Castleman disease of plasma cell type accompanied with bronchiolitis obliterans: a case report and review of the literature.

BACKGROUND: Castleman disease, also known as giant lymph node hyperplasia or angiofollicular lymph node hyperplasia, is a highly heterogeneous clinicopathological entity that belongs to the family lymphoproliferative disorders. Castleman disease accompanied by bronchiolitis obliterans is uncommon and often poses a great diagnostic challenge, which is easily confused with respiratory diseases and impeding the correct diagnosis and treatment. The main aim in presenting such rare case studies is to raise awareness and expand the diagnostic horizon of clinicians for appropriate management. CASE PRESENTATION: Here, we present a 69-year-old Chinese male who was admitted to our hospital due to right chest pain for 6 months, accompanied by cough, expectoration, and fever. Laboratory examinations revealed elevated immunoglobulin G and C-reactive protein, and normal serum levels of tumor markers and interleukin-6. Computed tomography scan detected diffuse bronchial wall thickening and patchy area of air trapping consistent with small airway disease. Pulmonary function test showed mild small airway obstructive ventilation dysfunction and moderate decrease in diffusion capacity. The pathological result of the right axillary lymph node was consistent with the plasma cell type Castleman disease. According to the above examinations, the patient was finally diagnosed with the plasma cell type Castleman disease accompanied with bronchiolitis obliterans. He received immunosuppressive medication after surgery and has been followed up for 11 months. Now the patient is currently in stable condition without recurrence. CONCLUSION: Castleman disease is a rare lymphoproliferative disorder with a variety of symptoms. At present, the treatment of Castleman disease accompanied with bronchiolitis obliterans is mostly based on experiences or previous case reports, and there is no standard treatment. Here, we report an uncommon case of Castleman disease accompanied with bronchiolitis obliterans in which the patient received immunosuppressive medication after surgery and has been followed up for 11 months without experiencing a recurrence, which may deepen and extend our understanding of this disease.

[Related factors for hypokalemia during acute episode of bronchial asthma: clinical analysis in 56 children].

OBJECTIVE: To investigate the incidence and clinical features of hypokalemia in children with acute episode of bronchial asthma. METHODS: The clinical records of 56 children with acute episode of bronchial asthma were reviewed and analyzed. RESULTS: Altogether 21 children with the complication of hypokalemia were identified from the 56 patients, with the incidence of the complication of 37.5%. Multiple factors were involved in the occurrence of hypokalemia during the acute episode of asthma and its treatment. Due to the unspecific manifestations, hypokalemia was easy to escape detection. CONCLUSION: Hypokalemia is highly likely in children with acute episodes of bronchial asthma, which poses potential danger for the patients. Potassium supplementation should be timely administered especially in children taking glucocorticosteroid and beta2 receptor agonist.