Multicentric Castleman disease, Kaposi sarcoma, hemophagocytic syndrome, and a novel HHV8-lymphoproliferative disorder.
The case of a 45-year-old man with HIV disease with bulky lymphadenopathy, fevers, and weight loss is presented. Immune reconstitution inflammatory syndrome was initially believed to be the cause, but the patient was found to suffer from Kaposi sarcoma, multicentric Castleman disease, hemophagocytic syndrome, and a newly described lymphoproliferative disorder. The diagnostic reasoning related to the causes of the fulminant illness is discussed as well as the roles of Epstein-Barr virus, human herpesvirus 8, and hepatitis C virus in the patient's clinical presentation and the therapeutic choices.
Yates
Jennifer A
JA
Department of Internal Medicine, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Zakai
Neil A
NA
Griffith
Rogers C
RC
Wing
Edward J
EJ
Schiffman
Fred J
FJ
D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D005871:Castleman Disease / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D003937:Diagnosis, Differential; D015658:HIV Infections / Q000150:complications / Q000821:virology; D015497:HIV-1; D006566:Herpesviridae Infections / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D019288:Herpesvirus 8, Human; D006801:Humans; D008198:Lymph Nodes / Q000166:cytology / Q000821:virology; D051359:Lymphohistiocytosis, Hemophagocytic / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D008232:Lymphoproliferative Disorders / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012514:Sarcoma, Kaposi / Q000150:complications* / Q000175:diagnosis / Q000473:pathology