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Multicentric CD occurs at multiple lymph node stations and is associated with a proinflammatory response that leads to the development of the so\u2010called \u2018B symptoms\u2019. IL\u20106 seems to be a key cytokine involved in various manifestations such as lymphadenopathies, hepatosplenomegaly, and polyclonal hypergammaglobulinemia. Its levels correlate with the activity of the disease. Other consequences of MCD include increased fibrinogen levels leading to deep vein thrombosis and thromboembolic disorders, high hepcidin levels causing anaemia, elevated VEGF levels promoting angiogenesis and vascular permeability, which, along with hypoalbuminemia, induce oedema, ascites, pleural and pericardial effusions, and in severe cases, generalized anasarca. In extreme cases multiple organ failure can occur, often resulting in death. We propose the use of continuous renal replacement therapy (CRRT) in managing severe multicentric CD. Our arguments are based on the principles that CRRT is able to remove IL\u20106 from circulation thus attenuating the cytokine storm, can influence hepcidin levels, and reduction in oedema, and is often used in multiple organ failure to regain homeostasis control. Therefore, it could be used as a therapy or bridge therapy in severe cases. To sustain our hypothesis with evidence, we have gathered several studies from the literature confirming the successful removal of cytokines, especially IL\u20106 from circulation, which can be used as a starting point.<\/jats:p>","DOI":"10.1111\/jcmm.70026","type":"journal-article","created":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T05:38:42Z","timestamp":1725946722000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A hypothesis on treatment strategy of severe multicentric Castleman disease with continuous renal replacement therapy"],"prefix":"10.1111","volume":"28","author":[{"given":"C\u0103t\u0103lin","family":"Constantinescu","sequence":"first","affiliation":[{"name":"Department of Hematology Iuliu Hatieganu University of Medicine and Pharmacy  Cluj\u2010Napoca Romania"},{"name":"Department of Anesthesia and Intensive Care Iuliu Hatieganu University of Medicine and Pharmacy  Cluj\u2010Napoca 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