Multicentric Castleman's disease in a patient with HIV.
Multicentric Castleman's disease (MCD) was originally described in non-HIV patients. It is a rare lymphoproliferative disorder, which is more commonly seen in HIV-positive patients and is associated with human herpes virus-8 (HHV-8). We describe a patient with advanced HIV who responded well to conventional highly active antiretroviral treatment. She was diagnosed with MCD soon after her diagnosis of HIV. She presented with multiple flares of her MCD. The case illustrates the difficulty of differentiating between episodes of septicaemia and a flare of MCD. The patient was treated with various chemotherapy regimens, which included several cycles of liposomal doxyrubicin and etoposide. There is currently no consensus on the treatment of MCD and various therapies are described in the literature, which include chemotherapy. Chemotherapy must be chosen with the immunosuppressive effects of the treatment being considered with caution. Both doxyrubicin and etoposide are well tolerated and successfully controlled the symptoms of MCD in our patient.
Fowler
A
A
Department of Genito-urinary Medicine, Guy's and St Thomas' NHS Foundation Trust, London SE7 7EH, UK. afowler@doctors.org.uk
Collins
L
L
de Ruiter
A
A
Whittaker
S
S
Kulasegaram
R
R
Bradbeer
C
C
D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D005871:Castleman Disease / Q000175:diagnosis / Q000188:drug therapy*; D004317:Doxorubicin / Q000627:therapeutic use*; D005047:Etoposide / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D015497:HIV-1; D019288:Herpesvirus 8, Human; D006801:Humans; D008081:Liposomes / Q000627:therapeutic use
D000903:Antibiotics, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D008081:Liposomes; D005047:Etoposide; D004317:Doxorubicin