[HHV 8 positive Castleman's disease and auto-immune neutropenia in 2 HIV-infected patients].
BACKGROUND
Castleman's disease (CD) is a polyclonal lymphoplasmacytic and vascular proliferation prominent in lymphoid tissues, associated to Human Herpesvirus 8 (HHV-8) in Human Immunodeficiency Virus (HIV)-infected patients. The presence of autoimmune stigmates is frequent.


METHODS
We report two cases of neutropenia secondary to IgG neutrophil autoantibodies, indeterminate specificity, occurring in two HIV-infected patients with CD HHV-8+, treated by vinblastine since several years. The neutropenia was associated to other biologic stigmates of autoimmunity and the evolution has been complicated by several infections. Granulocyte-colony stimulating factor (G-CSF) and polyvalent immunoglobulin permitted a transient and low increase of neutrophila in one case.


CONCLUSIONS
Auto-immune neutropenia in CD is rare and difficult to treat in our cases. This evolution is independent of relapse of CD. The immunoglobulin and G-CSF may be transitory effective.
Aaron
L
L
Service des maladies infectieuses et tropicales, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75743 Paris 15, France. laaaron@wanadoo.fr
Kahn
J-E
JE
Therby
A
A
Lidove
O
O
Zucman
D
D
Viard
J-P
JP
D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D001323:Autoantibodies / Q000097:blood; D005871:Castleman Disease / Q000150:complications* / Q000188:drug therapy; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006566:Herpesviridae Infections / Q000150:complications* / Q000188:drug therapy; D019288:Herpesvirus 8, Human; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000188:drug therapy / Q000276:immunology*; D016896:Treatment Outcome; D014747:Vinblastine / Q000627:therapeutic use
D000972:Antineoplastic Agents, Phytogenic; D001323:Autoantibodies; D007074:Immunoglobulin G; D014747:Vinblastine