司妥昔单抗与托珠单抗序贯治疗儿童特发性多中心型Castleman病1例

Sequential treatment with siltuximab and tocilizumab for childhood idiopathic multicentric Castleman disease: a case report

摘要

患儿，女，11岁，因反复发热20 d，加重伴腹胀7 d入院。入院后患儿以反复发热、淋巴结及肝脾大、多浆膜腔积液及多器官功能障碍为突出表现，结合淋巴结病理结果及临床表现确诊为特发性多中心型Castleman病-TAFRO综合征，使用司妥昔单抗联合糖皮质激素治疗后改托珠单抗维持治疗，患儿病情得到控制。因此，当患儿一旦明确为特发性多中心型Castleman病-TAFRO综合征，应尽早使用司妥昔单抗以迅速缓解病情，后可尝试改用托珠单抗进行维持治疗。

Abstract

The patient, an 11-year-old girl, was admitted with recurrent fever for 20 days, worsening with abdominal distension for 7 days. Upon admission, she presented with recurrent fever, lymphadenopathy, hepatosplenomegaly, polyserositis, and multiple organ dysfunction. Lymph node pathology and clinical manifestations confirmed the diagnosis of idiopathic multicentric Castleman disease-TAFRO syndrome. Treatment with siltuximab combined with glucocorticoids was initiated, followed by maintenance therapy with tocilizumab. The patient is currently in complete clinical remission. Therefore, once a child is diagnosed with idiopathic multicentric Castleman disease -TAFRO syndrome, early use of siltuximab should be considered for rapid disease control, followed by tocilizumab for maintenance therapy.

关键词

Castleman病 / TAFRO综合征 / 司妥昔单抗 / 托珠单抗

Key words

Castleman disease / TAFRO syndrome / Siltuximab / Tocilizumab