MULTICENTRIC CASTLEMAN DISEASE PRESENTING WITH BILATERAL PANUVEITIS.

Abstract

Purpose: The objective of this study was to report a rare case of multicentric Castleman disease presenting with bilateral panuveitis.

Methods: Case report.

Results: A 65-year-old White man presented with progressive blurred vision in both eyes for 2 weeks, along with weight loss, polyarthralgia, and reduced muscle strength persisting for about a year. Examination revealed bilateral panuveitis after intraocular lymphoma being initially considered. Computed tomography scans showed multiple lymph node enlargements suggestive of lymphoproliferative disorder. Excisional biopsy of an axillary lymph node confirmed the diagnosis of plasmacytic-type Castleman disease. Treatment was started with topical dexamethasone and tropicamide for anterior chamber inflammation, followed by oral prednisolone. After definitive diagnosis, treatment with siltuximab was initiated, which led to significant improvement in panuveitis and systemic symptoms. The patient became off corticosteroids and continued on siltuximab with stable visual acuity and low-grade vitritis.

Conclusion: To the best of our knowledge, we described the first case in which the diagnosis of multicentric Castleman disease was established through the investigation of bilateral panuveitis, which was successfully managed with corticosteroids and siltuximab.