Renal complications of Castleman's disease: report of two cases and analysis of 75 cases
Renal complications of Castleman's disease: report of two cases and analysis of 75 cases
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DOI：
10.1007/s10157-011-0499-9
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发表时间：
2011-12-01
影响因子：
2.3
通讯作者：
Zhao, Xiao-Ying
中科院分区：
文献类型：
--
作者：
Yuan, Xiang-Gui;Hu, Wen;Zhao, Xiao-Ying
经活检证实的卡斯尔曼病 (CD) 肾脏并发症很少见，目前的知识主要基于零星病例报告。我们报告了另外两例，均为多中心 CD，具有透明血管病理模式，并表现为慢性肾功能衰竭。病例1为多中心CD，伴肾系膜增生性肾小球肾炎并发症，病例2为多中心CD，伴膜增生性肾小球肾炎样并发症。尽管两人最终都接受了皮质类固醇和细胞毒性药物的联合治疗，但两人都表现出攻击性和复发性。然后，我们对 1954 年 1 月至 2011 年 3 月期间 51 篇英文文献中报道的 75 例经活检证实的 CD 肾脏并发症（包括我们的两例）进行了分析。我们发现 CD 肾脏并发症的临床和组织学表现存在异质性。组织学诊断肾脏并发症后，中位随访时间为 22 个月（0-204 个月）后，17% 的患者死亡。估计5年累积生存率为75%。进一步的研究需要更好的理解和治疗干预。
Biopsy-proven renal complications of Castleman's disease (CD) are rare and current knowledge is largely based on sporadic case reports. We reported two more cases, both of which were multicentric CD with hyaline-vascular pathological pattern and presented with chronic renal failure. Case 1 was multicentric CD with renal mesangial proliferative glomerulonephritis complications, and case 2 was multicentric CD with membranoproliferative glomerulonephritis-like complications. Although both were eventually administered corticosteroids combined with cytotoxic drugs, both behaved in an aggressive and relapsing manner. We then made an analysis of 75 cases of biopsy-proven renal complications of CD (including our two cases) which were reported in 51 English literatures from January 1954 to March 2011. We found that the clinical and histological findings of renal complications of CD were heterogeneous. Death was observed in 17% patients after a median follow-up time of 22 months (0-204 months) since histological diagnosis of renal complications. The estimated 5-year cumulative survival rate was 75%. Better understanding and therapeutic interventions are required in further investigations.