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Submitted: 19 Apr 2019
Accepted: 10 Aug 2019
ePublished: 10 Sep 2019
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Immunopathol Persa. 2020;6(1): e01.
doi: 10.15171/ipp.2020.01
  Abstract View: 167
  PDF Download: 115

Case Report

TAFRO syndrome with skin manifestations treated with bortezomib and tocilizumab; a case report

Seyedeh Tahereh Mohaddes 1 ORCID logo, Zahra Rezaei Borojerdi 1 * ORCID logo, Maryam Miri 2 ORCID logo, Mohammad Moeini Nodeh 1, Alireza Rezaei 3, Mahin Ghorban Sabbagh 2, Samane Sajjadi 1, Fatemeh Seyyedi khabbaz 1, Amin Ranjbar 1

1 Hematology Oncology Department, Internal Medicine Department, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
2 Kidney Transplantation Complications Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
3 Department of Pathology, Islamic Azad University of Medical Sciences, Mashhad, IR Iran
*Correspondence to Zahra Rezaei Borojerdi, Email: Rezaeibz961@mums.ac.ir

Abstract

TAFRO syndrome is a new presentation of idiopathic multicentric Castleman disease which is termed as thrombocytopenia, anasarca, myelofibrosis, renal failure and organomegaly (TAFRO). The exact pathophysiology of TAFRO syndrome is unclear and management is mostly based on case reports and expert opinion. In this report, a 37 years old male patient with TAFRO syndrome is discussed. The patient was referred with fever, sweating, anorexia, abdominal distension and generalized edema which has been hospitalized multiple times for such complaints. The patient also developed skin lesions dispersed in red nodules, which was reported as “granuloid hemangioma”. Renal biopsy suggested mesangioproliferative glomerulonephritis and bone marrow specimen showed hypercellular active marrow with reticulin fibrosis. The lymph node biopsies were reported as Castleman disease. This report demonstrates that different manifestations of TAFRO syndrome may overlap with other syndromes and can be managed by Bortezomib and Tocilizumab.
Keywords: Bortezomib, mesangioproliferative glomerulonephritis, Tocilizumab, Castleman disease, Hemangioma, Glomerulonephritis
Citation: Tahereh Mohaddess ST, Rezaei Borojerdi Z, Miri M, Moeini Nodeh M, Rezaei A, Ghorban Sabbagh M. TAFRO syndrome with skin manifestations treated with bortezomib and tocilizumab; a case report. Immunopathol Persa. 2020;6(1):e01. DOI:10.15171/ipp.2020.01. 
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