title: Iron-refractory microcytic anemia as the presenting feature of unicentric Castleman disease in children.
abstract: Chronic, iron-refractory, microcytic anemia can be a diagnostic and therapeutic challenge. We report the cases of 2 children with occult, unicentric Castleman disease whose primary presenting feature was a chronic, unexplained, iron-refractory, microcytic anemia. Diagnosis was delayed because neither child had palpable lymphadenopathy and the lymphoproliferation was intra-abdominal. Surgical resection cured the anemia and the Castleman disease. A diagnostic clue to Castleman disease is an elevated concentration of interleukin-6 in blood, which causes anemia by inducing the expression of the iron-regulatory hormone hepcidin.
authors.affiliation: Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Shanmuganathan
authors.initials: S
authors.lastname: Chandrakasan
authors.affiliation: Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Nihal
authors.initials: N
authors.lastname: Bakeer
authors.affiliation: Department of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Jun Qin
authors.initials: JQ
authors.lastname: Mo
authors.affiliation: Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Carrye
authors.initials: C
authors.lastname: Cost
authors.affiliation: Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. Electronic address: charles.quinn@cchmc.org.
authors.forename: Charles T
authors.initials: CT
authors.lastname: Quinn
mesh_terms: D000293:Adolescent; D018798:Anemia, Iron-Deficiency / Q000209:etiology*; D005871:Castleman Disease / Q000150:complications* / Q000175:diagnosis*; D002648:Child; D005260:Female; D006801:Humans