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Systemic reactive amyloidosis associated with Castleman's disease: serial changes of the concentrations of acute phase serum amyloid A and interleukin 6 in serum.
  1. S Ikeda,
  2. H Chisuwa,
  3. S Kawasaki,
  4. J Ozawa,
  5. Y Hoshii,
  6. T Yokota,
  7. T Aoi
  1. Department of Medicine (Neurology), Shinshu University School of Medicine, Matsumoto, Japan. ikedasi@gipac.shinshu-u.ac.jp

    Abstract

    A case is reported of a 21 year old woman who suffered from Castleman's disease and systemic reactive amyloidosis. The serum concentrations of serum amyloid A (SAA) and interleukin 6 (IL-6) were extremely high and amyloid protein was immunohistochemically identified as AA. After surgical excision of a large retroperitoneal lymph node with the pathological findings of plasma cell type of Castleman's disease, both serum SAA and IL-6 declined, showing a similar pattern of reduction curves. All clinical symptoms and laboratory abnormalities greatly improved. The biochemical feature of Castleman's disease is abnormal production of IL-6 and this cytokine continuously may stimulate the synthesis of an amyloid precursor, SAA, causing systemic reactive (AA) amyloidosis. This pathogenetic theory is strongly supported by the present study.

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