Abstract | RATIONALE: PATIENT CONCERNS: The patient was admitted due to dyspnea, fever, polyarthralgia, and generalized edema. She had been diagnosed with Sjögren's syndrome at the age of 14 years, based on histopathological examination of a biopsy of the minor salivary glands and the development of Raynaud's phenomenon, with no follow-up treatment required. On admission, she presented with anemia, elevated C-reactive protein levels, anasarca, and hepato- splenomegaly. A bone marrow examination revealed increased megakaryocytes with reticulin fibrosis, and the histopathology of an axillary lymph node was consistent with mixed-type Castleman disease. Eventually, she developed thrombocytopenia. INTERVENTIONS: Her symptoms fulfilled all of the major and minor categories of the diagnostic criteria for TAFRO syndrome. However, considering her prior diagnosis, we assumed that the clinical presentation was consistent with an acute exacerbation of Sjögren's syndrome. Unlike typical cases of TAFRO syndrome, the administration of relatively low-dose prednisolone relieved her symptoms. LESSONS:
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Authors | Shino Fujimoto, Hiroshi Kawabata, Nozomu Kurose, Haruka Kawanami-Iwao, Tomoyuki Sakai, Takafumi Kawanami, Yoshimasa Fujita, Toshihiro Fukushima, Yasufumi Masaki |
Journal | Medicine
(Medicine (Baltimore))
Vol. 96
Issue 50
Pg. e9220
(Dec 2017)
ISSN: 1536-5964 [Electronic] United States |
PMID | 29390349
(Publication Type: Case Reports, Journal Article)
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Copyright | Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved. |
Chemical References |
- Glucocorticoids
- Prednisolone
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Topics |
- Adult
- Castleman Disease
(diagnosis, drug therapy)
- Diagnosis, Differential
- Female
- Glucocorticoids
(therapeutic use)
- Humans
- Prednisolone
(therapeutic use)
- Sjogren's Syndrome
(diagnosis)
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