Causative & risk factors
The exact cause of Castleman’s disease is not known. But it has been found that many patients with this disorder are infected with herpes virus 8 (HHV8). HIV positive people have a higher risk of catching HHV8 infection and thus of developing Castleman’s disease.
Clinical presentation
In individuals with unilateral CD, a single lymph node is affected, which becomes enlarged. Depending upon the location, there may be symptoms arising in the neck, chest or abdomen caused as a result of pressure from the enlarged lymph node. Systemic symptoms may occur in some people causing fever, night sweats and fatigue.
Persons with multicentric CD present with several enlarged lymph nodes, especially in the neck, groin or axillae. The patient develops systemic symptoms such as fever with night sweats and excessive fatigue. The patient starts losing his appetite and weight loss occurs. The patient may develop hepatomegaly and/or splenomegaly. Some patients may develop skin rashes and peripheral neuropathy.
Investigations
Imaging scans such as CT or MRI of the affected areas are carried out. A PET scan may be done. A lymph node biopsy is performed to confirm the diagnosis of Castleman’s disease.
Treatment
Localized forms of Castleman’s disease can be treated surgically. Surgery can be followed up with radiation therapy. The widespread form of CD is treated with a combination of medications and chemotherapy.
