[The 516th case: hyperinflammatory state, acute renal dysfunction, hepatosplenomegaly with lymphadenopathy, and recurrent cerebral infarctions].

A 25-year-old male patient presented with diarrhea, elevated serum creatinine, and thrombocytopenia for six months, with a recurrence for one month. He developed a systemic hyperinflammatory state following SARS-CoV-2 infection, involving the renal, gastrointestinal, and hematologic systems. Although glucocorticoid therapy initially demonstrated efficacy, the patient experienced disease relapse post-gastrointestinal infection, complicated by recurrent cerebral infarctions. Through multidisciplinary collaboration and integrated assessment of clinical manifestations and lymph node biopsy pathology, a diagnosis of idiopathic multicentric Castleman disease (iMCD) with TAFRO syndrome was established. Following aggressive treatment targeting the primary disease, the patient achieved complete remission. This case illustrates that the complex clinical presentation of iMCD-TAFRO syndrome requires early intervention and rigorous multidisciplinary cooperation to improve patient prognosis.