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January 2020; 7 (1) Clinical/Scientific NotesOpen Access

A case of idiopathic multicentric Castleman disease in an alemtuzumab-treated patient with MS

Leoni Rolfes, Steffen Pfeuffer, Tobias Ruck, Susanne Windhagen, Ilske Oschlies, Hermann-Joseph Pavenstädt, View ORCID ProfileLinus Angenendt, Heinz Wiendl, Julia Krämer, Sven G. Meuth
First published November 8, 2019, DOI: https://doi.org/10.1212/NXI.0000000000000638
Leoni Rolfes
From the Clinic of Neurology with Institute of Translational Neurology (L.R., S.P., T.R., H.W., J.K., S.G.M.), University Hospital Münster; Department of Neurology and Neurological Rehabilitation (S.W.), Hospital Osnabrück, Am Finkenhügel 1; Department of Pathology (I.O.), Hematopathology Section and Lymph Node Registry, University-Hospital Schleswig-Holstein, Campus Kiel; Department of General Internal Medicine (H.-J.P.), Nephrology, Hypertensiology, and Rheumatology, University Hospital Münster; and Department of Hematology (L.A.), Hemostaseology, Oncology, and Pneumology, University Hospital Münster, Germany.
MD
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Steffen Pfeuffer
From the Clinic of Neurology with Institute of Translational Neurology (L.R., S.P., T.R., H.W., J.K., S.G.M.), University Hospital Münster; Department of Neurology and Neurological Rehabilitation (S.W.), Hospital Osnabrück, Am Finkenhügel 1; Department of Pathology (I.O.), Hematopathology Section and Lymph Node Registry, University-Hospital Schleswig-Holstein, Campus Kiel; Department of General Internal Medicine (H.-J.P.), Nephrology, Hypertensiology, and Rheumatology, University Hospital Münster; and Department of Hematology (L.A.), Hemostaseology, Oncology, and Pneumology, University Hospital Münster, Germany.
MD
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Tobias Ruck
From the Clinic of Neurology with Institute of Translational Neurology (L.R., S.P., T.R., H.W., J.K., S.G.M.), University Hospital Münster; Department of Neurology and Neurological Rehabilitation (S.W.), Hospital Osnabrück, Am Finkenhügel 1; Department of Pathology (I.O.), Hematopathology Section and Lymph Node Registry, University-Hospital Schleswig-Holstein, Campus Kiel; Department of General Internal Medicine (H.-J.P.), Nephrology, Hypertensiology, and Rheumatology, University Hospital Münster; and Department of Hematology (L.A.), Hemostaseology, Oncology, and Pneumology, University Hospital Münster, Germany.
MD
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Susanne Windhagen
From the Clinic of Neurology with Institute of Translational Neurology (L.R., S.P., T.R., H.W., J.K., S.G.M.), University Hospital Münster; Department of Neurology and Neurological Rehabilitation (S.W.), Hospital Osnabrück, Am Finkenhügel 1; Department of Pathology (I.O.), Hematopathology Section and Lymph Node Registry, University-Hospital Schleswig-Holstein, Campus Kiel; Department of General Internal Medicine (H.-J.P.), Nephrology, Hypertensiology, and Rheumatology, University Hospital Münster; and Department of Hematology (L.A.), Hemostaseology, Oncology, and Pneumology, University Hospital Münster, Germany.
MD
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Ilske Oschlies
From the Clinic of Neurology with Institute of Translational Neurology (L.R., S.P., T.R., H.W., J.K., S.G.M.), University Hospital Münster; Department of Neurology and Neurological Rehabilitation (S.W.), Hospital Osnabrück, Am Finkenhügel 1; Department of Pathology (I.O.), Hematopathology Section and Lymph Node Registry, University-Hospital Schleswig-Holstein, Campus Kiel; Department of General Internal Medicine (H.-J.P.), Nephrology, Hypertensiology, and Rheumatology, University Hospital Münster; and Department of Hematology (L.A.), Hemostaseology, Oncology, and Pneumology, University Hospital Münster, Germany.
MD
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Hermann-Joseph Pavenstädt
From the Clinic of Neurology with Institute of Translational Neurology (L.R., S.P., T.R., H.W., J.K., S.G.M.), University Hospital Münster; Department of Neurology and Neurological Rehabilitation (S.W.), Hospital Osnabrück, Am Finkenhügel 1; Department of Pathology (I.O.), Hematopathology Section and Lymph Node Registry, University-Hospital Schleswig-Holstein, Campus Kiel; Department of General Internal Medicine (H.-J.P.), Nephrology, Hypertensiology, and Rheumatology, University Hospital Münster; and Department of Hematology (L.A.), Hemostaseology, Oncology, and Pneumology, University Hospital Münster, Germany.
MD
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Linus Angenendt
From the Clinic of Neurology with Institute of Translational Neurology (L.R., S.P., T.R., H.W., J.K., S.G.M.), University Hospital Münster; Department of Neurology and Neurological Rehabilitation (S.W.), Hospital Osnabrück, Am Finkenhügel 1; Department of Pathology (I.O.), Hematopathology Section and Lymph Node Registry, University-Hospital Schleswig-Holstein, Campus Kiel; Department of General Internal Medicine (H.-J.P.), Nephrology, Hypertensiology, and Rheumatology, University Hospital Münster; and Department of Hematology (L.A.), Hemostaseology, Oncology, and Pneumology, University Hospital Münster, Germany.
MD
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  • ORCID record for Linus Angenendt
Heinz Wiendl
From the Clinic of Neurology with Institute of Translational Neurology (L.R., S.P., T.R., H.W., J.K., S.G.M.), University Hospital Münster; Department of Neurology and Neurological Rehabilitation (S.W.), Hospital Osnabrück, Am Finkenhügel 1; Department of Pathology (I.O.), Hematopathology Section and Lymph Node Registry, University-Hospital Schleswig-Holstein, Campus Kiel; Department of General Internal Medicine (H.-J.P.), Nephrology, Hypertensiology, and Rheumatology, University Hospital Münster; and Department of Hematology (L.A.), Hemostaseology, Oncology, and Pneumology, University Hospital Münster, Germany.
MD
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Julia Krämer
From the Clinic of Neurology with Institute of Translational Neurology (L.R., S.P., T.R., H.W., J.K., S.G.M.), University Hospital Münster; Department of Neurology and Neurological Rehabilitation (S.W.), Hospital Osnabrück, Am Finkenhügel 1; Department of Pathology (I.O.), Hematopathology Section and Lymph Node Registry, University-Hospital Schleswig-Holstein, Campus Kiel; Department of General Internal Medicine (H.-J.P.), Nephrology, Hypertensiology, and Rheumatology, University Hospital Münster; and Department of Hematology (L.A.), Hemostaseology, Oncology, and Pneumology, University Hospital Münster, Germany.
MD
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Sven G. Meuth
From the Clinic of Neurology with Institute of Translational Neurology (L.R., S.P., T.R., H.W., J.K., S.G.M.), University Hospital Münster; Department of Neurology and Neurological Rehabilitation (S.W.), Hospital Osnabrück, Am Finkenhügel 1; Department of Pathology (I.O.), Hematopathology Section and Lymph Node Registry, University-Hospital Schleswig-Holstein, Campus Kiel; Department of General Internal Medicine (H.-J.P.), Nephrology, Hypertensiology, and Rheumatology, University Hospital Münster; and Department of Hematology (L.A.), Hemostaseology, Oncology, and Pneumology, University Hospital Münster, Germany.
MD, PhD
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Full PDF
Citation
A case of idiopathic multicentric Castleman disease in an alemtuzumab-treated patient with MS
Leoni Rolfes, Steffen Pfeuffer, Tobias Ruck, Susanne Windhagen, Ilske Oschlies, Hermann-Joseph Pavenstädt, Linus Angenendt, Heinz Wiendl, Julia Krämer, Sven G. Meuth
Neurol Neuroimmunol Neuroinflamm Jan 2020, 7 (1) e638; DOI: 10.1212/NXI.0000000000000638

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This article has a correction. Please see:

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    Figure Diagnostic work-up and treatment regimes in an alemtuzumab-treated patient with RRMS developing idiopathic multicentric Castleman disease

    (A–E) Charts show the course of CRP, hemoglobin, platelets, white blood cell count, and blood urea nitrogen since the initial presentation during hospitalization. Time points and length of different treatment regimens are outlined in (A) (♦: IV methylprednisolone 250 mg, cumulative dose 2,750 mg; •: immunoadsorption; *: IVIG single dose, 1 mg/kg). Arrows represent platelet (B) and erythrocyte concentrate (C) transfusions and hemodialysis (E). (F) Abdominal CT scan outlining extensive abdominal (red arrows) and inguinal (yellow arrows) lymphadenopathy. (G–H) Axial thoracic and abdominal CT scan indicating polyserositis with pleural (G: yellow arrows) and pericardial (G: red arrows) effusions and ascites (F: yellow arrows) as well as hepatosplenomegaly (F: red arrows). (I) H&E staining of bone marrow puncture displaying megakaryocytosis. (J–K) Mediastinal lymph node biopsy consistent with iMCD plasma cell type. (J) Haematoxylin and eosin stain displaying regressive germinal centers (blue arrows), with small vessels reaching into germinal centers (“lollipop vessels,” black arrows). (K) Giemsa staining displaying interfollicular proliferation of plasma cells (black arrows).

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