SYSTEMIC REACTIVE AMYLOIDOSIS ASSOCIATED WITH CASTLEMANS-DISEASE - SERIAL CHANGES OF THE CONCENTRATIONS OF ACUTE-PHASE SERUM AMYLOID-A AND INTERLEUKIN-6 IN SERUM

A case is reported of a 21 year old woman who suffered from Castleman' s disease and systemic reactive amyloidosis. The serum concentrations of serum amyloid A (SAA) and interleukin 6 (IL-6) were extremely high and amyloid protein was immunohistochemically identified as AA. After surgical excision of a large retroperitoneal lymph node with the patho logical findings of plasma cell type of Castleman's disease, both seru m SAA and IL-6 declined, showing a similar pattern of reduction curves . All clinical symptoms and laboratory abnormalities greatly improved. The biochemical feature of Castleman's disease is abnormal production of IL-6 and this cytokine continuously may stimulate the synthesis of an amyloid precursor, SAA, causing systemic reactive (AA) amyloidosis . This pathogenetic theory is strongly supported by the present study.