TAFRO Syndrome with Renal Thrombotic Microangiopathy: Insights into the Molecular Mechanism and Treatment Opportunities

Int J Mol Sci. 2021 Jun 11;22(12):6286. doi: 10.3390/ijms22126286.


TAFRO syndrome is an extremely rare form of idiopathic MCD, characterized by thrombocytopenia, anasarca, fever, reticulin fibrosis on bone marrow biopsy, and organomegaly. Like idiopathic MCD, renal involvement is also a common presentation in patients with TAFRO syndrome. Furthermore, membranoproliferative glomerulonephritis (MPGN)-like injury and thrombotic microangiopathy (TMA) are the most reported histopathologic findings of renal biopsy. Several molecular mechanisms have been previously postulated in order to explain the TAFRO syndrome symptoms, including abnormal production of interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), etc. The role of these cytokines in renal injury, however, is not well understood. The aim of this review article is to summarize the latest knowledge of molecular mechanisms behind the TAFRO syndrome and their potential role in renal damage.

Keywords: IL-6; TAFRO syndrome; VEGF; idiopathic multicentric Castleman disease (MCD); renal thrombotic microangiopathy.

Publication types

  • Review

MeSH terms

  • Animals
  • Castleman Disease / complications*
  • Castleman Disease / physiopathology
  • Castleman Disease / therapy*
  • Humans
  • Kidney / pathology*
  • Thrombotic Microangiopathies / complications*
  • Thrombotic Microangiopathies / physiopathology
  • Thrombotic Microangiopathies / therapy*

Supplementary concepts

  • Multi-centric Castleman's Disease