Iron therapy resistant microcytic anaemia in a 13-year-old girl with Castleman disease

We describe the case history of a 13-year-old girl with chronic fatigue and prolonged microcytic anaemia. She received oral iron since the age of 11 but failed to respond to it. Laboratory studies revealed elevated C-reactive protein and hypergammaglobulinaemia. A large solitary mesenterial lymph node could be demonstrated by ultrasonography and CT. A diagnosis of Castleman disease was suspected and confirmed histologically. After surgical removal of the lymphoma the patient recovered completely. Conclusion Castleman disease should, be considered in cases of chronic fatigue, unexplained fever, microcytic anaemia and hypergammaglobulinaemia.