Multicentric Castleman's Disease presenting with bilateral panuveitis.

Abstract

Purpose: To report a rare case of Multicentric Castleman's Disease presenting with bilateral panuveitis.

Methods: Case report.

Results: A 65-years-old caucasian man presented with progressive blurred vision in both eyes for two weeks, along with weight loss, polyarthralgias and reduced muscle strength persisting for about a year. Examination revealed bilateral panuveitis after intraocular lymphoma being initially considered. CT scans showed multiple lymph node enlargements suggestive of lymphoproliferative disorder. Excisional biopsy of an axillary lymph node confirmed the diagnosis of plasmacytic type Castleman's 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's Disease was established through the investigation of bilateral panuveitis, which was successfully managed with corticosteroids and siltuximab.