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HHV-8 POSITIVE MULTICENTRIC CASTLEMAN'S DISEASES IN HIV POSITIVE PATIENT: A CASE REPORT AND LITERATURE REVIEW

Introduction: Multicenteric Castleman's disease (MCD) is a rare lymphoproliferative disorder with systemic symptoms and poor prognosis. Case presentation: We are presenting a case of a 35-year-old HIV positive Caucasian man, who presented with a 2 week history of fever, sweating, rigors and weight loss. Physical examination revealed generalised cervical lymphadenopathy and hepatosplenomegaly. The blood investigations showed an abnormal coagulation profile and deranged liver function test. Lymph node biopsy showed hyperplastic reactive germinal follicles with interfollicular plasmacytosis. The follicles were surrounded by a broad mantle zone composed of concentric circles of small lymphocytes. The mantle cells and interfollicular plasma cells showed intense positive staining with HHV-8 immunostain; and a diagnosis of human herpes virus type 8 (HHV-8) positive MCD was established. The patient was treated with rituximab and complete remission has been achieved. Conclusion: MCD is found primarily in chronic HIV carriers and is strictly associated with HHV-8 coinfection. This is believed to play a key role in the pathogenesis of MCD, and has emerged as an aetiologic factor for therapeutic targets. The anti-CD20 monoclonal antibody rituximab is now the preferred treatment for HIV positive MCD, which also lowers the risk of developing lymphoma in MCD.