title: Renal complications of Castleman's disease: report of two cases and analysis of 75 cases.
abstract: Biopsy-proven renal complications of Castleman's disease (CD) are rare and current knowledge is largely based on sporadic case reports. We reported two more cases, both of which were multicentric CD with hyaline-vascular pathological pattern and presented with chronic renal failure. Case 1 was multicentric CD with renal mesangial proliferative glomerulonephritis complications, and case 2 was multicentric CD with membranoproliferative glomerulonephritis-like complications. Although both were eventually administered corticosteroids combined with cytotoxic drugs, both behaved in an aggressive and relapsing manner. We then made an analysis of 75 cases of biopsy-proven renal complications of CD (including our two cases) which were reported in 51 English literatures from January 1954 to March 2011. We found that the clinical and histological findings of renal complications of CD were heterogeneous. Death was observed in 17% patients after a median follow-up time of 22 months (0-204 months) since histological diagnosis of renal complications. The estimated 5-year cumulative survival rate was 75%. Better understanding and therapeutic interventions are required in further investigations.
authors.affiliation: The Second Affiliated Hospital (Binjiang Branch), School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Xiang-Gui
authors.initials: XG
authors.lastname: Yuan
authors.forename: Wen
authors.initials: W
authors.lastname: Hu
authors.forename: Fei-Fei
authors.initials: FF
authors.lastname: Chen
authors.forename: Bin-Feng
authors.initials: BF
authors.lastname: Huang
authors.forename: Xiao-Ying
authors.initials: XY
authors.lastname: Zhao
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001706:Biopsy; D005871:Castleman Disease / Q000150:complications*; D003603:Cytotoxins / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D005260:Female; D015432:Glomerulonephritis, Membranoproliferative / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D003603:Cytotoxins