St. John's Resident Solves Rare TAFRO Disease

In late‑2023, Ian Gillies Jr., a 22‑year‑old from Conception Bay South, fell ill and spent two months at St. Johns’ Health Sciences Centre. Despite fluid‑filled ascites, swollen lymph nodes, a 15‑cardinal‑card dip of 15 two‑litre milk‑carton‑equivalent drains and low blood counts, the case baffled staff. On Oct 31, first‑year internal‑medicine resident Dr. Steven Rowe, then at Memorial University, combed literature and identified the rare TAFRO subtype of Castleman disease. Testing revealed severe cytokine storm and organ failure; treatment with the IV drug siltuximab curbed the 30 % mortality risk. Gillies Jr. was discharged before Christmas and continues regular infusions. Rowe co‑authored a paper in the American Journal of Hematology, establishing a simple blood test that can differentiate TAFRO from HLH within days, expediting care for future patients across Canada and beyond.