PDF(Pubmed)
Abstract：
We present a clinical case of a 79-year-old male admitted to inpatient care for longstanding asthenia and respiratory symptoms. Associated features were polyserositis, multiple enlarged lymphatic nodules, acute kidney injury, and heart failure. The patient\'s recent medical history revealed SARS-CoV-2 vaccination a week prior and an upper respiratory tract infection. The laboratory results from thoracentesis were compatible with a transudate, with no immunological stain. Epstein-Barr virus polymerase chain reaction (PCR) was positive. The thoracic, abdominal, and pelvic CT scans revealed multiple enlarged lymphatic nodules, worsening the pre-existent polyserositis and hepatosplenomegaly. The patient began to show signs of neurologic symptoms and deterioration of the global health status. An enlarged lymphatic nodule was excised and the pathology showed human herpesvirus 8 multicentric Castleman disease. The disease evolved rapidly into hematological dysfunction and blood transfusions were necessary. Even though the patient was started on high-dose rituximab therapy combined with etoposide, the disease evolved into multiorgan dysfunction with a fatal outcome.
摘要：
我们介绍了一例79岁男性因长期虚弱和呼吸道症状而住院的临床病例。相关特征是多发性浆膜炎，多发肿大的淋巴结节，急性肾损伤，和心力衰竭。患者最近的病史显示一周前接种SARS-CoV-2疫苗和上呼吸道感染。胸腔穿刺术的实验室结果与渗出液一致，没有免疫染色。EB病毒聚合酶链反应（PCR）阳性。胸部，腹部，盆腔CT扫描显示多个肿大的淋巴结节，恶化先前存在的多浆膜炎和肝脾肿大。患者开始出现神经系统症状和全球健康状况恶化的迹象。切除肿大的淋巴结节，病理显示人疱疹病毒8型多中心Castleman病。该疾病迅速演变成血液学功能障碍，因此需要输血。即使患者开始接受大剂量利妥昔单抗联合依托泊苷治疗，该疾病演变成多器官功能障碍，具有致命的后果。
