Abstract A man with multicentric angiofollicular lymph node hyperplasia and a polyclonal gammopathy developed a debilitating sensory-motor peripheral neuropathy that resolved with plasmapheresis and immunosuppressive therapy. Fourteen similar cases have been reported in the literature; however, to our knowledge, this is the first report of successful treatment with plasmapheresis. Severe peripheral neuropathy usually occurs in the setting of multicentric, plasma cell-type disease with hypergammaglobulinemia and is often responsive to immunosuppressive therapy. (Arch Intern Med. 1991;151:789-790) References 1. Castleman B, Iverson L, Menendez VP. Localized mediastinal lymph node hyperplasia resembling thymoma . Cancer. 1956;9:822-830.Crossref 2. Keller AR, Hochholzer L, Castleman B. Hyaline-vascular and plasma-cell types of giant lymph node hyperplasia of the mediastinum and other locations . Cancer. 1972;29:670-683.Crossref 3. Kessler E. Multicentric giant lymph node hyperplasia: a report of seven cases . Cancer. 1985;56:2446-2451.Crossref 4. Bartoli E, Massarelli G, Soggis G, Tanda F. Multicentric giant lymph node hyperplasia: a hyperimmune syndrome with a rapidly progressive course . Am J Clin Pathol. 1980;73:423-426. 5. Gaba AR, Stein RS, Sweet D, Variakojis D. Multicentric giant lymph node hyperplasia . Am J Clin Pathol. 1978;69:86-90. 6. Weisenburger DD, Nathwani BN, Winberg CD, Rappaport H. Multicentric angiofollicular lymph node hyperplasia: a clinicopathologic study of 16 cases . Hum Pathol. 1985;16:162-172.Crossref 7. Frizzera G, Peterson BA, Bayrd E, Goldman A. A systemic lymphoproliferative disorder with morphologic features of Castleman's disease: clinical findings and clinicopathologic correlations in 15 patients . J Clin Oncol. 1985;3:1202-1216. 8. Hineman VL, Phyliky RL, Banks PM. Angiofollicular lymph node hyperplasia and peripheral neuropathy: association with monoclonal gammopathy . Mayo Clin Proc. 1982;57:379-382. 9. Mallory A, Spink WW. Angiomatous lymphoid hamartoma in the retroperitoneum: presenting with neurologic signs in the legs . Ann Intern Med. 1968;69:305-308.Crossref 10. Yu GSM, Carson JW. Giant lymph-node hyperplasia, plasma-cell type, of the mediastinum, with peripheral neuropathy . Am J Clin Pathol. 1976;66:46-53. 11. Case Records of the Massachusetts General Hospital . N Engl J Med. 1984;311:388-398. Case 32-1984.Crossref 12. Case Records of the Massachusetts General Hospital . N Engl J Med. 1987;316:606-618. Case 10-1987.Crossref 13. Donaghy M, Hall P, Gawler J, et al. Peripheral neuropathy associated with Castleman's disease . J Neurol Sci. 1989;89:253-267.Crossref 14. Gottfried MR, Northals JK, Prockop ID. Peripheral neuropathy associated with angiofollicular lymph node hyperplasia: report of a case with immunostaining of sural nerve biopsy . J Neuropathol Exp Neurol. 1986;45:347.Crossref 15. Black DA, Forgacs I, Davies DR, Thompson RPH. Pseudotumor cerebri in a patient with Castleman's disease . Postgrad Med J. 1988;64:217-219.Crossref 16. Kelly JJ, Kyle RA, Latov N, eds. Polyneuropathies Associated With Plasma Cell Dyscrasias . Hague, the Netherlands: Martinus Nijhoff Publishing; 1987:73-76, 91-103. 17. Mendel JR, Sahenk Z, Whitaker JN, et al. Polyneuropathy and IgM monoclonal gammopathy: studies on the pathogenetic role of anti-myelin-associated glycoprotein antibody . Ann Neurol. 1985;17:243-254.Crossref 18. Hall PA, Donaghy M, Cotter FE, Stansfeld AG, Levison DA. An immunohistological and genotypic study of the plasma cell form of Castleman's disease . Histopathology. 1989;14:333-346.Crossref
Archives of Internal Medicine – American Medical Association
Published: Apr 1, 1991
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