title: A HHV-8 positive, HIV negative multicentric Castleman disease treated with R-CEOP chemotherapy and valganciclovir combination.
abstract: Multicentric Castleman disease (MCD) is a lymphoproliferative disorder characterized by systemic symptoms like recurrent lymphadenopathy, fever and hepatosplenomegaly. Human herpes virus 8 (HHV-8) can be associated with MCD whether the patient is infected with human immunodeficiency virus (HIV) or not. A 59-year-old male patient presented with fatigue, drowsiness and enlarged lymph nodes. Thoracic and abdominal computed tomography showed enlarged mediastinal, axillary, paracardiac, paraaortic, celiac, mesenteric, obturator and inguinal lymph nodes concomitant with enlarged liver and spleen. Cervical lymph node biopsy revealed HHV-8 positive plasma cell MCD. The patient's tests were negative for HIV. R-CEOP (rituximab, cyclophosphamide, etoposide, vincristin, prednisolone) and valganciclovir treatments were started simultaneously. After sixth cycle of R-CEOP, the patient achieved unconfirmed complete remission. Rituximab combined with CEOP protocol and antiviral therapy against HHV-8 might be an effective therapeutic approach without a considerable side effect for HHV-8-positive HIV-negative MCD patients.
authors.affiliation: İstanbul Training and Research Hospital, Internal Medicine Department, Turkey.
authors.forename: Fatma Eda Nuhoglu
authors.initials: FE
authors.lastname: Kantarci
authors.affiliation: İstanbul Training and Research Hospital, Hematology Department, Turkey.
authors.forename: Rafet
authors.initials: R
authors.lastname: Eren
authors.affiliation: İstanbul Training and Research Hospital, Nuclear Medicine Department, Turkey.
authors.forename: Cihan
authors.initials: C
authors.lastname: Gündoğan
authors.affiliation: İstanbul Training and Research Hospital, Pathology Department, Turkey.
authors.forename: Gülben Erdem
authors.initials: GE
authors.lastname: Huq
authors.affiliation: İstanbul Training and Research Hospital, Hematology Department, Turkey.
authors.forename: Mehmet Hilmi
authors.initials: MH
authors.lastname: Doğu
authors.affiliation: İstanbul Training and Research Hospital, Hematology Department, Turkey. Electronic address: elifsuyani@hotmail.com.
authors.forename: Elif
authors.initials: E
authors.lastname: Suyanı
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D005871:Castleman Disease / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D003520:Cyclophosphamide / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005047:Etoposide / Q000627:therapeutic use; D015774:Ganciclovir / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019288:Herpesvirus 8, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D000069283:Rituximab / Q000627:therapeutic use; D000077562:Valganciclovir; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D000069283:Rituximab; D014750:Vincristine; D005047:Etoposide; D003520:Cyclophosphamide; D011239:Prednisolone; D000077562:Valganciclovir; D015774:Ganciclovir
keywords: Castleman disease; Human herpes virus 8; Human immunodeficiency virus; Multicentric Castleman disease; Treatment; Valganciclovir