Severe anemia in a patient with idiopathic plasmacytic lymphadenopathy with polyclonal hyperimmunoglobulinemia associated with marked increase in the serum interleukin-6 level

Abstract

A 24-year-old female who was diagnosed as having idiopathic plasmacytic lymphadenopathy with polyclonal hyperimmunoglobulinemia (IPL) was admitted to our hospital because of general fatigue and fever. Physical examination revealed general lymphadenopathy but no hepatosplenomegaly. Hematological findings were: red cell count, 283×10⁴/μl; hemoglobin 4.9g/dl; hematocrit, 33%; platelet, 72.6×10⁴/μl; and white cell count, 11000/μl. Cervical lymph node rebiopsy revealed folliclar hyperplasia with germinal centers, prominent mature plasma cells proliferation between follicles and sinuses, and the findings were identical to those of IPL. After administration of prednisone, the hemoglobin level increased to 9.0g/dl accompanied by a reduction in lymphadenopathy. However, she did not achieve complete remission.
Before administration of prednisolone, Interleukin-6 activities in serum as well as the supernatants of lymph node cell and peripheral blood leukocyte cultures were 2.07, 21.3 and 6.6U/ml, respectively.