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首页> 外文期刊>Journal of Medical Case Reports >Successful treatment of HIV-associated multicentric Castleman's disease and multiple organ failure with rituximab and supportive care: a case report
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Successful treatment of HIV-associated multicentric Castleman's disease and multiple organ failure with rituximab and supportive care: a case report

机译：利妥昔单抗和支持治疗成功治疗HIV相关的多中心Castleman病和多器官衰竭：一例病例报告

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Introduction Multicentric Castleman's Disease (MCD), a lymphoproliferative disorder associated with Human Herpes Virus-8 (HHV-8) infection, is increasing in incidence amongst HIV patients. This condition is associated with lymphadenopathy, polyclonal gammopathy, hepato-splenomegaly and systemic symptoms. A number of small studies have demonstrated the efficacy of the anti-CD20 monoclonal antibody, rituximab, in treating this condition. Case presentation We report the case of a 46 year old Zambian woman who presented with pyrexia, diarrhoea and vomiting, confusion, lymphadenopathy, and renal failure. She rapidly developed multiple organ failure following the initiation of treatment of MCD with rituximab. Following admission to intensive care (ICU), she received prompt multi-organ support. After 21 days on the ICU she returned to the haematology medical ward, and was discharged in remission from her disease after 149 days in hospital. Conclusion Rituximab, the efficacy of which has thus far been examined predominantly in patients outside the ICU, in conjunction with extensive organ support was effective treatment for MCD with associated multiple organ failure. There is, to our knowledge, only one other published report of its successful use in an ICU setting, where it was combined with cyclophosphamide, adriamycin and prednisolone. Reports such as ours support the notion that critically unwell patients with HIV and haematological disease can benefit from intensive care.
机译：引言多中心Castleman病（MCD）是一种与人类疱疹病毒8（HHV-8）感染相关的淋巴增生性疾病，在艾滋病毒患者中的发病率正在增加。这种情况与淋巴结病，多克隆性丙种病，肝脾肿大和全身症状有关。许多小型研究证明了抗CD20单克隆抗体利妥昔单抗在治疗该疾病中的功效。病例介绍我们报告了一名46岁的赞比亚妇女的病例，该妇女出现发热，腹泻和呕吐，意识模糊，淋巴结肿大和肾功能衰竭。在开始用利妥昔单抗治疗MCD之后，她迅速发展出多器官功能衰竭。接受重症监护（ICU）后，她得到了迅速的多器官支持。在ICU住院21天后，她返回血液病学病房，住院149天后因病康复。结论迄今为止，主要在ICU以外的患者中检查了利妥昔单抗的疗效，并结合广泛的器官支持对伴有多器官功能衰竭的MCD是有效的治疗方法。据我们所知，只有另一篇已发表的报告表明它与环磷酰胺，阿霉素和泼尼松龙联合使用在ICU环境中成功。像我们这样的报告支持这样的观点，即重症艾滋病毒和血液病患者可以从重症监护中受益。

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