Castleman Disease can be classified into unicentric or multicentric, depending on the affected lymph nodes
Unicentric affects only a single lymph node region, while multicentric affects multiple regions
The symptoms of each variant differ, ranging from mild to severe and potentially life-threatening
The disease is associated with the over-production of interleukin-6 (a protein produced by cells in response to injuries and infections), but the exact cause remains unknown
Accurate diagnosis and timely treatment are critical for effective management of the disease
Introduction
Dealing with a rare medical condition can be tough. From the right diagnosis to effective care, it can be tricky. Castleman Disease (CD) is one such unusual illness. It has left many puzzled because of its hard-to-grasp nature and complex signs. But, what if we went deeper and really understood this disease? It would equip patients and their loved ones to better navigate the world of healthcare.
In this blog, we break down Castleman Disease – its types, signs, causes, and treatments. By the end of it, you’ll have a strong understanding of this rare disease that excites growth in the body’s cells. This knowledge can lead to better treatment and outcomes for those affected.
Did you know?
Castleman disease can affect lymph nodes in various body regions, including the neck, chest, abdomen, and pelvis. source: NCBI
Treatment options for Castleman disease include surgery, radiation therapy, and targeted drug therapy. source: cancer.org
Castleman disease can occur in two forms: unicentric Castleman disease (UCD) and multicentric Castleman disease (MCD).source: lymphoma.org
Castleman disease is more common in men than in women. source: lymphoma.org
Overview of Castleman Disease
Definition and Types
Castleman Disease is a rare health issue tied to the immune system. An overactive immune system leads to bigger lymph nodes which can affect lymph nodes of any body region, imitating both benign and malignant conditions, including the neck, chest, abdomen, and pelvis. The disease can be classified into two types. Unicentric Castleman Disease (UCD) affects only a single lymph node region and is the more common presentation, Multicentric Castleman Disease (MCD) brings about inflamed lymph nodes in many body parts.
Differences between Unicentric and Multicentric Castleman Disease
Let’s take a look at how the two main types of Castleman’s Disease differ:
Unicentric Castleman Disease (UCD)
Multicentric Castleman Disease (MCD)
Affects a single lymph node region
Affects multiple lymph node regions
Generally milder symptoms
Potentially life-threatening symptoms
Surgical removal often curative
Requires complex and ongoing treatments
Symptoms and Signs
Unicentric Castleman Disease Symptoms
People with Unicentric Castleman Disease may not show any signs at first (usually asymptomatic) and is usually discovered at radiological examinations performed for other reasons When symptoms do pop up, they are usually mild. They are linked to the growth of the lymph node. Common symptoms include:
A lump under the skin in areas like the neck.
Chest pressure or fullness, making it hard to breathe or swallow.
Pain in the affected area
Multicentric Castleman Disease Symptoms
Multicentric Castleman Disease (MCD) is a severe condition that can be life-threatening, and represents the “dark side” of Castleman disease. HIV infection is an important risk and bad prognosis factor associated with MCD Boosted by many whole-body symptoms, it shows up as larger lymph nodes. Such symptoms include:
Fever
Tiredness
Night sweats
Weight loss without trying
Swelling of the liver and spleen
MCD can also be divided into two more subtypes: Idiopathic Multicentric Castleman Disease (iMCD) and Kaposi Sarcoma-Associated Herpesvirus Multicentric Castleman Disease (KSHV-MCD).
Researchers have found that your risk of acquiring cancer, especially lymphoma (a cancer of the lymphatic system), is likely to increase by Castleman disease. Consult your doctor and he will keep a close eye on your condition and adapt your treatments wherever feasible to avoid complications.
Seeing a doctor is important when you come across unusual symptoms. An example would be a large lymph node area, e.g., neck or underarm. Other signs needing quick action include feelings of fullness in the chest, fever, fatigue, and weight loss without trying. Spotting these warning signs can lead to a quick diagnosis and helpful intervention.
Importance of Timely Consultation
Recognize how important it is to get medical help on time:
The benefits of timely consultation
Early diagnosis and detection of Castleman Disease
Opportunity for prompt intervention and treatment
Prevention of complications and related conditions
Improved prognosis and quality of life
In my experience, the symptoms of Castleman disease are comparable to those of other infections, such as the flu. To rule out certain illnesses, your doctor might do a number of tests. To ascertain the form of Castleman’s illness, they will do additional testing such as biopsy.
Researchers are still figuring out the exact cause. But, they believe that it comes from a faulty immune system response. This drives an overgrowth of certain cells in lymphoid organs. The growth could be brought about by ongoing mild inflammation, viral infections, abnormal cytokine control, or new blood vessel growth. Certain autoimmune conditions, cancers or infections can present with changes in lymph nodes or clinical features that closely resemble Castleman disease. It’s unknown whether Castleman disease should be considered an autoimmune disease, cancer or infectious disease.
2. Associated Viruses and Conditions
Human immunodeficiency virus (HIV) and human herpesvirus 8 (HHV-8), a common virus [Most people who have it don’t get sick. You’re more likely to have HHV-8-associated MCD if you’re HIV positive or if you have another condition that makes you more susceptible to infections (immunocompromised)]are linked to Multicentric Castleman Disease, mainly its KSHV-MCD variant.
3. Genetic and Environmental Factors
Even though clear genetic links haven’t been found yet, some cases hint at a possible family link. Environmental factors might also play a role, but we don’t know yet how much impact they have.
Take a look at this table showcasing possible causal factors:
Possible causative factors
Impaired immunoregulation
Chronic low-grade inflammation
Viral infections (HIV, HHV-8)
Abnormal cytokine modulation
Angiogenesis
Genetic predisposition (inferred)
Who does Castleman disease affect?
Castleman disease can affect anyone. UCD is more commonly diagnosed in people in their 30s and 40s. MCD is more common in people in their 50s and 60s. While UCD affects people equally regardless of sex, MCD is slightly more common in men and people assigned male at birth (AMAB).
How common is Castleman disease?
Castleman disease is rare, with approximately 4,300 to 5,200 new cases diagnosed in the United States each year. About 75% of these cases are UCD, and the remaining 25% are MCD.
Complications and Related Conditions
1. KSHV Inflammatory Cytokine Syndrome
This syndrome is shown by high levels of inflammation, fever, weight loss and severe organ failure. It is linked with the KSHV-MCD type of Castleman’s disease, usually as a result of sudden release of inflammatory compounds, causing tissue inflammation and damage.
2. POEMS Syndrome
POEMS Syndrome is a rare blood disorder that damages nerves and affects other body systems. POEMS stands for Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal gammopathy, Skin changes. This blood disorder is linked to a subtype of Multicentric Castleman Disease.
3. Lymphoproliferative Disorders
Some patients with Castleman Disease could get other diseases, like non-Hodgkin lymphoma.
The next table highlights, at a glance, complications and related conditions:
Complications and related conditions
KSHV Inflammatory Cytokine Syndrome
POEMS Syndrome
Lymphoproliferative Disorders
Diagnosis and Screening
1. Clinical Presentation
Medical history, physical exam, and imaging techniques, such as CT scans or MRIs, help identify large lymph nodes. This can guide further tests.
2. Pathological Features and Criteria
Checking affected lymph nodes is vital for diagnosing Castleman’s Disease, as different types have different features.
Unicentric Castleman Disease
This type usually shows up as large lymph nodes with a high number of certain cell types and a wide mantle zone. Small germinal centres may also be present.
Multicentric Castleman Disease
MCD can show up with many tissue features, including high blood vessel growth and hyalinization in certain zones. Plasma cell infiltration and faulty follicular dendritic cells might occur too.
3. Diagnostic Tests and Imaging
In addition to looking at tissue, blood tests and imaging studies like CT scans, MRIs and PET scan (Position Emission Tomography) can help diagnose Castleman Disease. This also guides to its extent.
4. Differential Diagnosis and Overlapping Disorders
Diseases that can act like Castleman Disease include lymphomas, solid tumors, autoimmune disorders, and other diseases leading to swollen lymph nodes. A detailed diagnostic test is needed to rule out these possible diagnoses.
Go through this table to learn about the main diagnostic methods for Castleman Disease:
Diagnostic methods for Castleman Disease
Clinical history and physical examination
Imaging techniques (CT scan, MRI, PET)
Histopathological examination of lymph nodes
Blood tests
Evaluation of associated viruses and conditions
Treatment and Management
1. Unicentric Castleman Disease Treatment
The standard treatment for Unicentric Castleman Disease is full surgical removal of the affected lymph node or group. This can often lead to a cure. Depending on where the lymph nodes are located or if they’re too big, you may need to receive radiation therapy or immunotherapy before surgery for UCD. These therapies shrink the growths on your lymph nodes, making them easier to remove. If surgeons can’t remove the tumour and you don’t have symptoms, your provider may prefer to monitor your tumour instead of treating it immediately. If surgery isn’t an option and you have symptoms, your provider may recommend treatments for multicentric Castleman disease.
2. Multicentric Castleman Disease Treatment
MCD is more difficult to treat than UCD. Because the multicentric type is widespread, healthcare providers don’t typically use surgery or radiation to treat it. Instead, treatment depends on whether you have HHV-8 and how severe the disease is. Treatment for MCD typically involves many therapies aiming at the root cause or disease path, such as antiviral drugs (for KSHV-MCD), monoclonal-antibody treatments (targeting interleukin-6 or CD20), chemotherapy, and palliative care. Some patients might need ongoing treatment to manage symptoms and avoid complications.
iMCD and iMCD-TAFRO
Patients with idiopathic multicentric Castleman Disease and iMCD-TAFRO might be treated with interleukin-6 inhibitors like tocilizumab and siltuximab. Other immune treatment methods and palliative care measures may also be essential.
KSHV-MCD and KSHV-Associated Lymphoproliferations
Antiviral drugs like ganciclovir, foscarnet, and cidofovir can help manage KSHV-MCD and KSHV clone disorders. More steps, like radiation therapy and targeted therapies, may also be needed for some cases.
What complications are associated with Castleman disease?
Castleman disease increases your chances of developing cancer, including lymphoma (cancer of the lymph system).
MCD can increase your risk of developing infections that can damage organs and even be life-threatening without treatment.
1. What are the risk factors for Castleman disease?
There aren’t any known risk factors for UCD or iMCD. People with the human immunodeficiency virus (HIV) or a weakened immune system are at higher risk of developing HHV-8-associated MCD.
2. Can Castleman disease be prevented?
There aren’t any known risk factors for most types of Castleman disease, so there’s nothing you can do to prevent them.
3. Monitoring and Follow-Up
Patients with Castleman Disease need regular check-ups with their healthcare provider. This monitors disease progress, how the treatment is doing, and possible complications.
Have a look at this table of treatment options for Castleman Disease:
Support groups like the Castleman Disease Collaborative Network (CDCN) offer valuable resources. These can help patients and their families navigate this rare disease. Professional talking therapies may also be helpful in managing stress, worry, and sadness tied to living with Castleman Disease.
Long-Term Prognosis and Outlook
The future outlook for people with Castleman Disease changes based on the type and severity of the disorder. Unicentric Castleman Disease often has a good outcome after surgical removal. On the other hand, managing Multicentric Castleman Disease can be more complex. It often requires ongoing treatment and monitoring.
Future Research and Development
1. Advances in Pathogenesis Understanding
We need ongoing research into the root causes and workings of Castleman Disease. This will help create better tests and treatments. Getting a firmer grasp on our immune system, cytokine control, and genetics may pave the way for new treatments for this rare disorder.
2. Diagnostic Innovations
Better existing diagnostic tools and finding new disease markers for Castleman Disease will aid early detection. It will also help tell it apart from other lymph proliferative diseases. This leads to improved outcomes for patients.
3. Therapeutic Improvements
Research is driving the development of new treatments targeting key pathways involved in Castleman Disease. It can lead to more effective treatment choices and fewer side effects. This can greatly enhance the patients’ lives.
Castleman Disease is a complex and rare disorder that excites cell growth. It has a diverse range of signs, from the harmless Unicentric Castleman Disease to the life-threatening Multicentric Castleman Disease. A correct diagnosis, quick steps, and proper care are crucial for fighting this hard to catch disease and reducing its impact on the patient’s life, and that of their loved ones. With ongoing research, we can hope for a future where we better understand the workings, diagnosis, and treatment of Castleman Disease. This can provide better options and improved outcomes for patients and their families.
FAQ (Frequently Asked Questions)
What is the life expectancy of someone with Castleman’s disease?
The life span of a person with Castleman Disease hinges on the type and severity. Surgical treatment of Unicentric Castleman Disease often has a good prognosis. Multicentric Castleman Disease requires more complex care, which may result in a varying life expectancy.
Is Castleman disease benign or malignant?
Castleman Disease isn’t a cancerous condition. But, it can mimic both non-cancerous and cancerous disorders. Some types might raise the risk of getting cancers, like non-Hodgkin lymphoma.
Is Castleman’s disease curable?
You can often cure Unicentric Castleman Disease through surgery to remove the affected lymph node. Multicentric Castleman Disease is more complex. So, it often needs ongoing care and treatment, instead of a sure-fire cure.
What are the signs and symptoms of multicentric Castleman disease?
Multicentric Castleman Disease usually shows whole-body symptoms. These include fever, fatigue, night sweats, and weight loss without trying, as well as larger lymph nodes in many parts of the body.
National Center for Biotechnology Information (NCBI). International evidence-based consensus diagnostic and treatment guidelines for unicentric Castleman disease [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7724917
National Center for Biotechnology Information (NCBI). Characteristics and outcomes of KSHV-associated multicentric Castleman disease with or without other KSHV diseases [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7993110
National Center for Biotechnology Information (NCBI). Clinical Manifestations of Kaposi Sarcoma Herpesvirus Lytic Activation: Multicentric Castleman Disease (KSHV–MCD) and the KSHV Inflammatory Cytokine Syndrome [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3291870
National Center for Biotechnology Information (NCBI). International, evidence-based consensus treatment guidelines for idiopathic multicentric Castleman disease [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6238190
National Center for Biotechnology Information (NCBI). Characteristics and survival for HIV-associated multicentric Castleman disease in Malawi [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4524888
National Center for Biotechnology Information (NCBI). The French paediatric cohort of Castleman disease: a retrospective report of 23 patients [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164260
National Center for Biotechnology Information (NCBI). Multicentric Castleman Disease in an HHV8-Infected Child Born to Consanguineous Parents With Systematic Review [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3273364
National Center for Biotechnology Information (NCBI). Epidemiological analysis of multicentric and unicentric Castleman disease and TAFRO syndrome in Japan [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6954167
National Center for Biotechnology Information (NCBI). Clinical spectrum and survival analysis of 145 cases of HIV-negative Castleman’s disease: renal function is an important prognostic factor [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4814900
National Center for Biotechnology Information (NCBI). Kaposi’s sarcoma herpesvirus/ Human herpesvirus-8 (KSHV/HHV8), and the oncogenesis of Kaposi’s sarcoma [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4721662
National Center for Biotechnology Information (NCBI). Recurrent PDGFRB mutations in unicentric Castleman disease [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6484698
National Center for Biotechnology Information (NCBI). Virome capture sequencing does not identify active viral infection in unicentric and idiopathic multicentric Castleman disease [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6594611
National Center for Biotechnology Information (NCBI). Next-generation sequencing of idiopathic multicentric and unicentric Castleman disease and follicular dendritic cell sarcomas [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5851414
National Center for Biotechnology Information (NCBI). DNMT3A haploinsufficiency causes dichotomous DNA methylation defects at enhancers in mature human immune cells [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111463
National Center for Biotechnology Information (NCBI). A novel FAS mutation with variable expressivity in a family with unicentric and idiopathic multicentric Castleman disease [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234382
National Center for Biotechnology Information (NCBI). Elevated levels of interleukin-1 beta (IL-1 beta) and IL-6 in serum and increased production of IL-1 beta mRNA in lymph nodes of patients with polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (POEMS) syndrome [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=8167341
National Center for Biotechnology Information (NCBI). ACCELERATE: A Patient-Powered Natural History Study Design Enabling Clinical and Therapeutic Discoveries in a Rare Disorder [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7762771
National Center for Biotechnology Information (NCBI). Identifying and targeting pathogenic PI3K/AKT/mTOR signaling in IL-6 blockade–refractory idiopathic multicentric Castleman disease [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6763254
National Center for Biotechnology Information (NCBI). Type I IFN response associated with mTOR activation in the TAFRO subtype of idiopathic multicentric Castleman disease [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7253017
National Center for Biotechnology Information (NCBI). Discovery and validation of a novel subgroup and therapeutic target in idiopathic multicentric Castleman disease [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8525223
National Center for Biotechnology Information (NCBI). Increased mTOR activation in idiopathic multicentric Castleman disease [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7205815
National Center for Biotechnology Information (NCBI). Mediterranean fever gene variants modify clinical phenotypes of idiopathic multi‐centric Castleman disease [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8663796
National Center for Biotechnology Information (NCBI). Distribution of human herpesvirus-8 latently infected cells in Kaposi’s sarcoma, multicentric Castleman’s disease, and primary effusion lymphoma [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC16369
National Center for Biotechnology Information (NCBI). Differential Viral Protein Expression in Kaposi’s Sarcoma-Associated Herpesvirus-Infected Diseases [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1876837
National Center for Biotechnology Information (NCBI). KSHV induces immunoglobulin rearrangements in mature B lymphocytes [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5919685
National Center for Biotechnology Information (NCBI). The Viral Interferon Regulatory Factors of Kaposi’s Sarcoma-Associated Herpesvirus Differ in Their Inhibition of Interferon Activation Mediated by Toll-Like Receptor 3 [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3554052
National Center for Biotechnology Information (NCBI). Kaposi sarcoma–associated herpesvirus: immunobiology, oncogenesis, and therapy [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5004954
National Center for Biotechnology Information (NCBI). High-dose zidovudine plus valganciclovir for Kaposi sarcoma herpesvirus-associated multicentric Castleman disease: a pilot study of virus-activated cytotoxic therapy [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3143547
National Center for Biotechnology Information (NCBI). A viral kinase mimics S6 kinase to enhance cell proliferation [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4948314
National Center for Biotechnology Information (NCBI). Human herpesvirus–encoded kinase induces B cell lymphomas in vivo [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5983348
National Center for Biotechnology Information (NCBI). Cellular Tropism and Viral Interleukin-6 Expression Distinguish Human Herpesvirus 8 Involvement in Kaposi’s Sarcoma, Primary Effusion Lymphoma, and Multicentric Castleman’s Disease [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC104197
National Center for Biotechnology Information (NCBI). Human and viral interleukin-6 and other cytokines in Kaposi sarcoma herpesvirus-associated multicentric Castleman disease [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3868925
National Center for Biotechnology Information (NCBI). HHV8/KSHV-Positive Lymphoproliferative Disorders and the Spectrum of Plasmablastic and Plasma Cell Neoplasms [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248411
National Center for Biotechnology Information (NCBI). Contribution of viral and cellular cytokines to Kaposi’s sarcoma-associated herpesvirus pathogenesis [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2538598
National Center for Biotechnology Information (NCBI). Critical cytoplasmic region of the interleukin 6 signal transducer gp130 is conserved in the cytokine receptor family. [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC53132
National Center for Biotechnology Information (NCBI). KSHV: Pathways to Tumorigenesis and Persistent Infection [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4104069
National Center for Biotechnology Information (NCBI). Kaposi’s Sarcoma-Associated Herpesvirus Interleukin-6 Modulates Endothelial Cell Movement by Upregulating Cellular Genes Involved in Migration [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676281
National Center for Biotechnology Information (NCBI). Extracellular vesicles from Kaposi Sarcoma-associated herpesvirus lymphoma induce long-term endothelial cell reprogramming [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361468
National Center for Biotechnology Information (NCBI). Pre-Micro RNA Signatures Delineate Stages of Endothelial Cell Transformation in Kaposi Sarcoma [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2663814
National Center for Biotechnology Information (NCBI). Reactivation of the p53 pathway as a treatment modality for KSHV-induced lymphomas [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1810577
National Center for Biotechnology Information (NCBI). UCD with MCD-like inflammatory state: surgical excision is highly effective [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7805307
National Center for Biotechnology Information (NCBI). International, evidence-based consensus diagnostic criteria for HHV-8–negative/idiopathic multicentric Castleman disease [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5364342
National Center for Biotechnology Information (NCBI). Viral, immunologic, and clinical features of primary effusion lymphoma [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6473499
National Center for Biotechnology Information (NCBI). Elevated serum interferon γ-induced protein 10 kDa is associated with TAFRO syndrome [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5304226
National Center for Biotechnology Information (NCBI). 18 F-fluorodeoxyglucose Positron Emission Tomography in Kaposi Sarcoma Herpesvirus–Associated Multicentric Castleman Disease: Correlation With Activity, Severity, Inflammatory and Virologic Parameters [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4577043
National Center for Biotechnology Information (NCBI). Interleukin-6 Receptor Polymorphism Is Prevalent in HIV-negative Castleman Disease and Is Associated with Increased Soluble Interleukin-6 Receptor Levels [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3553080
National Center for Biotechnology Information (NCBI). Unicentric castleman disease complicated by paraneoplastic bronchiolitis obliterans and pemphigus [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6098213
National Center for Biotechnology Information (NCBI). Treatment for POEMS (polyneuropathy, organomegaly, endocrinopathy, M‐protein, and skin changes) syndrome [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7389818
National Center for Biotechnology Information (NCBI). Tocilizumab in patients with symptomatic Kaposi sarcoma herpesvirus–associated multicentric Castleman disease [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316216
National Center for Biotechnology Information (NCBI). Kaposi Sarcoma Inflammatory Cytokine Syndrome (KICS): A Rare but Potentially Treatable Condition [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423516
National Center for Biotechnology Information (NCBI). Impact of siltuximab on patient-related outcomes in multicentric Castleman’s disease [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5769562
National Center for Biotechnology Information (NCBI). Patient-reported Outcomes for Multicentric Castleman’s Disease in a Randomized, Placebo-controlled Study of Siltuximab [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383814
National Center for Biotechnology Information (NCBI). Patient reported outcome measures in rare diseases: a narrative review [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5914068
National Center for Biotechnology Information (NCBI). Dysregulated interleukin 6 expression produces a syndrome resembling Castleman’s disease in mice. [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC296765
National Center for Biotechnology Information (NCBI). HHV-8–encoded viral IL-6 collaborates with mouse IL-6 in the development of multicentric Castleman disease in mice [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3370672
National Center for Biotechnology Information (NCBI). Validated international definition of the thrombocytopenia, anasarca, fever, reticulin fibrosis, renal insufficiency, and organomegaly clinical subtype (TAFRO) of idiopathic multicentric Castleman disease [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=34265103
National Center for Biotechnology Information (NCBI). Prognostic Factors in Chemotherapy-Treated Patients with HIV-Associated Plasmablastic Lymphoma [Internet]. [cited 2023 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227958
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