Post‐Liver Transplantation Multicentric Castleman Disease Treated with Valganciclovir and Weaning of Immunosuppression

摘要: Multicentric Castleman disease is a lymphoproliferative disorder which when seen in the setting of HIV/AIDS often associated with human herpes virus 8 (HHV-8) infection. We describe case HIV-negative man who developed HHV-8-associated multicentric 11 years after liver transplantation. The patient presented fevers and weight loss. Physical examination revealed enlarged cervical, axillary inguinal lymph nodes. Widespread lymphadenopathy was confirmed on computed tomography (CT) scanning. Histology an node showed polymorphous infiltrate mature plasma cells, plasmacytoid lymphocytes occasional blasts within cortex paracortex. diagnosis by finding numerous HHV-8-immunopositive cells around regressed follicles detection HHV-8 PCR. Although conventional treatment for this condition has been combination chemotherapy, post-transplant context it decided to treat valganciclovir cessation immunosuppression. His symptoms resolved rapidly repeat PCR done 3 months starting negative HHV-8. A follow-up CT scan dramatic reduction size amount lymphadenopathy. After 15 treatment, he remains well no evidence graft dysfunction or rejection.