A Case Of Overlap Syndrome And Castleman Disease With Literature Review

Objective: Castleman disease is a relatively rare lymphoid tissue hyperplasia,which can invade multiple systemic systems,and often accompanied by various autoimmune diseases.The causal relationship between Castleman disease and autoimmune diseases is not clear.Its laboratory tests and imaging examination lack specificity,the pathogenesis is unclear either.Thus,histopathology plays an important role for diagnosis.There is no standard treatment strategy.This paper explores the pathogenesis,diagnosis and treatment measures of the disease and emphasizes the importance of pathological biopsy by analyzing the process of diagnosis and treatment of patients with overlap syndrome and Castleman disease.Methods: A case of 54-year-old female from nephrology department of Hebei Gneneral Hospital with dry mouth,dry eyes,edema,proteinuria,oliguria,rashes and multiple lymph node enlargement was reviewed.The characteristics of symptoms,iconography,histopathology,pathogenesis and treatment strategies of Castleman disease were summarized by reviewing related papers.Results: Combined with medical history,clinical manifestations,laboratory and imaging examination,the biopsies of renal and lymph node,we made the diagnoses of “1.Overlap syndrome,Sjogren's disease,systemic lupus erythematosus,lupus nephritis,acute kidney injury,renal hypertension 2.Castleman disease”.Methylprednisolone 48 mg once daily and cyclophosphamide 50 mg once daily were administered.By about two months,renal function improved and lymph nodes shrank.Conclusions: Overlap syndrome with multicentric Castleman disease is rare and easy to miss diagnose and misdiagnose in clinic.Histopathology is needed for diganosis.After the diagnosis of Castleman disease,the changes of renal function should be monitored.If there is any abnormality,the pros and cons should be weighed and the renal biopsy should be performed actively to make the diagnosis clearly.