Seyedeh Tahereh Mohaddes
1 
, Zahra Rezaei Borojerdi
1* , Maryam Miri
2 , Mohammad Moeini Nodeh
1, Alireza Rezaei
3, Mahin Ghorban Sabbagh
2, Samane Sajjadi
1, Fatemeh Seyyedi khabbaz
1, Amin Ranjbar
11 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
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.