HHV8-positive multicentric Castleman’s disease and thrombotic thrombocytopenic purpura among HIV-positive patients
  • Roxane Pasquer
    Clinical Immunology Department, Nouvel Hôpital Civil, Strasbourg University, Strasbourg, France
  • Yannick Dieudonné
    Clinical Immunology Department, Nouvel Hôpital Civil, Strasbourg University, Strasbourg, France
  • Pauline Decours
    Clinical Immunology Department, Nouvel Hôpital Civil, Strasbourg University, Strasbourg, France
  • Olivier Hinschberger
    Internal Medicine and Clinical Immunology Department, Hôpitaux Civils de Colmar, Colmar, France
  • Alina Nicolae
    Anatomopathology Laboratory, Nouvel Hôpital Civil, Strasbourg, France
  • Martin Martinot
    Infectious Diseases Department, Hôpitaux Civils de Colmar, Colmar, France

Keywords

Castleman’s disease, thrombotic thrombocytopenic purpura, HHV8, HIV, auto-immune hypoglycemia

Abstract

Castleman’s disease (CD) and thrombotic thrombocytopenic purpura (TTP) are rare diseases that can affect the general population, especially those with HIV. Owing to their rarity, the association between CD and TTP remains insufficiently understood. In this study, we present a case of a 53-year-old patient with controlled HIV infection who presented with fever, lymphadenopathy, severe anaemia, and thrombocytopenia. After a series of tests, the diagnosis was concurrent human herpesvirus 8 (HHV8)-related multicentric CD (MCD) and TTP. Only four male patients were previously reported having this association, with HHV8 present in four and HIV in three patients, suggesting that coinfection with HHV8 and HIV is a pivotal factor in MCD with TTP occurrence.

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References

  • Bertinchamp R, Terriou L. Maladies de Castleman: épidémiologie, classification et critères diagnostiques. Rev Med Interne 2022;43:10S4–10S9.
  • Meignin V, Calvani J, Oksenhendler E. Castleman disease. Ann Pathol 2023;43:13–24.
  • Oksenhendler E, Boutboul D, Fajgenbaum D, Mirouse A, Fieschi C, Malphettes M, et al. The full spectrum of Castleman disease: 273 patients studied over 20 years. Br J Haematol 2018;180:206–216.
  • Plancoulaine S, Gessain A. Epidemiological aspects of human herpesvirus 8 infection and of Kaposi’s sarcoma. Med Mal Infect 2005;35:314–321.
  • Fajgenbaum DC, Uldrick TS, Bagg A, Frank D, Wu D, Srkalovic G, et al. International, evidence-based consensus diagnostic criteria for HHV-8-negative/idiopathic multicentric Castleman disease. Blood 2017;129:1646–1657.
  • London J, Boutboul D, Agbalika F, Coppo P, Veyradier A, Gérard L, et al. Autoimmune thrombotic thrombocytopenic purpura associated with HHV8-related Multicentric Castleman disease. Br J Haematol 2017;178:486–488.
  • Brecher ME, Hay SN, Park YA. Is it HIV TTP or HIV-associated thrombotic microangiopathy? J Clin Apher 2008;23:186–190.
  • Stebbing J, Adams C, Sanitt A, Mletzko S, Nelson M, Gazzard B, et al. Plasma HHV8 DNA predicts relapse in individuals with HIV-associated multicentric Castleman disease. Blood 2011;118:271–275.
  • Malak S, Wolf M, Millot GA, Mariotte E, Veyradier A, Meynard J-L, et al. Human immunodeficiency virus-associated thrombotic microangiopathies: clinical characteristics and outcome according to ADAMTS13 activity. Scand J Immunol 2008;68:337–344.
  • Arnautou P, Auclair M, Fellahi S, Bouché C, Fieschi C, Barrak E, et al. Autoimmune hypoglycemia expands the biological spectrum of HHV8+ multicentric Castleman disease. Blood Adv 2021;5:1848–1852.
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    Published: 2024-02-28
    Issue: 2024: Vol 11 No 3 (view)


    How to cite:
    1.
    Pasquer R, Dieudonné Y, Decours P, Hinschberger O, Nicolae A, Martinot M. HHV8-positive multicentric Castleman’s disease and thrombotic thrombocytopenic purpura among HIV-positive patients. EJCRIM 2024;11 doi:10.12890/2024_004361.

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