Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2022; 10(5): 1536-1547
Published online Feb 16, 2022. doi: 10.12998/wjcc.v10.i5.1536
Castleman disease and TAFRO syndrome: To improve the diagnostic consciousness is the key
Qian-Yun Zhou
Qian-Yun Zhou, Department of Critical Care Medicine, Peking University Shougang Hospital, Beijing 100144, China
Author contributions: Zhou QY designed the research, collected and analyzed data, and wrote the paper.
Supported by the Key Medical Projects of Technical College Development of Shijingshan District.
Institutional review board statement: This study was approved by the Ethics Committee of Peking University Shougang Hospital (approval number: IRBK-2021-010-01).
Informed consent statement: Written informed consent was waived by the Ethics Committee of Peking University Shougang Hospital for retrospective nature of the study.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qian-Yun Zhou, MD, Doctor, Department of Critical Care Medicine, Peking University Shougang Hospital, No. 9 Jinyuan Zhuang Road, Shijingshan District, Beijing 100144, China. 13521349450@163.com
Received: August 23, 2021
Peer-review started: August 23, 2021
First decision: October 16, 2021
Revised: October 29, 2021
Accepted: January 5, 2022
Article in press: January 5, 2022
Published online: February 16, 2022
Processing time: 171 Days and 22.4 Hours
ARTICLE HIGHLIGHTS
Research background

Castleman disease (CD) and TAFRO syndrome are very rare in clinical practice. Most clinicians, especially non-hematological clinicians, do not know enough about the two diseases, so it often leads to misdiagnosis or missed diagnosis.

Research motivation

What is the nature of CD? What are the internal relations and differences between different clinical and pathological types of CD? Can unicentric Castleman disease (UCD) transform into multicentric Castleman disease (MCD)? TAFRO syndrome is a special subtype of idiopathic MCD (iMCD)? Or is it just a new special group whose clinical manifestations overlap with iMCD and are different from iMCD? The aforementioned problems are the research motivation of our study.

Research objectives

This study aimed to explore the clinical features and diagnosis of CD and TAFRO syndrome.

Research methods

We retrospectively collected the clinical and laboratory data of 39 patients who were diagnosed with CD from a single medical center.

Research results

UCD and iMCD are significantly different in clinical manifestations, treatment, and prognosis. However, a few patients with MCD were diagnosed as UCD in their early stage. There was a correlation between two of Thrombocytopenia, anasarca and elevated creatinine, which were important components of TAFRO syndrome. In UCD group, the pathologies of lymph modes were mostly hyaline vascular type (13/18, 72.22%), however plasma cell type or mixed type could also appear. In iMCD-NOS group and TAFRO syndrome group, the pathologies of lymph mode shown polarity of plasma cell type and hyaline vascular type respectively. Compared with patients with TAFRO syndrome, patients with iMCD-NOS were diagnosed more difficultly.

Research conclusions

The clinical and pathological types of CD are not completely separate, there is an intermediate situation or mixed characteristics between two ends of clinical and pathological types. The clinical manifestations of patients with CD are determined by their pathological type. TAFRO syndrome is a special subtype of iMCD with unique clinical manifestations.

Research perspectives

In the future, further research should be carried out on the pathological manifestations of lymph nodes and kidneys in patients with CD and TAFRO syndrome.