Multicentric angiofollicular lymph node hyperplasia with peripheral neuropathy, pseudotumor cerebri, IgA dysproteinemia, and thrombocytosis in women

Article Abstract:

Angiofollicular lymph node hyperplasia is a disease of the lymph nodes, characterized by excessive proliferation or overgrowth of cells and blood vessels within the follicles of the lymph node. The lymphatic follicles consist of a collection of lymphocytes, a type of immune cell, and lymphoblasts, cells which give rise to lymphocytes. Multicentric lymphadenopathy, a lymph node disease similar to angiofollicular lymph node hyperplasia, has recently been associated with clinical abnormalities consistent with POEMS syndrome. This syndrome is characterized by polyneuropathy, disease affecting several nerves; organomegaly, the enlargement of the internal organs; endocrinopathy, disease of the secretory glands; monoclonal gammopathy, an increase in immunoglobulins or immune proteins; and skin changes. The multicentric form is considered to be a variant or subclassification of angiofollicular lymph node hyperplasia, with similar structural changes, but a more aggressive clinical course. Four cases are described of women with multicentric angiofollicular lymph node hyperplasia associated with dysproteinemia or protein in the blood; peripheral neuropathy or disease of the peripheral nerves; pseudotumor cerebri, or high blood pressure within the brain cavity; and thrombocytosis, an increase in the number of platelets, cells involved in blood clotting. The clinical findings and similarities between these four cases are described. It is suggested that this clinical syndrome may represent a distinct form of multicentric angiofollicular lymph node hyperplasia. Patients with this syndrome should be carefully monitored for the development of cancer and complications involving several body systems. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Lymphatic diseases

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The clinical behavior of localized and multicentric Castleman disease

Article Abstract:

Localized Castleman disease can often be successfully cured but multicentric disease is more aggressive and less likely to be cured. Castleman disease is a disorder characterized by a proliferation of lymph tissue. If the disease is limited to a specific area, or localized, it can be successfully treated with surgery. If it has spread to other parts of the body, it is called multicentric. A review of 15 patients with this disease found that 7 with localized disease were cured with surgery. Of the 8 patients with multicentric disease, 3 who received combination chemotherapy were cured, 2 treated with surgery died and 2 treated with prednisone have not been cured.

Prognosis, Lymphoproliferative disorders, Immunoproliferative disorders

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The HERS Trial Results: Paradigms Lost?

Article Abstract:

The use of estrogen/progestin therapy in postmenopausal women does not have any overall effect on coronary heart disease in a 4.1 year study, but there was a 50% increase in coronary disorders the first year followed by fewer problems than usual after two years of the therapy. This was the result of the Heart and Estrogen/progestin Replacement Study (HERS). Understanding the cause of this pattern is crucial. One possible explanation is that the therapy has no effect at all, and this is a chance result. Another explanation is that this increasing-decreasing risk pattern is due opposing effects of the therapy.

Risk factors, Physiological aspects, Coronary heart disease, Hormone therapy

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