ELEVATED LEVELS OF TUMOR NECROSIS FACTOR-BETA, GAMMA-INTERFERON, AND IL-6 MESSENGER-RNA IN CASTLEMANS DISEASE

Castleman's disease (CD) is a lymphoproliferative disorder characteriz ed by enlarged hyperplastic lymph nodes. CD may be localized or multif ocal, and is often associated with signs and symptoms of generalized i nflammation. The systemic manifestations of CD have been previously at tributed to an overproduction of interleukin-6 (IL-6) by the tumor, al though there is evidence that IL-6 is not responsible for all of the s ymptoms. We describe a 9-year-old boy who developed Castleman's diseas e with systemic findings of hypochromic microcytic anemia, growth arre st, inflammation, and hyperimmunoglobulinemia. Following surgical rese ction, all of the symptoms and laboratory abnormalities resolved. Usin g reverse transcriptase polymerase chain reaction (RT-PCR) analysis of the tumor, we found elevated levels of IL-6 mRNA as expected, but als o elevated levels of tumor necrosis factor beta (TNF-beta) and gamma i nterferon (gamma-IFN) mRNA. Because these cytokines are mediators of i mmune regulation and inflammation, we propose that TNF-beta and gamma- IFN also play an important role in the pathophysiology of Castleman's disease. (C) 1996 Wiley-Liss, Inc.