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Case Reports
. 2024 Aug 10;10(16):e36128.
doi: 10.1016/j.heliyon.2024.e36128. eCollection 2024 Aug 30.

TAFRO syndrome with abdominal pain as the first symptom accompanied by liver damage with hyperbilirubinemia: A case report

Yu Liu  1 , Xue Mei  1 , Zhiping Qian  1 , Wei Yuan  1 , Jiefei Wang  1 , Liujuan Ji  1 , Dong Zeng  2 , Yanli Zhou  3 , Yuyi Zhang  1
Affiliations
Case Reports

TAFRO syndrome with abdominal pain as the first symptom accompanied by liver damage with hyperbilirubinemia: A case report

Yu Liu et al. Heliyon. .

Abstract

Thrombocytopenia, anasarca, fever, reticulin fibrosis on bone marrow biopsy/renal dysfunction, and organomegaly (TAFRO) syndrome are infrequent conditions with diverse clinical and pathological characteristics related to multi-organ damage. There are few reports of TAFRO syndrome accompanied by liver damage with hyperbilirubinemia. We describe the case of a 61-year-old male who presented with sudden onset abdominal pain accompanied by liver damage with hyperbilirubinemia. His symptoms worsened, leading to fever, hepatic insufficiency, serous cavity effusions, thrombocytopenia, and acute renal failure. Fever and anasarca relapsed after steroid discontinuation. The patient was ultimately diagnosed with TAFRO syndrome by biopsies taken from the axillary lymph nodes. He was then administered steroids, which resolved his symptoms almost completely. Our case was notable for its atypical signs and total remission of TAFRO syndrome.

Keywords: Castleman's disease; Hyperbilirubinemia; Liver damage; TAFRO syndrome.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Chest CT image. (A) Minor pleural effusion with partial atelectasis of both lower lungs on July 3, 2021. (B) Minor pleural effusion with partial atelectasis of both lower lungs on July 17, 2021. (C) Massive pleural effusion with partial atelectasis of both lower lungs on July 30, 2021. (D) Massive pleural effusion with partial atelectasis of both lower lungs on August 7, 2021. (E) Massive pleural effusion with partial atelectasis of both lower lungs on August 30, 2021. (F) The pleural effusion significantly decreased compared to that before on October 3, 2021.
Fig. 2
Fig. 2
PET/CT. (A) Pleural effusion. (B) Pelvic effusion. (C) Anemia. (D) Enlarged lymph node in the armpit. (E) Enlarged lymph node in the pelvic wall. (F) Increased glucose metabolism in systemic bone marrow.
Fig. 3
Fig. 3
The clinical course and changes in clinical parameter levels. CRRT Continuous renal replacement therapy; IVIG Intravenous immunoglobulins; TB Total bilirubin; PLT Platelets; CR Creatinine; CRP C-reactive protein.
Fig. 4
Fig. 4
Pathological and immunohistochemical results of the lymph node biopsy (right armpit) for Castleman disease. A: HE 10X; B: CD3 (+) 20X; C: CD20 (+) 20X; D: Ki67 (+) 10X; E: CD138 (+) 20X; F: HHV8 (−) 20X.
See this image and copyright information in PMC

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