title: Human herpes virus-8-associated multicentric Castleman's disease in an HIV-positive patient presenting with relapsing and remitting hyponatraemia.
abstract: We report a case of human herpes virus-8-associated multicentric Castleman's disease in an HIV-positive patient with hyponatraemia. A 65-year-old man was admitted with relapsing and remitting fever, scattered skin eruptions and hepatosplenomegaly following combination antiretroviral therapy for his HIV infection. Based on histopathological findings, he was diagnosed as having human herpes virus-8-associated multicentric Castleman's disease and was treated with four-weekly infusions of rituximab. Prior to receiving chemotherapy, we observed several suspected biomarkers of disease activity, positive correlations between plasma human herpes virus-8 viral load and the levels of plasma interleukin-6, C-reactive protein and soluble interleukin-2 receptor, and negative correlations between platelet count, albumin levels and especially serum sodium levels. We hypothesize that non-osmotic release of plasma antidiuretic hormone is a cause of hyponatraemia in human herpes virus-8-associated multicentric Castleman's disease and that relapsing and remitting hyponatraemia could be correlated with plasma human herpes virus-8 viral load.
authors.affiliation: Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Sasaki
authors.affiliation: Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan tmaeda@ndmc.ac.jp.
authors.forename: Takuya
authors.initials: T
authors.lastname: Maeda
authors.affiliation: Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Hara
authors.affiliation: Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
authors.forename: Morichika
authors.initials: M
authors.lastname: Osa
authors.affiliation: Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Imai
authors.affiliation: Division of Neurology, Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
authors.forename: Kota
authors.initials: K
authors.lastname: Moriguchi
authors.affiliation: Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Mikita
authors.affiliation: Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Fujikura
authors.affiliation: Division of Neurology, Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kaida
authors.affiliation: Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kawana
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D005871:Castleman Disease / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D005334:Fever / Q000209:etiology*; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D019288:Herpesvirus 8, Human / Q000302:isolation & purification; D006801:Humans; D007010:Hyponatremia / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008206:Lymphatic Diseases; D008297:Male; D000069283:Rituximab / Q000627:therapeutic use; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: C508600:IL6 protein, human; D015850:Interleukin-6; D000069283:Rituximab; D002097:C-Reactive Protein
keywords: AIDS; HIV; Multicentric Castleman disease; antidiuretic hormone; central pontine myelinolysis; human herpes virus-8; hyponatraemia; interleukin-6; sodium