy led to clinical improvement. Despite the implication of HHV-8 as a cause of MCD, few studies have correlated HHV-8 levels with clinical response.
Senanayake
Sanjaya
S
Department of Infectious Diseases, Prince of Wales Hospital, Barker Street, Randwick, New South Wales 2031, Australia.
Kelly
John
J
Lloyd
Andrew
A
Waliuzzaman
Zubair
Z
Goldstein
David
D
Rawlinson
William
W
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000627:therapeutic use; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005871:Castleman Disease / Q000188:drug therapy* / Q000821:virology; D002699:Chlorambucil / Q000008:administration & dosage / Q000627:therapeutic use; D000077404:Cidofovir; D003596:Cytosine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D017245:Foscarnet / Q000008:administration & dosage / Q000627:therapeutic use*; D019288:Herpesvirus 8, Human / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D063065:Organophosphonates; D009943:Organophosphorus Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D012514:Sarcoma, Kaposi / Q000188:drug therapy / Q000821:virology; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D018906:Antineoplastic Agents, Alkylating; D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D063065:Organophosphonates; D009943:Organophosphorus Compounds; D002699:Chlorambucil; D017245:Foscarnet; D003596:Cytosine; D011239:Prednisolone; D000077404:Cidofovir