Fever of unknown origin and lymphadenopathy in the context of lupus: presentation of a clinical case of Castleman disease

Abstract

Lymphadenopathy occurs in approximately 60% of patients with systemic lupus erythematosus (SLE) during the course of the disease. These lymph node lesions are characterized by follicular hyperplasia, coagulative necrosis, hematoxylin bodies and DNA deposition within the vessels. As a consequence, the histopathological examination of the lymphnodes in SLE is underestimated1. There have been reports of SLE lymphadenopathy with Castleman's disease (CD) morphology, which is discovered in order to exclude malignant lymphoma. CD is an atypical lymphoproliferative disorder that can occur with orwithout systemic symptoms2-3. Histologically, CD is classified as an hyaline-vascular variant, plasmatic cells or mixed forms4. Hyaline-vascular histology represents the majority of cases of unicentric CD (UCD) and the type of plasmatic cell characterizes more to the multicentric CD (MCD). It has been shown that MCD is associated with various autoimmune diseases5-6. In this report, we present a patient with SLE and Crohn's disease with fever of unknown origin (FUO) and lymphadenopathy with MCD associated with herpes virus infection 8 (HHV-8).