Treatment of multicentric Castleman disease through combination of tocilizumab, lenalidomide and glucocorticoids: Case report

RATIONALE: Castleman's disease (CD) is a rare lymphoproliferative disease. Compared to unicentric CD, multicentric Castleman disease (MCD) displays poorer prognosis and great variance to different therapies. Though chemotherapy, immunization therapy, and glucocorticoids have been used in the treatment of MCD, its optimal treatment is still controversial. PATIENT CONCERNS: A 47-year-old woman was admitted due to poor appetite, general fatigue, puffiness of face, systemic rash, and abdominal distension. On physical examination, the patient displayed as general lymphadenopathy, splenomegaly, hepatomegaly, and shifting dullness. DIAGNOSES: After biopsy of her swollen lymph node and laboratory tests, her initial diagnosis was hyaline vascular-CD. INTERVENTIONS: She was treated with combination of tocilizumab, lenalidomide, and glucocorticoids. OUTCOMES: This patient achieved complete remission (CR) with all her indexes returned to be normal. Her blood routines and biochemical examinations were still normal during the following period. LESSONS: We reported a case with multicentric Castleman's disease (MCD) which acquired quite good remission after combination treatment with tocilizumab, lenalidomide, and glucocorticoids. Our report provided powerful evidence for displaying the efficiency and safety of target therapy against unicentric Castleman disease.