• C Ferreira De Matos, De Almeida ChavesSSService de médecine interne, CHU de Toulouse, URM, CHU Purpan, place du Dr Baylac, TSA 40031, 31059 Toulouse cedex 9, France., P Potin, C Syrykh, M-L Piel-Julian, L Sailler, and G Moulis.
• Service de médecine interne, CHU de Toulouse, URM, CHU Purpan, place du Dr Baylac, TSA 40031, 31059 Toulouse cedex 9, France. Electronic address: ferreiradematos.c@chu-toulouse.fr.
• Rev Med Interne. 2023 Feb 1; 44 (2): 858885-88.

IntroductionCastleman disease is a rare lymphoproliferation, which may mimic systemic lupus. Conversely, systemic lupus sometimes presents like an hematological malignancy. In these cases, a "Castleman-like" histology has been exceptionally described.ObservationA 55-year-old female treated by methotrexate for systemic lupus with skin and joint involvement presented weight loss, polyadenopathy and clinical signs of lupus flare. Biology showed pancytopenia, complement activation, and positive anti-DNA antibodies. PET/CT showed hypermetabolic polyadenopathy. The lymph node biopsy showed "Castleman-like" features. Treatment with corticosteroids and azathioprine resulted in complete remission.ConclusionSystemic lupus and Castleman disease may share common clinical, biological, and histological features. The presence of specific elements of systemic lupus flare and the remission obtained by low-dose corticosteroids results in considering the diagnosis of Castleman-like systemic lupus and avoiding treatment intensification.Copyright © 2022 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

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