Tocilizumab-effective multicentric Castleman's disease with infiltration of eosinophil and IgG4-positive plasma cells: A case report
A 67-year-old woman with fever and cough was diagnosed with eosinophilic pneumonia because of eosinophilia and increased eosinophil levels in the bronchoalveolar lavage fluid and transbronchial biopsy lung specimens. However, prednisolone therapy at a previous hospital was ineffective. Histological...
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doaj-22d41006381c4998b6445c777e512e902020-11-25T02:32:57ZengElsevierRespiratory Medicine Case Reports2213-00712018-01-01252529Tocilizumab-effective multicentric Castleman's disease with infiltration of eosinophil and IgG4-positive plasma cells: A case reportYusuke Katsumata, MD0Jun Ikari, MD1Nozomi Tanaka, MD2Mitsuhiro Abe, MD3Kenji Tsushima, MD4Yoko Yonemori, MD5Koichiro Tatsumi, MD6Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; Corresponding author. Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku Chiba 260-8670, Japan.Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Diagnostic Pathology, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanA 67-year-old woman with fever and cough was diagnosed with eosinophilic pneumonia because of eosinophilia and increased eosinophil levels in the bronchoalveolar lavage fluid and transbronchial biopsy lung specimens. However, prednisolone therapy at a previous hospital was ineffective. Histological findings from thoracoscopic lung and lymph node biopsies were consistent with multicentric Castleman's disease (MCD). Since specimens also showed prominent eosinophil and IgG4-positive plasma cell infiltration, it was difficult to distinguish IgG4-related disease (IgG4-RD) from MCD. Administration of prednisolone plus tocilizumab improved the symptoms and lung lesions, and prednisolone administration was successfully reduced and then terminated. The present case highlights the difficulty in diagnosing MCD and IgG4-RD, and suggests that combined administration of tocilizumab and prednisolone might be effective in such a case.http://www.sciencedirect.com/science/article/pii/S2213007118301291 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yusuke Katsumata, MD Jun Ikari, MD Nozomi Tanaka, MD Mitsuhiro Abe, MD Kenji Tsushima, MD Yoko Yonemori, MD Koichiro Tatsumi, MD |
spellingShingle |
Yusuke Katsumata, MD Jun Ikari, MD Nozomi Tanaka, MD Mitsuhiro Abe, MD Kenji Tsushima, MD Yoko Yonemori, MD Koichiro Tatsumi, MD Tocilizumab-effective multicentric Castleman's disease with infiltration of eosinophil and IgG4-positive plasma cells: A case report Respiratory Medicine Case Reports |
author_facet |
Yusuke Katsumata, MD Jun Ikari, MD Nozomi Tanaka, MD Mitsuhiro Abe, MD Kenji Tsushima, MD Yoko Yonemori, MD Koichiro Tatsumi, MD |
author_sort |
Yusuke Katsumata, MD |
title |
Tocilizumab-effective multicentric Castleman's disease with infiltration of eosinophil and IgG4-positive plasma cells: A case report |
title_short |
Tocilizumab-effective multicentric Castleman's disease with infiltration of eosinophil and IgG4-positive plasma cells: A case report |
title_full |
Tocilizumab-effective multicentric Castleman's disease with infiltration of eosinophil and IgG4-positive plasma cells: A case report |
title_fullStr |
Tocilizumab-effective multicentric Castleman's disease with infiltration of eosinophil and IgG4-positive plasma cells: A case report |
title_full_unstemmed |
Tocilizumab-effective multicentric Castleman's disease with infiltration of eosinophil and IgG4-positive plasma cells: A case report |
title_sort |
tocilizumab-effective multicentric castleman's disease with infiltration of eosinophil and igg4-positive plasma cells: a case report |
publisher |
Elsevier |
series |
Respiratory Medicine Case Reports |
issn |
2213-0071 |
publishDate |
2018-01-01 |
description |
A 67-year-old woman with fever and cough was diagnosed with eosinophilic pneumonia because of eosinophilia and increased eosinophil levels in the bronchoalveolar lavage fluid and transbronchial biopsy lung specimens. However, prednisolone therapy at a previous hospital was ineffective. Histological findings from thoracoscopic lung and lymph node biopsies were consistent with multicentric Castleman's disease (MCD). Since specimens also showed prominent eosinophil and IgG4-positive plasma cell infiltration, it was difficult to distinguish IgG4-related disease (IgG4-RD) from MCD. Administration of prednisolone plus tocilizumab improved the symptoms and lung lesions, and prednisolone administration was successfully reduced and then terminated. The present case highlights the difficulty in diagnosing MCD and IgG4-RD, and suggests that combined administration of tocilizumab and prednisolone might be effective in such a case. |
url |
http://www.sciencedirect.com/science/article/pii/S2213007118301291 |
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