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Biomedical subjects

Shinn-Jang Hwang

Publications and source records attributed to Shinn-Jang Hwang.

At least 19 recordsLinked to original sources
PubMed2006

Nutritional status and clinical outcomes among institutionalized elderly Chinese in Taiwan.

Nutrition is an important issue in institutional care, and is related to clinical outcomes in many aspects. Although Taiwan is marching to an aged society, related studies were lacking. Elderly residents in two long-term care facilities (LTCF) were enrolled for study. Nutritional status including anthropometric measurements and laboratory examinations was assessed every 3 months for 12 months. Age, sex-matched community-dwelling elderly participating in the annual health check-up was randomly selected as the control subjects. In total, 66 subjects in LTCF and 870 age, sex-matched community-dwelling elderly were enrolled. Body mass index, serum levels of albumin, and total cholesterol were significantly poorer in LTCF residents than the community-dwelling elderly. Triceps skinfold thickness, hemoglobin, serum albumin, and total cholesterol were progressively deteriorated among the institutionalized elderly during the 6-month follow-up. Thirteen subjects of the study group had been hospitalized during the follow-up. Body mass index, triceps skinfold thickness, mid-arm circumference, serum albumin at screening were significantly poorer and unintentional weight loss within 6 months was significantly greater in subjects who had been hospitalized. By using multivariate logistic regression model, only weight loss >5% within 6-month follow-up was the significant independent predictive factors to hospitalization. In conclusion, nutritional status of institutionalized elderly Chinese was significantly poorer than the community-dwelling elderly. Nutritional markers were progressively deteriorated in LTCF residents during the follow-up period. Unintentional weight loss >5% within 6 months was the only significantly independent predictive factor for hospitalization among the institutionalized elderly Chinese.

Aged↗
PubMed2006

Hospice utilization during the SARS outbreak in Taiwan.

BACKGROUND: The severe acute respiratory syndrome (SARS) epidemic threw the world into turmoil during the first half of 2003. Many subsequent papers have addressed its impact on health service utilization, but few have considered palliative (hospice) care. The aim of the present study was to describe changes in hospice inpatient utilization during and after the SARS epidemic in 2003 in Taiwan. METHODS: The data sources were the complete datasets of inpatient admissions during 2002 and 2003 from the National Health Insurance Research Database. Before-and-after comparisons of daily and monthly utilizations were made. Hospice analyses were limited to those wards that offered inpatient services throughout these two years. The comparisons were extended to total hospital bed utilization and to patients who were still admitted to hospice wards during the peak period of the SARS epidemic. RESULTS: Only 15 hospice wards operated throughout the whole of 2002 and 2003. In 2003, hospice utilization began to decrease in the middle of April, reached a minimum on 25 May, and gradually recovered to the level of the previous November. Hospices showed a more marked reduction in utilization than all hospital beds (e.g. -52.5% vs. -19.9% in May 2003) and a slower recovery with a three-month lag. In total, 566 patients were admitted to hospice wards in May/June 2003, in contrast to 818 in May/June 2002. Gender, age and diagnosis distributions did not differ. CONCLUSION: Hospice inpatient utilization in Taiwan was indeed more sensitive to the emerging epidemic than general inpatient utilization. A well-balanced network with seamless continuity of care should be ensured.

Aged↗
PubMed2006

Patterns of ambulatory care utilization in Taiwan.

BACKGROUND: We used the insurance claims of a representative cohort to quantify the patterns of ambulatory care visits, especially the doctor-shopping phenomenon, in Taiwan. METHODS: The ambulatory visit files of the 200,000-person cohort datasets from the National Health Insurance Research Database in 2002 were analyzed. Only a visit with physician consultation would be considered. We computed the visit patterns both by visit count and by patient count. RESULTS: In 2002, there were 182,474 eligible people with 2,443,003 physician consultations. During the year, 87.4% of the cohort had visited physician clinics and 57.5% had visited hospital-based outpatient or emergency departments. On average, a person had 13.4 physician consultations and consulted 3.4 specialties, 5.2 physicians, and 3.9 healthcare facilities in a year. In 2002, 17.3% of the cohort had ever visited different healthcare facilities on the same day; 23.5% had ever visited physicians of the same specialty at different healthcare facilities within 7 days and the percentage of second visits was 3.8% of all visits. Besides, 7.6% of the cohort had visited two or more specialties at the same facility on the same day, and such visits make up 2.5% of all visits. CONCLUSION: The people in Taiwan did visit the physicians and outpatient departments frequently. Many patients not only consulted several physicians of different specialties and at different healthcare facilities during the year, but also switched the physicians and facilities quickly. An effective referral system with efficient data exchange between facilities might be the solution.

Adult↗
PubMed2006

Asymptomatic bacteriuria among the institutionalized elderly.

BACKGROUND: Urinary tract infections (UTI) are the most common type of infection among residents of long-term care facilities (LTCFs). The presence of asymptomatic bacteriuria among LTCF residents brings challenges to onsite health professionals. The aim of this study was to explore the prevalence and related factors of aymptomatic bacteriuria among the institutionalized elderly in Taiwan. METHODS: In 2002, residents of 2 private LTCFs participated in this study. History taking, anthropometric measurements, and urine and blood samplings were performed by experienced research staff. Urine bacterial culture was performed by a standard procedure; subjects with symptoms indicating UTI were excluded. Repeated urine bacterial culture was performed 1 week after screening tests. Bacteriuria was defined as 1 or more organisms isolated from 2 consecutive urine specimens (> or =10(5) CFU [colony-forming units]/mL). Asymptomatic bacteriuria was defined as identical microorganisms isolated from 2 urine culture specimens taken at 1-week intervals from a subject who was free of UTI symptoms. The presence of asymptomatic bacteriuria and its related factors, such as age, sex, nutritional status, and long-term placement of urinary catheter, were evaluated. RESULTS: A total of 64 institutionalized Chinese elderly (mean age, 76.2 +/- 9.1 years; male:female, 48:16) were collected. The prevalence of asymptomatic bacteriuria was 57.8% (37/64), and was not associated with age, sex, functional status, long-term foley catheter, or previous UTI history. The most commonly isolated organisms were Escherichia coli (29.7%), Klebsiella pneumoniae (21.6%), Providentia stuartii (16.2%), and Pseudomonas aeruginosa (13.5%). Moreover, 21.6% of them showed multiple organisms. Nutritional status (body mass index, serum levels of albumin, total cholesterol, total lymphocyte count, and hemoglobin) was similar between subjects with or without bacteriuria (p > 0.05). CONCLUSION: Asymptomatic bacteriuria is common among Chinese residents in LTCFs. Escherichia coil was the most commonly cultured bacterium. Presence of asymptomatic bacteriuria was not associated with age, sex, functional status, catheter indwelling, previous history of UTI, or nutritional status of residents in LTCFs.

Aged↗
PubMed2006

Association of insulin resistance and hematologic parameters: study of a middle-aged and elderly Chinese population in Taiwan.

BACKGROUND: Chronic inflammation is a common feature related to changes in hematologic parameters in insulin resistance. The aims of this study were to explore the relationship between hematologic parameters and insulin resistance, and to establish a gerontologic profile for following studies. METHODS: Residents aged over 40 years in 3 major townships in I-Lan County participating in the Adult Health Examination were invited for the study. Diagnosis of diabetes mellitus (DM) was done according to American Diabetes Association criteria. Insulin resistance was measured by homeostasis model assessment (HOMA-IR), and subjects with the highest tertile of HOMA-IR were defined as being insulin resistant. Hematologic parameters including white blood cell (WBC) count, red blood cell (RBC) count, hemoglobin, and platelet count were measured for comparisons. RESULTS: A total of 857 subjects (mean age, 64.6 +/- 11.2 years; male/female, 373/484) participated in this study. Their mean body mass index (BMI) was 24.5 +/- 3.7 kg/m2, and 42.4% of them were obese and 21.8% were overweight. The overall prevalence of DM was 15.4% (7.7% were previously diagnosed and 7.7% were newly diagnosed), and impaired fasting glucose was 7.2%. Trend analyses confirmed that age, BMI, HOMA-IR, WBC and platelet counts were significantly increased as glycemic metabolism exacerbated (p = 0.007, < 0.001, < 0.001, < 0.001 and 0.025, respectively). Compared with insulin-sensitive subjects, insulin-resistant subjects were more likely to be females (70.2% vs. 49.7%, p < 0.001), and had significantly higher BMI (26.2 +/- 3.9 kg/m2 vs. 23.7 +/- 3.3 kg/m2, p < 0.001), HOMA-IR (3.6 +/- 3.5 vs. 0.7 +/- 0.3, p < 0.001), WBC count (6686.9 +/- 1889.2/mm3 vs. 5942.9 +/- 1740.4/mm3, p < 0.001), and platelet count (243.5 +/- 70.9 x 10(3)/mm3 vs. 231.0 +/- 62.2 x 10(3)/mm3, p = 0.011), but not age (64.5 +/- 11.0 years vs. 64.6 +/- 11.4 years, p = 0.93) or RBC count (4.6 +/- 0.6 M/mm3 vs. 4.6 +/- 0.6 M/mm3, p = 0.76). When age and sex were controlled, HOMA-IR significantly correlated with WBC count (gamma = 0.23, p < 0.001) and platelet count (gamma = 0.09, p = 0.007). However, by multiple logistic regression, female gender, overweight and obesity, and elevated WBC count were all found to be independent risk factors of insulin resistance, but age, RBC and platelet counts were not. CONCLUSION: Elevated WBC count but not RBC count was significantly associated with insulin resistance and glycemic metabolism. The relationship between platelet count and insulin resistance deserves further investigations.

Aged↗
PubMed2006

Health care utilization of home care patients at an academic medical center in Taiwan.

BACKGROUND: Previous surveys of home care patients in Taiwan have primarily concentrated on patients' status and needs. The aim of this study was to review the actual health care utilization of home care patients during the course of 1 year. METHODS: Home care patients at an academic medical center in Taiwan were selected and their insurance claims data at this hospital in 2001 were analyzed. Analyses included the patients' patterns and diagnoses of visits and admissions, and their drug utilization. For diagnoses made at outpatient departments, the grouping system from the National Hospital Ambulatory Medical Care Survey in the United States was used. The Anatomical Therapeutic Chemical Classification system was applied to drug grouping. RESULTS: The home care agency of the hospital cared for 165 patients (66 women, 99 men) in 2001. In total, these 165 patients received 1,358 home visits, 2,751 outpatient visits, and 108 inpatient admissions. While the most frequent diagnoses for all visits were cerebrovascular disease, hypertension, diabetes mellitus, chronic and unspecified bronchitis, psychoses, and other disorders of the central nervous system, the most frequent diagnoses at discharge from the hospital were urinary tract infection and pneumonia. In all visits, 12,282 items of drugs were prescribed in 2,337 prescriptions. On average, each prescription contained 5.3 +/- 2.8 items of drugs. The most frequently prescribed drugs were antacids, expectorants, laxatives, selective calcium channel blockers, and antithrombotic agents. CONCLUSION: The home care agency of the hospital should pay more attention to provision of comprehensive care and review of drug prescribing.

Academic Medical Centers↗
PubMed2006

Demographics and patterns of acupuncture use in the Chinese population: the Taiwan experience.

BACKGROUND: The use of complementary and alternative medicine (CAM), including Traditional Chinese Medicine (TCM) and acupuncture, has substantially increased in western countries in the past decade. However, informative data concerning large-scale investigations of acupuncture used in the Chinese society remain rare so far. DESIGN AND OUTCOME MEASURE: The complete datasets of acupuncture outpatient reimbursement claims from 1996 to 2002 were supplied by the National Health Insurance Research Database, Taiwan, and the usage frequencies and characteristics of the acupuncture users, as well as the disease categories that were treated by acupuncture in Taiwan were analyzed. RESULTS: At the end of 2002, among the 21,869,478 total valid beneficiaries of National Health Insurance (NHI), 1,362,351 subjects (6.2%) used acupuncture during this year, but 4,948,464 subjects (22.6%) had used it for the whole 7-year period since 1996. A mean increment of 1,191,164 (53.6%) new users had been involved yearly. Among all those acupuncture users, a female predominance was observed (female:male = 1.12:1), and the age distribution displayed a peak at around the 40s, followed by the 30s and 50s. Private TCM clinics provided more acupuncture usage (82.0%) than did private TCM hospitals (13.7%). The disease categories treated mostly by acupuncture were diseases of the musculoskeletal system (46.2%); injury (41.8%); diseases of the nervous system (3.5%); and symptoms, signs, and ill-defined conditions (2.7%). CONCLUSIONS: Twenty-three percent (23%) of people in Taiwan had used acupuncture during this 7-year period. Musculoskeletoal and neurologic disorders were two major categories commonly treated with acupuncture.

Acupuncture Therapy↗
PubMed2006

The different immunomodulation of indirect moxibustion on normal subjects and patients with systemic lupus erythematosus.

Moxibustion has been thought to enhance immunity in healthy condition, but suppress abnormal immune response in disease status. We collected 12 patients with systemic lupus erythematosus (SLE) and 12 healthy women who received indirect moxibustion on acupuncture points ST-36 (Zusanli) and SP-6 (Sanyinjiao) 20 minutes per day for 1 week. During the course, there were no changes of their regular medications or intercurrent infections in normal subjects and SLE patients. We found that indirect moxibustion for 1 week could elevate CD3+ and CD4+ T-lymphocytes in normal subjects, whereas decrease relative proportions of CD8+ T-lymphocytes in patients with SLE. This result confirms that indirect moxibustion has different immunomodulation in normal condition and autoimmune status. However, whether immunomodulatory effects of indirect moxibustion are beneficial for normal subjects and patients with SLE require further confirmation.

Adult↗
PubMed2006

Effects of electro-acupuncture on serum cytokine level and peripheral blood lymphocyte subpopulation at immune-related and non-immune-related points.

The purpose of this study is to find out whether electro-acupuncture (EA) at acupoint LI.10 (Shou San Li), which has not been considered as an immune-related point, has a similar immune effect as LI.11 (Qu Chi). We recruited 24 male medical students for this study. They were randomized into 3 groups: control group (without acupuncture during the study period, n=7), LI.11 group (EA at LI.11 acupoint, n=9) and LI.10 group (EA at LI.10 acupoint, n=8). At the first day (Day 1), blood was taken from all subjects. But EA was applied to the LI.11 and LI.10 group immediately after blood drawing. On the second day (Day 2), EA was applied to the LI.11 and LI.10 group right before blood sample was taken. At the fourteenth day (Day 14), blood sample was taken for all subjects. The parameters of EA were 4 sec alternating intervals of 2 and 15 HZ (dense and disperse) and 1-4 mA in intensity for 20 min. The waveform of electrical impulse was bi-directional and pulse duration of 50 microsec. Blood analysis included flow cytometry for lymphocyte subpopulations (CD4 and CD8 positive cell percentages) and ELISA for cytokines [soluble interleukin-2 receptor (sIL-2R), interferon (INF)-gamma, IL-4, IL-6, and IL-10]. We treated the result of Day 1 as a baseline value. After EA at acupoint LI.11, CD4 positive cell percentage at Day 14 showed significant decrease compared to the baseline value (p = 0.011). CD8 positive cell percentage also decreased at Day 2 (p = 0.038) and Day 14 (p= 0.015). In the LI.10 group, CD4 and CD8 levels at Day 14 were decreased significantly (CD4, p = 0.012; CD8, p = 0.017). Results of all cytokines concentrations of the LI.11 group did not change during the study period. But the serum level of sIL-2R of the LI.10 group at Day 14 was higher than the baseline value (p = 0.018). The serum level of IL-6 at Day 14 was lower than the baseline value (p = 0.028). The serum level of IL-4 at Day 2 was lower than the baseline value (p = 0.025). Our results showed that LI.11 and LI.10 acupoints cause a similar decrease of CD4 and CD8 populations. Increase of serum sIL-2R and decrease of serum IL-4 and IL-6 were observed when EA was applied at LI.10 acupoint, but not at LI.11 acupoint. In this study, we can understand that EA may modulate the peripheral blood lymphocyte subpopulations and serum cytokine levels of the immune system.

Adult↗
PubMed2005

Health-related quality of life and impact of antiviral treatment in Chinese patients with chronic hepatitis C in Taiwan.

AIM: To evaluate health-related quality of life (HRQOL) in Chinese patients with chronic hepatitis C (CH-C), and the impact of antiviral treatment. METHODS: Short Form 36 (SF-36) Health-related Quality of Life Questionnaires to interview CH-C patients, and age- and sex-matched control subjects at outpatient clinics of a medical center in Taiwan were used. Data were transformed to scores for comparisons of eight major SF-36 domains. We also enrolled consecutive CH-C patients who completed one course of antiviral treatment (interferon alpha with ribavirin), and measured the HRQOL before, at the 12th wk of treatment, at the end of treatment, and at mo 6, after stopping the treatment to evaluate the impact of antiviral treatment. RESULTS: A total of 371 outpatients were enrolled, including 182 with CH-C and 189 age- and sex-matched subjects without CH-C. CH-C subjects had obviously lower educational status (P<0.01). Mean scores of domains in general health, physical functioning, role-physical, role-emotional, vitality, and mental health of the SF-36 were significantly lower in subjects with CH-C than those without CH-C (P<0.05). In an analysis of 47 CH-C patients who received and completed the whole course of antiviral treatment, mean scores of all domains were significantly lower at wk 12 of treatment compared to baseline. The scores returned to pretreatment values by the end of treatment, but were significantly increased at mo 6 after stopping the treatment. Among the 47 CH-C patients, 21 had sustained responses and 26 had non-sustained responses to antiviral treatment. Compared to pretreatment values, subjects with sustained responses had significantly lower social functioning scores at wk 12 of treatment, and scores for all SF-36 domains returned to pretreatment values, and increased significantly at mo 6 after stopping the treatment. For non-sustained virological responders, scores of all SF-36 domains significantly decreased at wk 12 of treatment, and did not increase significantly by the end of treatment, or at mo 6 after stopping the treatment when compared to the pretreatment values. CONCLUSION: HRQOL in CH-C patients is significantly impaired in most SF-36 domains. Antiviral treatment impaired HRQOL of CH-C subjects during early treatment, mainly in non-sustained virological responders, and improved at mo 6 after stopping the treatment, mainly in sustained virological responders.

Adult↗
PubMed2005

Metabolic characteristics and insulin resistance of impaired fasting glucose among the middle-aged and elderly Taiwanese.

Impaired fasting glucose (IFG), a newly defined category of glycemic metabolism, has gained extensive attentions after the introduction of the diagnostic criteria of diabetes mellitus (DM) by the American Diabetes Association. To explore the metabolic characteristics of IFG, we conducted this prospective community-based study among people aged more than 40 years residing in three major townships of I-Lan, an agricultural county in Taiwan. People attending the annual health examinations in community health stations were recruited for study. Experienced research staff recorded the past medical history, performed comprehensive physical examinations, and drew blood for further laboratory tests for each subject. Insulin resistance was evaluated by homeostasis model assessment (HOMA), and the renal hemodynamics was evaluated by estimated glomerular filtration rate (GFR). In total, 824 subjects (mean age=64.4+/-11.3 years, M:F=366:458) participated this study, the overall prevalence of DM was 15.3% (8.7% previously undiagnosed), and the prevalence of IFG was 7.2%. Lipid profiles including serum levels of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride of subjects with IFG were basically indistinguishable from subjects with DM. Insulin resistance was significantly associated with the progression of glycemic metabolism (HOMA-IR of subjects with normal fasting glucose, IFG, and DM were 1.12+/-1.24, 1.88+/-1.64, 4.47+/-5.12, P<0.001). However, the prevalence of metabolic syndrome was similar among subjects of IFG and DM (86.4 versus 85.6%). The prevalence of overt proteinuria was significantly increased as the glycemic metabolism progressed. The mean GFR was slightly increased in subjects with IFG, which may represent hyperfiltration in this category. In conclusion, metabolic characteristics of IFG were complex. Lipid profile and prevalence of metabolic syndrome of IFG were indistinguishable from DM, but renal hemodynamics and prevalence of overt proteinuria were intermediate between NFG and DM. To prevent or delay the onset of type 2 DM, aggressive lifestyle modifications should be engaged in our clinical practice for subjects with IFG.

Adult↗
PubMed2005

Convulsive syncope: an unusual complication of acupuncture treatment in older patients.

Vasovagal syncope is an uncommon complication during acupuncture. However, convulsive syncope during acupuncture treatment in older individuals is seldom reported in the literature. Two older patients who experienced convulsive syncope during acupuncture treatment at Taipei Veterans Hospital, Taipei, Taiwan, from January 2000 to December 2002 are reported. These cases are instructive to acupuncturists. Although acupuncture treatment is generally safe in most situations, one needs to be cautious in delivering acupuncture to older and debilitated individuals.

Acupuncture Therapy↗
PubMed2004

Thrombocytosis: a paraneoplastic syndrome in patients with hepatocellular carcinoma.

AIM: Hepatocellular carcinoma (HCC) patients manifest a variety of paraneoplastic syndromes. Thrombocytosis was reported in children with hepatoblastoma. The aims of this study were to evaluate the prevalence and clinical significance of thrombocytosis in HCC patients and its relationships with serum thrombopoietin (TPO). METHODS: We retrospectively reviewed clinical, biochemical and image data of 1,154 HCC patients. In addition, we measured platelet count and serum TPO in HCC patients with and without thrombocytosis, in patients with cirrhosis, chronic hepatitis and healthy subjects in a cross-sectional study. RESULTS: Thirty-one (2.7%) of 1,154 HCC patients had thrombocytosis (platelet count > or = 400 K/mm3). HCC patients with thrombocytosis were significantly younger, had a higher serum alpha-fetoprotein, higher rate of main portal vein thrombosis, larger tumor volume, shorter survival, and were less likely to receive therapy than HCC patients without thrombocytosis. Multivariate logistic regression analyses showed that tumor volumes > or = 30% and serum alpha-fetoprotein > or = 140,000 ng/mL could significantly predict thrombocytosis. HCC patients with thrombocytosis had a significantly higher mean serum TPO than those without, as well as patients with cirrhosis, chronic hepatitis and healthy subjects. Platelet count and serum TPO dropped significantly after tumor resection in HCC patients with thrombocytosis and re-elevated after tumor recurred. Furthermore, the expression of TPO mRNA was found to be more in tumor tissues than in non-tumor tissues of liver in an HCC patient with thrombocytosis. CONCLUSION: Thrombocytosis is a paraneoplastic syndrome of HCC patients due to the overproduction of TPO by HCC. It is frequently associated with a large tumor volume and high serum alpha-fetoprotein.

Adolescent↗
PubMed2004

Hospice palliative care for patients with hepatocellular carcinoma in Taiwan.

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer death in Taiwan. In order to delineate the unique demographic features and clinical profile of terminal HCC, we conducted a retrospective study in a hospital-based hospice in Taiwan. Of a total of 991 terminally ill cancer patients (654 men and 337 women, mean age 66.1 years) admitted to our palliative care unit during a three-year period, 110 patients (11.1%) were diagnosed as having HCC (93 men and 17 women, mean age 60.5 years). The most common metastatic sites were bone and lung. Eighty-five HCC patients (77.3%) also had associated liver cirrhosis. The most common symptoms of HCC patients upon admission to the hospice ward were pain, fatigue or weakness, anorexia/vomiting, peripheral edema, cachexia, and ascites. Hypoalbuminemia, anemia, hyponatremia and jaundice were common laboratory abnormalities. Eighty-four patients (76.4%) required opiates for pain management. Upper gastrointestinal bleeding or varices bleeding developed in 76 patients (69.1%). Ninety-four patients (85.5%) died at the hospital, and the overall median survival time at hospice ward was 12 days. Because of more severe underlying portal hypertension and deteriorated liver function, terminal HCC patients with decompensated liver cirrhosis (Child-Pugh class C) had a significantly higher prevalence of peripheral edema, ascites, dyspnea, jaundice, thrombocytopenia, and stage III-IV hepatic encephalopathy than noncirrhotic or Child-Pugh class A and B terminal HCC patients. Symptoms and signs resulting from these portal hypertensions frequently complicated the symptomatic management of terminal HCC patients in the hospice ward. The treatment of these complications is mostly empirical in hospice ward, where intensive laboratory or diagnostic tests are usually not performed. In conclusion, symptoms and signs of terminally ill HCC patients in hospice are unique and should be managed appropriately.

Aged↗
PubMed2004

Hyaline-vascular variant of Castleman's disease mimicking a gastric submucosal tumor.

Castleman's disease is a rare lymphoproliferative disorder with unknown underlying cause. Three histologic variants (hyaline-vascular, plasma cell and mixed) as well as 2 clinical groups (localized and multicentic) have been described. Most patients with the hyaline-vascular variant are asymptomatic other than localized pressure from the mass. Hyaline-vascular Castleman's disease was commonly found as intrathoracic presentation. Extrathoracic lesions have been reported in the retroperitoneum, mesentery, central nervous system, orbit, pelvis, neck, axilla, and skeletal muscles. Herein, we report a case of hyaline-vascular Castleman's disease mimicking a gastric submucosal leiomyoma that has rarely been reported in English literature review. The lesion was not actually developing from the stomach, however, the clinical presentation was mimicking a submucosal gastric tumor. Furthermore, the patient in this case had both chronic hepatitis C and splenosis. The relationship between the underlying diseases and the development of the CD deserves further investigations.

Castleman Disease↗