Castleman's disease is a rare disorder, yet a rarer newly described syndrome 
called TAFRO syndrome was discovered to accompany it. TAFRO represents the 
constellation of symptoms (Thrombocytopenia, Anasarca, MyeloFibrosis, Renal 
failure, Organomegaly). Most cases were described in Japan. We present the first 
case of TAFRO syndrome in Syria. A 58-year-old Caucasian male with no relevant 
history presented with fatigue, oliguria, decreased platelets, increased 
creatinine level, hepatosplenomegaly, ascites, pitting edema and lymph node 
enlargement. Possible differential diagnoses were excluded by laboratory, 
radiologic and cytologic tests including TB, malignancy and autoimmune diseases. 
A biopsy of a supraclavicular lymph node confirmed Castleman disease. Our 
patient had Catleman's disease, and presented with only four diagnostic criteria 
for TAFRO syndrome (Myelofibrosis was absent) in addition to other minor 
characteristics (microcytic anemia, negative HIV and HHV-8 infections.) which 
make the presentation consistent with TAFRO syndrome described in the Japanese 
cases. The criteria for diagnosing TAFRO syndrome are still changing, and the 
pathophysiology behind it is unclear. We recommend further research to 
understand this syndrome taking into account that its prevalence might be 
worldwide.