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Inicio Medicina Clínica (English Edition) Castleman’s disease, pathophysiology, advances in diagnosis and treatment
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Vol. 162. Issue 6.
Pages 283-290 (March 2024)
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Vol. 162. Issue 6.
Pages 283-290 (March 2024)
Review
Castleman’s disease, pathophysiology, advances in diagnosis and treatment
Enfermedad de Castleman, fisiopatología, avances en el diagnóstico y tratamiento
Roberto Pertusa Mataix
Corresponding author
roberpm97@gmail.com

Corresponding author.
, Daniel Loaiza Cabello, José Salvador García Morillo
Servicio de Medicina Interna, Departamento de Enfermedades Autoinmunes, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Table 1. Differential diagnosis of Castleman disease.
Table 2. Summary of Castleman disease variants.
Table 3. Diagnostic criteria for multicentric CD.
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Abstract

Castleman’s disease (CD) encompasses a heterogeneous set of reactive lymphoproliferative processes that share well-defined histologic features.

CD is considered a rare or minority disease (Munshi et al., 2014). The incidence of CD is not fully known, although it is estimated at less than 1 per 100,000 inhabitants (Castleman et al., 1956). It has a bimodal distribution (30−40 years and then 60–80 years). The incidence is similar in both sexes, although the unicentric variant seems to have a slight predominance in women with a 2:1 ratio.

CD is classified into a hyalinovascular form (this being the most frequent) and a plasmocellular form, related to the HIV and VHH-8 viruses, which together with other autoimmune mechanisms develop hyperproduction of interleukin-6 (IL-6) by B lymphocytes.

There are different lines of treatment, where the use of anti IL-6 stands out, being siltuximab the most used as orphan drug in this pathology.

Keywords:
Castleman
Interleukin-6
Siltuximab
Resumen

La enfermedad de Castleman (EC) engloba a un conjunto heterogéneo de procesos linfoproliferativos que comparten rasgos histológicos bien definidos.

Se considera una enfermedad rara o minoritaria2. Su incidencia no es del todo conocida, aunque se estima en menos de 1 por cada 100.000 habitantes1. Tiene una distribución bimodal (30−40 años y luego los 60–80 años). Su incidencia es similar en ambos sexos, aunque la variante unicéntrica parece tener ligero predominio en mujeres con proporción 2:1.

La EC se clasifica en una forma hialinovascular (siendo esta la más frecuente) y otra plasmocelular, relacionadas con el virus de la inmunodeficiencia humana (VIH) y el virus herpes humano tipo 8 (VHH-8), que junto a otros mecanismos autoinmunitarios desarrollan la hiperproducción de interleucina-6 (IL-6) por parte de los linfocitos B.

Existen diferentes líneas de tratamiento, donde destaca el uso de anti IL-6, siendo el siltuximab el más utilizado y catalogado como fármaco huérfano de esta patología.

Palabras clave:
Castleman
Interleucina 6
Siltuximab

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