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Background <p>Human immunodeficiency virus-associated multicentric Castleman disease (HIV-MCD), a human herpesvirus 8 (HHV-8)-driven lymphoproliferative disorder affecting individuals infected by HIV, typically exhibits a relapsing-remitting course and can be fatal. The incidence of HIV-MCD is on the rise while that of Kaposi’s sarcoma, another HHV-8-associated disease, has been declining. Although an increasing number of studies have reported relapses of human herpesvirus-associated diseases and HIV-negative MCD following coronavirus disease 2019 (COVID-19), to the best of our knowledge there are no reports of HIV-MCD relapses.</p> Case presentation <p>A 75-year-old male patient with well-controlled HIV infection and pre-existing HIV-MCD experienced a relapse of HIV-MCD temporally associated with infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). He had a two-month history of persistent cough and received the diagnosis of mild COVID-19 based on positivity for SARS-CoV-2 on a polymerase chain reaction test and characteristic findings on computed tomography. Although the COVID-19 resolved with remdesivir therapy, the patient subsequently experienced a fever, generalized lymphadenopathy, splenomegaly, and thrombocytopenia. A lymph node biopsy confirmed a MCD relapse. The patient improved markedly after rituximab therapy.</p> Conclusion <p>This case is the first to report a temporal association between SARS-CoV-2 infection and HIV-MCD relapse. While a direct causal relationship cannot be established, the clinical course is consistent with the hypothesis that SARS-CoV-2 infection may have contributed to HHV-8 reactivation and MCD relapse. Further case series and mechanistic studies are needed to evaluate this potential association.</p>

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Relapse of HIV-associated multicentric Castleman disease temporally associated with acute coronavirus disease 2019: a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月20日

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  • Hiroki Yamamoto,
  • Kazuaki Fukushima,
  • Yota Aizawa,
  • Kohei Ukai,
  • Shota Kodaira,
  • Yukari Nishikawa,
  • Shuhei Tada,
  • Seowoong Jung,
  • Masaru Tanaka,
  • Taiichiro Kobayashi,
  • Ryoko Sekiya,
  • Keishiro Yajima,
  • Atsushi Ajisawa,
  • Ryu Gomikawa,
  • Tsunekazu Hishima,
  • Akifumi Imamura

摘要

Background

Human immunodeficiency virus-associated multicentric Castleman disease (HIV-MCD), a human herpesvirus 8 (HHV-8)-driven lymphoproliferative disorder affecting individuals infected by HIV, typically exhibits a relapsing-remitting course and can be fatal. The incidence of HIV-MCD is on the rise while that of Kaposi’s sarcoma, another HHV-8-associated disease, has been declining. Although an increasing number of studies have reported relapses of human herpesvirus-associated diseases and HIV-negative MCD following coronavirus disease 2019 (COVID-19), to the best of our knowledge there are no reports of HIV-MCD relapses.

Case presentation

A 75-year-old male patient with well-controlled HIV infection and pre-existing HIV-MCD experienced a relapse of HIV-MCD temporally associated with infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). He had a two-month history of persistent cough and received the diagnosis of mild COVID-19 based on positivity for SARS-CoV-2 on a polymerase chain reaction test and characteristic findings on computed tomography. Although the COVID-19 resolved with remdesivir therapy, the patient subsequently experienced a fever, generalized lymphadenopathy, splenomegaly, and thrombocytopenia. A lymph node biopsy confirmed a MCD relapse. The patient improved markedly after rituximab therapy.

Conclusion

This case is the first to report a temporal association between SARS-CoV-2 infection and HIV-MCD relapse. While a direct causal relationship cannot be established, the clinical course is consistent with the hypothesis that SARS-CoV-2 infection may have contributed to HHV-8 reactivation and MCD relapse. Further case series and mechanistic studies are needed to evaluate this potential association.