1.Multicentric Castleman disease with high IgG4 level: report of one case and review of literature
Yinli ZHANG ; Yaping XIE ; Pengfei SHI ; Shenxian QIAN
Journal of Leukemia & Lymphoma 2021;30(8):480-482
Objective:To investigate the diagnosis and treatment of multicentric Castleman disease (MCD).Methods:The diagnosis and treatment of one MCD patient admitted in Hangzhou First People's Hospital in July 2020 was analyzed and related literatures were reviewed.Results:The patient was a 55-year-old male with anemia, elevated globulin levels and IgG4 > 10 g/L, and enlarged lymph nodes. He was undiagnosed for 7 years. Lymph node biopsy revealed a large number of polyclonal plasma cell hyperplasia, and the ratio of IgG4/IgG was less than 0.40; the serum interleukin (IL)-6 was more than 6 000 pg/ml and then he was eventually diagnosed as MCD (plasma cell type). Rituximab + cyclophosphamide + dexamethasone (RCD) regimen was not effective, and it was changed to anti-IL-6 receptor antibody tocilizumab for 2 courses and then the patient obtained good results.Conclusions:Castleman disease is a rare disease with a poor prognosis. It has high heterogeneity and is easy to be misdiagnosed clinically. The diagnosis requires pathological examination. IL-6 is considered to be closely related to the onset of Castleman disease and has become an effective target for treatment.
2.Application of retrievable inferior vena cava filter placement in patients with deep venous thrombosis after fracture
Yinli XIE ; Dachun ZHANG ; Xingxing ZHI ; Rui ZHU ; Gaojie WENG ; Feng ZHOU ; Li YANG ; Qian XU ; Shi ZHOU
Chinese Journal of Interventional Imaging and Therapy 2018;15(2):69-72
Objective To explore the value of retrievable inferior vena cava (IVC) filter placement for prevention of perioperative pulmonary embolism (PE) in patients with lower extremity/pelvic fracture with deep vein thrombosis (DVT).Methods Clinical data of 1 891 lower extremity/pelvic fracture patients combined with DVT were retrospectively analyzed.Totally 411 patients with permanent filters were excluded,and the other patients were divided into filter group (n=843) and control group (n=637) according to whether receiving retrievable IVC filter placement or not.The incidence of perioperative symptomatic PE and mortality were compared between the two groups.Results In filter group,Optease nonpermanent filters were inserted in 218 patients,and the mean indwelling time was (14.3±3.6) days.Celcet filters were inserted in 625 patients,and the filters were successfully removed in 566 out of 578 patients who underwent filter removal surgery (97.92%,566/578),and the mean indwelling time was (15.8±4.1) days.The incidence of PE in filter group (0.12%[1/843]) was significantly lower than that in control group (1.57% [10/637],P<0.05).Among the patients who received chemical anticoagulant therapy,the incidence of PE in filter group and control group was 0.14 % (1/700) and 1.47%(9/612),respectively (P<0.05).Conclusion Retrievable IVC filter placement is a safe and effective method for preventing perioperative symptomatic and fatal PE in lower extremity/pelvic fracture patients with DVT.