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ICDO
International
Castlemans
Disease
Organization

Issue 1 - March 1998

Author(s) :C. Herbelin, P. Roux-Lombard, A . Herbelin, M. Peuchmaur, D. De Groote, C. Griscelli, J.M. Dayer and A.M. Prieur
Keywords :Castleman disease, inflammation, interleukin-1, interleukin-6, tumor necrosis factor, cytokine inhibitors.


 Inflammation: "a natural experiment" for the

systemic pathogenicity of cytokines

*Summary: It has previously been demonstrated that the overproduction of interleukin-6 (IL-6) is a key element in the clinical and biological abnormalities encountered in Castleman’s disease (CD). The particular case of a male child with a localized form of CD is reported. In this patient, evidence was found of a correlation between systemic manifestations and circulating IL-6, and IL-6 gene overexpression in the germinal centers of hyperplastic lymph nodes. Circulating IL-6 levels were 10- to 100-fold higher than in all CD cases previously documented. This unique biological feature was closely associated with high levels of circulating IL-1 and tumor necrosis factor-alpha (TNF- ), which are known for their ability to induce and/or amplify IL-6 production. One month after surgical removal of the pathological lymph node, the clinical and biological abnormalities diminished, while circulating IL-6 levels dropped dramatically eight months later. It is worth noting that after resection, the time-course of the IL-6 decrease closely correlated with that of IL-1 and TNF- . Considering that in various inflammatory diseases IL-1, TNF- and IL-6 may act in a synergistic manner in inducing systemic manifestations, this case report raises new questions as to the nature of the systemic pathogenicity of cytokines in CD.


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CASTLEMAN's DISEASE HOMEPAGE is provided for educational purposes only. Consult your own physician regarding the applicability of any opinions or recommendations with respect to your symptoms or medical condition.

* CASTLEMAN's DISEASE HOMEPAGE is intended as a reference for health care professionals. The authors and editors have used sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication.

Medical knowledge changes rapidly. In view of the possibility of human error or changes in medical science, neither the authors, the editors, St. Vincent Hospital, nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from the use of such information. Readers are encouraged to confirm the information contained herein with other sources.