MCD with David Fajgenbaum, MD, MBA, Msc: Case 1 - Episode 4
What is the most likely diagnosis for this patient?
Based on the laboratory values and now the pathology report, as well as the clinical featureselevated platelets, a bit of fluid gain, fevers, night sweats, and some cytopenias, anemia included—and then based on the lymph node pathology, we are really thinking that this is HHV-8-negative idiopathic Multicentric Castleman Disease.
Multicentric Castleman Disease: Case 1
Mary is a 13-year old female who presents with a 10-month history of night sweats, fatigue, and weight loss. She presents to urgent care with complaints of flu-like symptoms. Her physical exam is notable for bilateral cervical lymphadenopathy (1-2 cm), mild splenomegaly, and mild edema. She has no neuropathy and no joint pain. She is referred to a hematologist to rule out lymphoma. Her medical history is unremarkable. Her family history is relevant for a mother with systemic lupus erythematous and father who died from colon cancer at 65 years old.
At the hematology office, the following laboratory abnormalities are noted: