Case Report
Copyright ©The Author(s) 2022.
World J Clin Cases. Oct 16, 2022; 10(29): 10794-10802
Published online Oct 16, 2022. doi: 10.12998/wjcc.v10.i29.10794
Table 1 Some laboratory examination results of patients during hospitalization
Before treatment
After treatment
Reference range
ESR in mm/h296< 38
HB in g/L128119115-150
PLT as × 109/L229213100-300
CRP (mg/L)28.9222.6300.068-8.200
ALT in U/L17147-40
AST in U/L151413-35
ANA spectrumNegativeNot reviewedNegative
Acid fast bacillus smearAcid fast bacteria not foundNot reviewedAcid fast bacteria not found
Female tumor-associated antigenNegativeNot reviewedNegative
ACANegativeNot reviewedNegative
IL-6 in pg/mL5.5Not reviewed< 7.0
T-SPOTPositiveNot reviewedNegative
Table 2 Idiopathic multicentric Castleman's disease diagnostic criteria
Diagnostic criteria
Main diagnostic criteriaLymph node pathology conforms to iMCD spectrum; Enlargement of lymph nodes in 2 or more lymph nodes (short axis ≥ 1 cm)
Secondary diagnostic criteriaLaboratory standards: (1) C-reactive protein > 10 mg/L. ESR > 20 mm/h (female) or 15 mm/h (male); (2) Anemia (Hgb < 100 g/L). Thrombocytopenia (PLT < 100) × 109/L) or increased (PLT > 350 × 109/L); (3) Serum albumin < 35 g/L; and (4) Estimated glomerular filtration rate < 60 mL/(min· 73 m2) or proteinuria (total urinary protein > 150 mg/24 h or 100 mg/L), serum IgG > 17 g/L
Clinical criteria: (1) Systemic symptoms: night sweats, fever (> 38 °C), weight loss (≥ 10% after 6 mo) or fatigue (affecting instrumental activities of daily living); (2) Hepatomegaly and/or splenomegaly; (3) Edema or serous effusion; and (4) Cherry or violet skin rash. Lymphocytic interstitial pneumonia
Exclusion criteria(1) Infection-related diseases (such as EBV, HIV, tuberculosis); (2) Autoimmune diseases (such as rheumatoid arthritis, systemic lupus erythematosus, adult still disease, adolescent idiopathic arthritis, autoimmune lymphoproliferative syndrome); and (3) Neoplastic diseases (such as multiple myeloma, lymphoma, primary lymph node plasmacytoma, follicular dendritic cell sarcoma, POEMS syndrome)
Table 3 Idiopathic multicentric Castleman's disease-thrombocytopenia, anasarca, myelofibrosis, renal dysfunction, and organomegaly diagnostic criteria
Diagnostic criteria
Histopathological criteria(1) The pathological results of lymph nodes are consistent with the characteristic manifestations of TAFRO lymph nodes1; and (2) Negative LANA-1 for HHV-8
Main diagnostic criteria(1) Three of the five TAFRO related symptoms were met: Thrombocytopenia, fever (body temperature ≥ 38 ℃), anasarca, organomegaly, reticulin fibrosis; (2) Absence of hypergammaglobulinemia; and (3) Small volume lymphadenopathy
Secondary diagnostic criteria(1) Normal or proliferative of megakaryocytes in bone marrow; and (2) The level of serum alkaline phosphatase increased, but the level of transaminase did not increase significantly