Seyede Tahereh Mohaddess - Assistant Professor, Division of hematology oncology, department of internal medicine,Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad ,Iran
Zahra Rezaei Borojerdi - Internal Medicine Resident, Division of Hematology Oncology, Department of Internal Medicine,Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad ,Iran
Abbas Shirdel - Hematology Oncology Fellowship, Division of Hematology Oncology, Department of Internal Medicine,Faculty of Medicine, Mashhad, Iran.
Mohammad Moeini Nodeh - Professor of Hematology and Oncology, Division of Hematology Oncology, Department of InternalMedicine, Faculty of Medicine, Mashhad, Iran

Introduction: TAFRO syndrome is new presentation of idiopathic multicentric Castlemandisease which is termed as thrombocytopenia, anasarca, fever, reticulinmyelofibrosis andorganomegaly. The exact pathophysiology of TAFRO syndrome is unclear and management ismostly based on case reports and expert opinion.Materials Methods: Histologic findings of bone marrow, skin, kidney and lymph node biopsyand other laboratory findings of the 37 year old male has been provided.Results: The patient was referred with fever, sweating, anorexia, abdominal distension andgeneralized edema which has been hospitalized multiple times. The patient also developed skinlesions dispersed in red nodules, which was reported as granuloid hemangioma Renal biopsyreported mesangioprolifrative glomerulonephritis and bone marrow specimen showed hypercellularmarrow with reticulin fibrosis. The lymph node biopsy was reported as Castleman disease.Conclusions: Different manifestations of TAFRO syndrome may overlap with other syndromes andcan be managed by corticosteroids, tocilizumab, retuximab, and bortezomib.