Highly active antiretroviral therapy alone may be an effective treatment for HIV-associated multi-centric Castleman's disease

Lee, Siow Ming; Edwards, Simon; Chilton, Daniella; Ramsay, Alan D.; Miller, R F

doi:10.3324/haematol.2010.027441

Cited by 12 publications

(8 citation statements)

References 13 publications

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“…There are few other published reports describing the occurrence of MCD on a background of IRIS. 4,5 Our patient had an unusually high CD4 count 6 but also, as more conventionally observed in IRIS, a rapid decrease in VL post-HAART initiation. 7…”

Section: Discussionsupporting

confidence: 67%

A case of multicentric Castleman’s disease in HIV infection with the rare complication of acquired angioedema

Fernando

Scott

2013

Int J STD AIDS

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Multicentric Castleman's disease (MCD), a polyclonal lymphoproliferative disorder of unknown aetiology, is a well-recognised complication of HIV disease. We present a case of MCD in an HIV-positive patient that is unusual on two counts: our patient's MCD first presented in the context of an immune restoration inflammatory syndrome (IRIS), following the initiation of highly active antiretroviral therapy (HAART). In addition, her MCD was associated with the unusual complication of acquired angioedema (AAE), which resolved following treatment of the MCD. While AAE is frequently found to have an underlying diagnosis of a lymphoproliferative disease, this is the first reported case linking AAE to MCD.

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Section: Discussionsupporting

confidence: 67%

A case of multicentric Castleman’s disease in HIV infection with the rare complication of acquired angioedema

Fernando

Scott

2013

Int J STD AIDS

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“…(88) Another study identified four HIV MCD patients who received HAART alone as treatment with resolution of constitutional symptoms within three months of starting HAART. (89)…”

Section: Treatmentmentioning

confidence: 99%

HIV-associated multicentric Castleman disease

Reddy

Mitsuyasu²

2011

Current Opinion in Oncology

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Purpose of review HIV-associated multicentric Castleman disease (HIV MCD) is a rare lymphoproliferative disorder, the incidence of which appears to be increasing in the highly active antiretroviral therapy (HAART) era. Current knowledge of the disease is limited and this review will discuss what is known about the pathophysiology, diagnosis, management, and prognosis of HIV MCD. Recent findings HIV MCD has been shown to be associated with infection with human herpervirus-8 (HHV8). Vascular endothelial growth factor and the cytokine interleukin-6 (IL-6) are also thought to play a role in the pathogenesis of MCD. Currently, rituximab is often used alone or in combination with chemotherapy for treatment of MCD. Novel monoclonal antibodies targeting IL-6 and the IL-6 receptor are also being studied for the management of this disease. Summary Because HIV MCD is an uncommon diagnosis, comprehensive clinical studies have not been done, and understanding of the disease is incomplete. Further studies are needed to make definitive conclusions regarding optimal treatment of HIV MCD.

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“…Our aims were first to determine the relationship between plasma HHV8 VL and specific diagnoses, and second to identify whether measurement of plasma HHV8 load could be used adjunctively to aid diagnosis of MCD. UK, or University College London Hospitals (UCLH), London, UK, between January 2007 and July 2009 with a diagnosis of MCD-confirmed histologically 22 and with evidence of fludeoxyglucose (FDG) avidity in lymph nodes with positron emission tomography-computed tomography (PET-CT) 23 were identified from the hospital electronic Clinical Data Repository (CDR) system at UCLH and the e-Oasis system at MMC. All patients with MCD had active disease as defined by the French ANRS (Agence Nationale de Recherche sur le SIDA) 117 CastlemaB trial group: 19 i.e.…”

Section: Introductionmentioning

confidence: 99%

Can plasma HHV8 viral load be used to differentiate multicentric Castleman disease from Kaposi sarcoma?

et al. 2011

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We measured plasma human herpesvirus 8 (HHV8) DNA load in consecutive patients presenting with HIV-associated multicentric Castleman disease (MCD) and in contemporaneous patients who had Kaposi sarcoma (KS), lymphoma or other diagnoses. All 11 patients with MCD had detectable plasma HHV8 DNA compared with 18 (72%) of 25 patients with KS, none with lymphoma and one of 38 patients with other diagnoses. Detectable plasma HHV8 DNA levels were higher among MCD patients, median (interquartile range [IQR]) = 43,500 (5200-150,000) copies/mL, when compared with those with KS, median (IQR) = 320 (167-822) copies/mL and those with lymphoma and other diagnoses (one-way analysis of variance; P = 0.0303). Using receiver operating characteristic analysis, a cut-off of >1000 copies HHV8 DNA/mL of plasma helped to discriminate between MCD and other diagnoses, with a specificity of 94.7% and a negative predictive value of 97.3%. The level of HHV8 viraemia, while not diagnostic, may aid discrimination between patients with MCD and those with KS and other systemic illnesses.

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Highly active antiretroviral therapy alone may be an effective treatment for HIV-associated multi-centric Castleman's disease

Cited by 12 publications

References 13 publications

A case of multicentric Castleman’s disease in HIV infection with the rare complication of acquired angioedema

A case of multicentric Castleman’s disease in HIV infection with the rare complication of acquired angioedema

HIV-associated multicentric Castleman disease

Can plasma HHV8 viral load be used to differentiate multicentric Castleman disease from Kaposi sarcoma?

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