CASE REPORT article
Front. Med.
Sec. Hematology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1626722
Atypical clinical presentation associated with Castleman disease: A case report and review of the literature
Provisionally accepted
- 1Lanzhou University Second Hospital, Lanzhou, China
- 2Southern Medical University Nanfang Hospital, guangzhou, China
- 3nanfang hospital, guangzhou, China
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Background: Castleman disease (CD) is a group of rare and complicated disease characterized by systemic inflammation, lymphadenopathy, and multiorgan involvement, it can usually be misdiagnosed as infections, multiple autoimmune diseases, and malignant cancers.In this case, we report a patient of a 33-year-old Chinese man who was finally diagnosed with idiopathic multicenter Castleman disease. The patient initially presenting with intermittent fever and abdominal pain, and than appear abdominal and thoracic cavity effusion, anemia, thrombocytopenia, increased Ddimmer as well as acute kidney injury (AKI) but lacked significant lymphadenopathy primarily in the early stages of disease progression and was eventually diagnosed as idiopathic multicentric Castleman disease ( iMCD )in the end.This case emphasize that it is significant to consider idiopathic multicenter Castleman's disease in patients who have persistent fever and systemic inflammation with a development perspective, no matter if he has a noticeable lymphadenopathy. We should follow the progression of the disease and take a developmental view. Different stages of the disease can have different clinical manifestations. Diagnosis required a comprehensive assessment of clinical, laboratory, and histopathological findings. IMCD's rarity and complexity can pose diagnostic challenges, especially for healthcare providers unfamiliar with it, potentially leading to misdiagnosis. To prevent this, healthcare providers must keep a high suspicion for Castleman Disease (CD) in patients with prolonged fever and absent significant lymph node enlargement. Timely recognition and accurate diagnosis are critical for initiating appropriate treatments and improving patient outcomes. Enhancing awareness of iMCD among healthcare providers is essential for early detection and effective management.
Keywords: Castleman disease (CD), Idiopathic multicentric Castleman disease(iMCD), atypical clinical presentation, Acute kidney injury（AKI）, Lymph Node
Received: 11 May 2025; Accepted: 05 Aug 2025.
Copyright: © 2025 Hu, kong, hu, Ai and zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Weiwei Hu, Lanzhou University Second Hospital, Lanzhou, China
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