Consulting rheumatologists often assess patients with atypical clinical presentations for the possibility of an underlying rheumatic disease. Inflammatory syndromes that are not clearly rheumatic in nature can be particularly challenging to diagnose. Here, we share the case of a young woman with a long-standing undiagnosed illness and highly elevated inflammatory markers, and describe the evaluation…
The difference between Castleman disease and Castleman-like disease may be subtle, but it comes with significant ramifications. Case Presentation This case involves a pregnant 19-year-old woman who presents over multiple hospitalizations with concerns for systemic lupus erythematosus and macrophage activation syndrome. At 36 weeks’ gestation, the patient’s weight had dropped from 215 lbs. to 170…
The diagnosis of rheumatic diseases requires the exclusion of other systemic disorders. Infection, hematologic conditions, malignancies and some drugs may all lead to syndromes that closely mimic rheumatic diseases, which may lead to diagnostic delays. Idiopathic multicentric Castleman disease (iMCD) is a heterogeneous group of lymphoproliferative diseases (LPDs) characterized by systemic inflammatory manifestations.1,2 As with…
SAN DIEGO—At the 2017 Thieves Market, held Nov. 6 at the ACR/ARHP Annual Meeting, rheumatologists from around the world presented patient cases to an audience of colleagues, who then voted via text messaging to choose the cases they felt were most perplexing or intriguing. The winner received a free 2018 Annual Meeting registration, and the…
We report a case of a 27-year-old woman who was initially diagnosed with systemic lupus erythematosus (SLE), had features of scleroderma and was subsequently found to have lymph node biopsy consistent with multicentric Castleman disease (MCD). She also had serologic evidence of acute Epstein-Barr virus (EBV) infection (vs. reactivation of EBV). The occurrence of MCD…