Baylor University Medical Center Proceedings January 2014, Volume 27, Number 1 | Page 30

Multicentric Castleman’s disease and HIV
John R. Krause, MD, Sara D. Robinson, MD, and Estil A. Vance, MD

Multicentric Castleman’s disease (MCD) is a rare lymphoproliferative disorder found with a higher frequency in HIV-seropositive patients. Human
herpes virus 8 is found in virtually all cases of HIV-associated MCD.
The majority of cases of MCD in patients with HIV are also associated
with Kaposi’s sarcoma. The dysregulated production of human IL-6 is
thought to be an important factor in the pathogenesis of MCD. HIVseropositive individuals with MCD have a significantly greater risk of
developing non-Hodgkin lymphomas than their HIV-seronegative counterparts. MCD occurring in HIV patients has been associated with a poor
prognosis. With newer therapy regimens, it is hoped that the prospects
of HIV-infected patients with MCD will improve.

ulticentric Castleman’s disease (MCD) is a rare lymphoproliferative disorder. It is found with a higher frequency in patients with HIV infection and is associated
with systemic symptoms and a poor prognosis. We present the case of a 43-year-old man with HIV receiving antiretroviral
therapy. A week prior to admission, he developed symptoms of
fever, myalgias, and malaise. He had extensive lymphadenopathy,
and a lymph node biopsy revealed human herpes virus 8 (HHV-8)
MCD. MCD is discussed in the setting of HIV infection.

M

CASE PRESENTATION
A 43-year-old man was first diagnosed with HIV 1 year
before presentation. He had been compliant with his antiretroviral therapy. One week before admission, his therapy was
changed, as he had become resistant to efavirenz, emtricitabine,
and tenofovir, as demonstrated by a viral load plateau. The
patient subsequently developed a diffuse rash and fevers up to
100.6°F, initially thought to be drug related. He continued,
however