Nódulos eritematovioláceos y telangiectasias en muslos / Erythematous violaceous nodules and telangiectasis on the thighs

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[Two HHV8-related illnesses in a HIV-negative patient: Kaposi's sarcoma and multicentric Castleman's disease. Response to treatment with Rituximab and CHOP]. / Dos enfermedades relacionadas con el VHH-8 en un paciente VIH-negativo: sarcoma de Kaposi y enfermedad de Castleman multicéntrica. Respuesta a tratamiento con rituximab y CHOP.

Human herpes virus 8 (HHV8) was discovered in 1994 in the biopsy of a Kaposi's sarcoma in a patient with AIDS. Since then it has been identified in all variants of Kaposi's sarcoma and in another two rare disorders: multicentric Castleman's disease and primary body-cavity based lymphomas. The case discusses a 68 year old, HIV-negative male patient, presenting Kaposi's sarcoma for one year and being monitored by dermatology, who presented for weakness, anorexia and fever. On examination, he was found to have adenitis of the lymph nodes in his neck, underarm and groin. A biopsy on one of the swellings led to findings characteristic of multicentric plasma cell variant Castleman's disease. Blood tests for HHV8 and HIV were carried out, resulting positive and negative respectively (IgG anti-HHV8 positive, title 1/640, indirect immunofluorescence). PCR amplification showed HHV8 in peripheral blood. Patient received 8 cycles of CHOP and rituximab, leading to complete disappearance of the adenitis and general symptoms, with no worsening of his Kaposi's sarcoma. Patient remained in complete remission for 10 months after treatment. This paper discusses the case of a HIV-, HHV8+ patient, diagnosed with classic Kaposi's sarcoma, who developed multicentric plasma cell variant Castleman's disease. The coincidence of two or more HHV8-related illnesses in a HIV-negative patient has rarely been described in medical literature. Treatment with rituximab combined with CHOP chemotherapy was effective in this case, and no worsening of the patient's KS was observed.

Dos enfermedades relacionadas con el VHH-8 en un paciente VIH-negativo: sarcoma de Kaposi y enfermedad de Castleman multicéntrica. Respuesta a tratamiento con rituximab y CHOP / Two HHV8-related illnesses in a HIV-negative patient: Kaposi’s sarcoma and multicentric castleman’s disease. Response to treatment with Rituximab and CHOP

El virus herpes humano tipo 8 (VHH-8) se descubrió en 1994 a partir de la biopsia de un sarcoma de Kaposi en un paciente con sida. Desde entonces se ha identificado en todas las variantes de sarcoma de Kaposi y en otros dos raros procesos: la enfermedad de Castleman multicéntrica y el linfoma primario de cavidades. Se presenta el caso de un paciente varón de 68 años de edad VIH-negativo con sarcoma de Kaposi de un año de evolución en seguimiento por Dermatología que consultó por astenia, anorexia y fiebre. A la exploración se detectaron múltiples adenopatías laterocervicales, axilares e inguinales. En la biopsia de una de dichas adenopatías se apreciaron hallazgos característicos de la variante de células plasmáticas de la enfermedad de Castleman. Se realizaron serologías para el VHH-8 y el VIH que resultaron positiva y negativa respectivamente (IgG anti-VHH-8 positivo, título 1/640, inmunofluorescencia indirecta). Mediante reacción en cadena de la polimerasa se amplificó VHH-8 en sangre periférica. El paciente recibió tratamiento con 8 ciclos de CHOP y rituximab con una completa resolución de las adenopatías y la sintomatología general sin observarse empeoramiento de su sarcoma de Kaposi. El paciente permanece en remisión completa 10 meses después de finalizado el tratamiento. Se presenta el caso de un paciente VIH-negativo y VHH-8-positivo, diagnosticado de sarcoma de Kaposi clásico que desarrolló una enfermedad de Castleman multicéntrica variante de células plasmáticas. La coincidencia de dos o más enfermedades relacionadas con el VHH-8 en un paciente VIH-negativo es un hecho descrito raramente en la literatura. El tratamiento con rituximab combinado con quimioterapia tipo CHOP ha demostrado ser eficaz en este caso sin que haya podido observarse un agravamiento de su SK

Human herpes virus 8 (HHV8) was discovered in 1994 in the biopsy of a Kaposi's sarcoma in a patient with AIDS. Since then it has been identified in all variants of Kaposi's sarcoma and in another two rare disorders: multicentric Castleman's disease and primary body-cavity based lymphomas. The case discusses a 68 year old, HIV-negative male patient, presenting Kaposi's sarcoma for one year and being monitored by dermatology, who presented for weakness, anorexia and fever. On examination, he was found to have adenitis of the lymph nodes in his neck, underarm and groin. A biopsy on one of the swellings led to findings characteristic of multicentric plasma cell variant Castleman's disease. Blood tests for HHV8 and HIV were carried out, resulting positive and negative respectively (IgG anti-HHV8 positive, title 1/640, indirect immunofluorescence). PCR amplification showed HHV8 in peripheral blood. Patient received 8 cycles of CHOP and rituximab, leading to complete disappearance of the adenitis and general symptoms, with no worsening of his Kaposi's sarcoma. Patient remained in complete remission for 10 months after treatment. This paper discusses the case of a HIV­, HHV8+ patient, diagnosed with classic Kaposi's sarcoma, who developed multicentric plasma cell variant Castleman's disease. The coincidence of two or more HHV8-related illnesses in a HIV-negative patient has rarely been described in medical literature. Treatment with rituximab combined with CHOP chemotherapy was effective in this case, and no worsening of the patient's KS was observed

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