Multicentric Castleman's disease treated with antivirals and immunosuppressants

J Med Virol. 2003 Nov;71(3):399-403. doi: 10.1002/jmv.10500.

Abstract

A patient negative for human immunodeficiency virus (HIV) developed multicentric Castleman's disease (MCD) and Kaposi's sarcoma (KS) associated with active human herpesvirus 8 (HHV-8) infection. He was treated with sequential antiviral therapy, chemotherapy, and corticosteroids. HHV-8 levels were monitored throughout the course of the patient's illness, and were found to rise on relapse. No consistent change in HHV-8 levels was found with antiviral therapy. We demonstrate that in this patient antiviral therapy was clinically ineffective, and did not alter HHV-8 levels, but that corticosteroid and combination chemotherapy led to clinical improvement. Despite the implication of HHV-8 as a cause of MCD, few studies have correlated HHV-8 levels with clinical response.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / therapeutic use
  • Antineoplastic Agents, Alkylating / administration & dosage
  • Antineoplastic Agents, Alkylating / therapeutic use
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / therapeutic use*
  • Castleman Disease / drug therapy*
  • Castleman Disease / virology
  • Chlorambucil / administration & dosage
  • Chlorambucil / therapeutic use
  • Cidofovir
  • Cytosine / administration & dosage
  • Cytosine / analogs & derivatives*
  • Cytosine / therapeutic use*
  • Drug Therapy, Combination
  • Foscarnet / administration & dosage
  • Foscarnet / therapeutic use*
  • Herpesvirus 8, Human / genetics
  • Herpesvirus 8, Human / isolation & purification
  • Herpesvirus 8, Human / physiology
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / therapeutic use*
  • Male
  • Organophosphonates*
  • Organophosphorus Compounds / administration & dosage
  • Organophosphorus Compounds / therapeutic use*
  • Prednisolone / administration & dosage
  • Prednisolone / therapeutic use
  • Sarcoma, Kaposi / drug therapy
  • Sarcoma, Kaposi / virology
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Antineoplastic Agents, Alkylating
  • Antiviral Agents
  • Immunosuppressive Agents
  • Organophosphonates
  • Organophosphorus Compounds
  • Chlorambucil
  • Foscarnet
  • Cytosine
  • Prednisolone
  • Cidofovir