TAFRO syndrome is a systemic inflammatory disorder of unknown etiology, and its diagnosis requires the exclusion of autoimmune diseases.A 42-year-old Japanese woman presented with TAFRO syndrome-like manifestations, but had undiagnosed limited-cutaneous systemic sclerosis preventing a definitive diagnosis of TAFRO syndrome.However, her clinical course and pathological findings, including renal glomerular microangiopathy, were consistent with TAFRO syndrome.
We performed a systematic review of the literature to evaluate how autoimmunity affects the clinical characteristics of TAFRO syndrome/idiopathic multicentric Castleman disease (iMCD)-TAFRO.We reviewed 95 reported cases of TAFRO syndrome/iMCD-TAFRO and found that at rs808br least 41 (43.6%) had various autoantibodies.
In particular, the positive rates of anti-nuclear steely dan gaucho t-shirt antibody, anti-SS-A antibody, anti-SS-B antibody, PA-IgG, and direct Coombs test were high.Furthermore, we identified 14 cases of autoimmune diseases with TAFRO syndrome-like manifestations.We compared the clinical characteristics of these 14 with those of the autoantibody-positive and -negative cases among the 95 cases of TAFRO syndrome/iMCD-TAFRO.
Apart from sex ratio, we found no significant difference in clinical presentation, treatment, or outcome among the groups.In conclusion, TAFRO syndrome/iMCD-TAFRO often accompanies autoantibodies and shares many clinical characteristics with other autoimmune diseases.Clinicians should be aware that some autoimmune diseases mimic TAFRO syndrome/iMCD-TAFRO.