title: Anemia and autoimmunity markers in an adolescent with Castleman disease.
abstract: We describe herein the case of an adolescent girl with anemia non-responsive to oral iron, associated with low-grade fever, diminished appetite and fatigue. A palpable mass below the xiphoid was noted. Laboratory findings were consistent with anemia of inflammation. Direct antiglobulin test was positive without any other evidence of autoimmune anemia. Other autoantibodies, such as anti-thyroid and anti-nuclear antibodies, were also positive. After thorough investigation, Castleman disease was the most likely diagnosis on the basis of high serum interleukin (IL)-6 and the magnetic resonance imaging findings. (18)F-FDG positron emission tomography-computed tomography showed a localized hypermetabolic mass, which was resected. Castleman disease of plasma type was identified on histology. Hemogloblin and IL-6 gradually returned to normal, whereas positive autoantibodies became negative. This case emphasizes the need to investigate thoroughly for the underlying cause of anemia of inflammation and to include Castleman disease in the differential diagnosis, on the measurement of IL-6.
authors.affiliation: Third Department of Pediatrics, University of Athens, School of Medicine, "Attikon" University Hospital, Athens University School of Medicine, Athens, Greece.
authors.forename: Andrew
authors.initials: A
authors.lastname: Fretzayas
authors.affiliation: Third Department of Pediatrics, University of Athens, School of Medicine, "Attikon" University Hospital, Athens University School of Medicine, Athens, Greece.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Stasinopoulou
authors.affiliation: Third Department of Pediatrics, University of Athens, School of Medicine, "Attikon" University Hospital, Athens University School of Medicine, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Moustaki
authors.affiliation: Third Department of Pediatrics, University of Athens, School of Medicine, "Attikon" University Hospital, Athens University School of Medicine, Athens, Greece.
authors.forename: Efstathios
authors.initials: E
authors.lastname: Stefos
authors.affiliation: Third Department of Pediatrics, University of Athens, School of Medicine, "Attikon" University Hospital, Athens University School of Medicine, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Kaniouras
authors.affiliation: Third Department of Pediatrics, University of Athens, School of Medicine, "Attikon" University Hospital, Athens University School of Medicine, Athens, Greece.
authors.forename: Polyxeni
authors.initials: P
authors.lastname: Nicolaidou
mesh_terms: D000293:Adolescent; D000740:Anemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D015551:Autoimmunity; D015415:Biomarkers / Q000097:blood; D005871:Castleman Disease / Q000097:blood / Q000150:complications* / Q000276:immunology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers
keywords: Castleman disease; anemia; autoimmunity; interleukin-6