European Journal of Pediatrics

Abstract Volume 155 Issue 12 (1996) pp 1015-1017

Iron therapy resistant microcytic anaemia in a 13-year-old girl with Castleman disease

T. A. De Heer-Groen (1), A. B. J. Prakken (3), N. M. A. Bax (3), P. J. van Dijken (2)

(1) Hospital Centre Apeldoorn, The Netherlands
(2) Riyadh Armed Forces Hospital, Kingdom of Saudi Arabia
(3) University Hospital for Children and Youth, `Het Wilhelmina Kinderziekenhuis\', P. O. BOX 18009, 3501 CA Utrecht, The Netherlands Tel.: 31(0)30-2320625 Fax: 31(0)30-2320712

Received: 10 February 1996 Accepted: 23 March 1996

Abstract We describe the case history of a 13-year-old girl with chronic fatigue and prolonged microcytic anaemia. She received oral iron since the age of 11 but failed to respond to it. Laboratory studies revealed elevated C-reactive protein and hypergammaglobulinaemia. A large solitary mesenterial lymph node could be demonstrated by ultrasonography and CT. A diagnosis of Castleman disease was suspected and confirmed histologically. After surgical removal of the lymphoma the patient recovered completely.

Conclusion Castleman disease should be considered in cases of chronic fatigue, unexplained fever, microcytic anaemia and hypergammaglobulinaemia.

Key words Castleman disease · Microcytic anaemia · Childhood