Atypical clinical presentation associated with Castleman disease: a case report and review of the literature

作者：Weiwei Hu, Yuke Kong, Bianxiang Hu, Jun Ai, Peng Zhang · 发表于：Frontiers in Medicine · 年份：2025 · DOI：10.3389/fmed.2025.1626722 · 被引用次数：2 · 研究领域：Viral-associated cancers and disorders、IgG4-Related and Inflammatory Diseases、CNS Lymphoma Diagnosis and Treatment

Background: Castleman disease (CD) is a group of rare and complicated diseases characterized by systemic inflammation, lymphadenopathy, and multiorgan involvement. It is often misdiagnosed as an infection, an autoimmune disease, or a malignant cancer. Case presentation: In this case, we report a 33-year-old Chinese male patient who was diagnosed with idiopathic multicentric Castleman disease (iMCD). The patient initially presented with intermittent fever and abdominal pain, followed by the development of abdominal and thoracic cavity effusions, anemia, thrombocytopenia, increased D-dimer levels, and acute kidney injury (AKI). Notably, there was an absence of significant lymphadenopathy in the early stages of disease progression. The final diagnosis was idiopathic multicentric Castleman disease (iMCD). Conclusion: This case emphasizes the importance of considering iMCD in patients with persistent fever and systemic inflammation, even in the absence of noticeable lymphadenopathy. We should monitor the progression of the disease and adopt a developmental perspective. Different stages of the disease can have different clinical manifestations. Diagnosis requires a comprehensive assessment of clinical, laboratory, and histopathological findings. The rarity and complexity of iMCD can pose diagnostic challenges, especially for healthcare providers who are not familiar with the disease, potentially leading to misdiagnosis. To prevent misdiagnosis, healthcare providers must maintain a ...