AUTHOR=Ma Luyuan , Gu Ruolan , Ma Luzhuo , Li Xiaoting , Yang Lan , Xie Peng , Xiao Xuelan , Gao Feng , Liu Fang , Shen Chuan , Zhao Caiyan TITLE=Case Report: TAFRO syndrome misdiagnosed as liver cirrhosis due to persistent abdominal distension JOURNAL=Frontiers in Immunology VOLUME=Volume 16 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2025.1554198 DOI=10.3389/fimmu.2025.1554198 ISSN=1664-3224 ABSTRACT=This report described a male patient presenting with recurrent fever, fatigue, persistent abdominal distension, and diarrhea, who was repeatedly misdiagnosed with decompensated cirrhosis at multiple hospitals. The diagnostic process was complex, ultimately leading to the diagnosis of TAFRO syndrome through lymph node and bone marrow biopsies, following 18F-FDG PET/CT imaging. The patient initially responded to treatment, while later succumbed to severe intra-abdominal infection and multiple organ failure. TAFRO syndrome, a rare subtype of Castleman disease, is frequently misdiagnosed due to limited clinical awareness, delaying appropriate treatment. This case highlighted the diagnostic challenges and therapeutic considerations associated with TAFRO syndrome, providing insights for clinical practice based on the existing research.