Ascites as a presenting sign of multicentric mixed-type Castleman disease variant of POEMS syndrome

摘要

The POEMS syndrome is a rare disorder characterised by polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin manifestations. Castleman disease can be present in POEMS patients. Castleman disease was named after Benjamin Castleman, who first described the specific histological findings of angiofollicular lymph node hyperplasia in a lymph node in 1954. 1 It is a group of heterogenous lymphoproliferative disorders which can be divided into three histological subtypes, namely hyaline vas- cular, plasma cell and mixed type. The concept of the Castleman disease variant of the POEMS syndrome was first described by Dispenzieri in 2014. 2 About 11–30% of the patients who were diagnosed with the POEMS syndrome have concomitant Castleman disease. 3 This case report aims to highlight the need for awareness among clinicians of this disorder and the importance of examining for other associated clinical features to avoid missing such a vital diag- nosis.