Background: Idiopathic multicentric Castleman disease (iMCD) with TAFRO syndrome (characterized by thrombocytopenia, anasarca, fever, reticulin fibrosis/renal failure, organomegaly) is a recently described disorder. The diagnostic criteria for iMCD-TAFRO exclude patients with concomitant autoimmune diseases such as primary Sjögren’s syndrome. However, recent case reports suggest that although rare, these conditions may coexist. Case report: We report the case of a 37-year-old woman who presented with escalating systemic inflammation, cytopenias, anasarca, renal dysfunction and organomegaly, with lymph node biopsy suggestive of Castleman disease. Simultaneously, dense lacrimal gland hyperplasia with histopathology demonstrating lymphoepithelial sialadenitis and strongly positive anti-Ro52 antibodies led to a diagnosis of Sjögren’s syndrome. Given the rapid clinical deterioration and marked hyperinflammation, corticosteroid therapy and tocilizumab were implemented, leading to sustained remission. Conclusion: This case illustrates the diagnostic complexity posed by overlapping features of Idiopathic multicentric Castleman disease with TAFRO syndrome and Sjögren’s syndrome and reinforces the need to reconsider existing diagnostic criteria to ensure timely diagnosis and effective treatment. Epidemiologically, this is also a rare case of iMCD with TAFRO syndrome in a patient of African descent, contrasting with previous reports predominantly involving Asian individuals.
Radiology, particularly MRI, is critical for the diagnosis and timely management of spinal cord injury. In 20–25
Hepatic candidiasis is an uncommon but serious manifestation of invasive candidiasis (IC), most often associated with prolonged neutropenia in patients with hematological malignancies or in those who have undergone abdominal surgery. Diagnosis is challenging because of the low sensitivity of cultures, the limitations of serologic assays, and the frequent impracticality of tissue biopsy. Imaging, particularly CT and [18F]fluoro-2-deoxy-D-glucose positron emission tomography (18FDG-PET), plays a central role in identifying characteristic hepatosplenic lesions and in monitoring response to therapy. We present a case of hepatic candidiasis in a non-neutropenic patient presenting with persistent fever and multiple risk factors for IC, highlighting the diagnostic complexity and the importance of maintaining clinical suspicion beyond the classical neutropenic setting. Management requires prompt initiation of appropriate antifungal therapy, thorough evaluation for secondary foci of infection, and prolonged treatment until complete radiologic resolution is achieved to prevent relapse. Current recommendations for the management of deep-seated candidiasis remain largely based on retrospective data and expert opinion. Further research is needed to optimize diagnostic strategies, define the role of molecular diagnostic techniques, and identify patients with underlying genetic susceptibilities that may predispose them to invasive disease.
