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Zhang C, Chen J, Hui Y, Chen H, Deng D, Sang H, Liu F. Risk of Nephritis and Recurrence in Kimura Disease: A Retrospective Study. Indian J Dermatol 2023; 68:611-618. [PMID: 38371566 PMCID: PMC10869022 DOI: 10.4103/ijd.ijd_670_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
Background Kimura disease (KD) presents a diagnostic challenge to clinicians because of its rarity and atypical symptoms in its early stages, and it is difficult to treat and prone to recurrence or involvement of other organs. Aims and Objectives This study aims to investigate the possible relevance of renal involvement and recurrence by analysing the clinical presentations, laboratory results, histopathological features, therapeutic data and follow-up results of KD. Materials and Methods A total of 27 patients diagnosed as KD in two hospitals from January 1999 to December 2021 were analysed retrospectively in this study based on the diagnosis of histopathology. Results KD mainly affected male more than female (8:1) with the onset age ranging from 3 to 58 years (median 29.8 years). The common initial symptoms included subcutaneous soft tissue or lymph node enlargement, non-specific skin lesions and proteinuria. One patient presented cough and expectoration as the first symptoms. KD patients often had high levels of serum immunoglobulin E (IgE) and basophils, which exhibited a significantly positive correlation with renal involvement and recurrence (p < 0.05). Early mass resection could prevent the development of nephritis and decrease the risk of relapse (p < 0.05). Conclusion KD should be noted in patients presenting with intractable and relapsing atopic skin lesions and (or) subcutaneous mass. Patients with high levels of serum IgE and blood basophils may be prone to developing KD-associated nephritis and predict a high risk of recurrence. Early surgical removal of the mass may result in a better prognosis.
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Affiliation(s)
- Caiyun Zhang
- From the Department of Dermatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
- Department of Medical Cosmetology, Nanjing Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Jun Chen
- From the Department of Dermatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yun Hui
- From the Department of Dermatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Huan Chen
- From the Department of Dermatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Dequan Deng
- From the Department of Dermatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Hong Sang
- From the Department of Dermatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Fang Liu
- From the Department of Dermatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
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Han MM, Dermarkarian CR, Del Valle Estopinal MD, Tao JP. Kimura Disease of the Periorbita and Earlobe in a 15-Year-Old Male: A Case Report and Review of the Literature. Ophthalmic Plast Reconstr Surg 2023; 39:26-33. [PMID: 35699221 DOI: 10.1097/iop.0000000000002221] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE The authors describe a case of Kimura disease (KD) affecting the lacrimal gland, the ipsilateral periorbita, and the contralateral earlobe. The authors also review the literature for characteristics and outcomes of KD affecting the periorbita or earlobe. METHODS The authors review retrospectively a single chart and abstract data from the English language literature. RESULTS A 15-year-old Samoan male presented with a left upper eyelid mass and later the contralateral earlobe and ipsilateral periorbita. Surgical resection was partially effective and normal vision and eye motility were maintained. Histopathology was consistent with KD. Thirty-seven cases of periorbital KD were identified in the literature. The average age of patients with periorbital KD was 31.9 years (standard deviation: 17.8 years), with 81.1% (30/37) of patients being male and 69.4% (25/36) Asian. Over half of periorbital KD patients had lacrimal gland involvement (51.3%; 19/37). Fifteen patients were initially treated with surgery; 3 (20%) had recurrence of the disease. Another 15 patients were initially treated with corticosteroids; 12 (80%) had recurrence of the disease. Ophthalmologic data, when reported, demonstrated that, most patients had no visual (77.8%; 14/18 patients) or motility disturbances (82.4%; 14/17 patients) but most had proptosis 71.4% (10/14). Only 4 cases of earlobe involvement in KD were identified, all in women. CONCLUSIONS In the literature, orbital KD was rare but often affected the lacrimal gland and caused proptosis, commonly in young adult Asian males. Vision and extraocular motility were usually normal. Earlobe involvement was very rare. This unique case of KD that affected the orbit and contralateral earlobe corroborates the prior literature that KD is prone to recurrence but may not adversely affect vision or extraocular motility.
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Desai AS, Dudzinski DM, Stib MT, Chen ST, Newton-Cheh C, Blumenthal KG, Stone JR. Case 32-2022: A 76-Year-Old Man with Postoperative Cardiogenic Shock and Diffuse Rash. N Engl J Med 2022; 387:1502-1513. [PMID: 36260795 DOI: 10.1056/nejmcpc2201245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Akshay S Desai
- From the Department of Medicine, Brigham and Women's Hospital (A.S.D.), the Departments of Medicine (D.M.D., S.T.C., C.N.-C., K.G.B.), Radiology (M.T.S.), Dermatology (S.T.C.), and Pathology (J.R.S.), Massachusetts General Hospital, and the Departments of Medicine (D.M.D., S.T.C., C.N.-C., K.G.B.), Radiology (M.T.S.), Dermatology (S.T.C.), and Pathology (J.R.S.), Harvard Medical School - all in Boston
| | - David M Dudzinski
- From the Department of Medicine, Brigham and Women's Hospital (A.S.D.), the Departments of Medicine (D.M.D., S.T.C., C.N.-C., K.G.B.), Radiology (M.T.S.), Dermatology (S.T.C.), and Pathology (J.R.S.), Massachusetts General Hospital, and the Departments of Medicine (D.M.D., S.T.C., C.N.-C., K.G.B.), Radiology (M.T.S.), Dermatology (S.T.C.), and Pathology (J.R.S.), Harvard Medical School - all in Boston
| | - Matthew T Stib
- From the Department of Medicine, Brigham and Women's Hospital (A.S.D.), the Departments of Medicine (D.M.D., S.T.C., C.N.-C., K.G.B.), Radiology (M.T.S.), Dermatology (S.T.C.), and Pathology (J.R.S.), Massachusetts General Hospital, and the Departments of Medicine (D.M.D., S.T.C., C.N.-C., K.G.B.), Radiology (M.T.S.), Dermatology (S.T.C.), and Pathology (J.R.S.), Harvard Medical School - all in Boston
| | - Steven T Chen
- From the Department of Medicine, Brigham and Women's Hospital (A.S.D.), the Departments of Medicine (D.M.D., S.T.C., C.N.-C., K.G.B.), Radiology (M.T.S.), Dermatology (S.T.C.), and Pathology (J.R.S.), Massachusetts General Hospital, and the Departments of Medicine (D.M.D., S.T.C., C.N.-C., K.G.B.), Radiology (M.T.S.), Dermatology (S.T.C.), and Pathology (J.R.S.), Harvard Medical School - all in Boston
| | - Christopher Newton-Cheh
- From the Department of Medicine, Brigham and Women's Hospital (A.S.D.), the Departments of Medicine (D.M.D., S.T.C., C.N.-C., K.G.B.), Radiology (M.T.S.), Dermatology (S.T.C.), and Pathology (J.R.S.), Massachusetts General Hospital, and the Departments of Medicine (D.M.D., S.T.C., C.N.-C., K.G.B.), Radiology (M.T.S.), Dermatology (S.T.C.), and Pathology (J.R.S.), Harvard Medical School - all in Boston
| | - Kimberly G Blumenthal
- From the Department of Medicine, Brigham and Women's Hospital (A.S.D.), the Departments of Medicine (D.M.D., S.T.C., C.N.-C., K.G.B.), Radiology (M.T.S.), Dermatology (S.T.C.), and Pathology (J.R.S.), Massachusetts General Hospital, and the Departments of Medicine (D.M.D., S.T.C., C.N.-C., K.G.B.), Radiology (M.T.S.), Dermatology (S.T.C.), and Pathology (J.R.S.), Harvard Medical School - all in Boston
| | - James R Stone
- From the Department of Medicine, Brigham and Women's Hospital (A.S.D.), the Departments of Medicine (D.M.D., S.T.C., C.N.-C., K.G.B.), Radiology (M.T.S.), Dermatology (S.T.C.), and Pathology (J.R.S.), Massachusetts General Hospital, and the Departments of Medicine (D.M.D., S.T.C., C.N.-C., K.G.B.), Radiology (M.T.S.), Dermatology (S.T.C.), and Pathology (J.R.S.), Harvard Medical School - all in Boston
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Alanazi FM, Alobaid AS, Alahmadi RM, AlGhamdi F. Kimura Disease: An Unusual Presentation of Parotid Mass in a Sickle Cell Disease Patient. Cureus 2022; 14:e24787. [PMID: 35676993 PMCID: PMC9167805 DOI: 10.7759/cureus.24787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2022] [Indexed: 11/05/2022] Open
Abstract
Kimura disease (KD) is a rare benign chronic inflammatory condition of unknown cause, usually affecting young men of the Asian race. It is frequently associated with nephrotic syndrome. In this report, we present an uncommon case of KD in a 40-year-old Saudi man with sickle cell disease who presented with swelling on the right side of his face. CT scan of the head and neck showed the asymmetrical appearance of both parotid glands: the right side appeared heterogeneously enlarged, with adjacent moderate-to-significant fat stranding. Histologically, hyperplastic changes in lymphoid tissue were observed. The patient underwent superficial parotidectomy and was then followed up till the healing of the surgical site with no complications.
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Huang HY, Yang CY, Yao WT, Chen YF, Yu CM, Tung KY, Tsai MF. Kimura Disease of the Thigh Treated With Surgical Excision and Dupilumab. Ann Plast Surg 2022; 88:S110-S113. [PMID: 35225857 DOI: 10.1097/sap.0000000000003106] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Kimura disease (KD) is a rare, chronic inflammatory disorder presenting with solitary or multiple masses. Treatment options include surgical excision, corticosteroids, and radiotherapy; however, optimal therapy remains to be established. Moreover, efficacy of a humanized monoclonal antibody, dupilumab (Dupixent), requires to be demonstrated. Here, we present a 36-year-old male patient with an enlarging mass in the left medial thigh and chronic eczema over the abdomen and lower legs. Kimura disease was diagnosed after surgical excision. Postoperative treatment with dupilumab was applied with an initial dose of 600 mg followed by 300 mg every 2 weeks for 8 months. No recurrence of KD was observed in the 1-year follow-up. The eczematous lesions improved greatly. To our knowledge, this is the first report of using dupilumab for treating KD.
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Affiliation(s)
- Hsuan-Yu Huang
- From the Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei
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Sim DW, Yu J, Koh YI. Efficacy of add-on therapy with intravenous immunoglobulin in steroid hyporesponsive DRESS syndrome. Clin Transl Sci 2021; 15:782-788. [PMID: 34796665 PMCID: PMC8932711 DOI: 10.1111/cts.13201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/18/2021] [Accepted: 11/08/2021] [Indexed: 12/17/2022] Open
Abstract
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare, potentially life-threatening, delayed, drug-induced hypersensitivity reaction. Immediate withdrawal of the culprit drug and administration of systemic corticosteroids is the most widely accepted treatment. However, it is difficult to manage patients with DRESS syndrome who are not responsive to systemic steroids. We studied the efficacy of intravenous immunoglobulins (IVIGs) in patients with DRESS syndrome unresponsive to systemic steroids. We retrospectively reviewed patients with DRESS syndrome who received IVIG in addition to systemic steroids during 2012-2017 and compared the clinical features and course of DRESS syndrome, before and after IVIG treatment. Eighteen DRESS patients (9 men) were included. The most frequent offending drugs were dapsone in five patients, followed by vancomycin in three patients, and carbamazepine in three patients. Rash, fever, lymphadenopathy, atypical lymphocytes, and hepatic involvement were common clinical findings. IVIG treatment was added within a median time of 7 days from the commencement of systemic steroid therapy. After IVIG treatment (total dosage: 1-2 g/kg), the fever resolved within a median time of 1 day (range, 0-3) and liver enzymes improved substantially within a median time of 13 days (range, 0-27). No severe adverse reactions related to IVIG therapy were observed in this study; however, there was one case of mortality. The addition of IVIG in DRESS syndrome in cases refractory to systemic steroid treatment may be helpful in hastening recovery. However, comparative studies using a placebo group are needed.
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Affiliation(s)
- Da Woon Sim
- Division of Allergy, Asthma, and Clinical Immunology, Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea
| | - Jieun Yu
- Division of Allergy, Asthma, and Clinical Immunology, Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea
| | - Young-Il Koh
- Division of Allergy, Asthma, and Clinical Immunology, Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea
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Ho J, Walter S, Harvey RJ. Eosinophilic chronic rhinosinusitis and concurrent Kimura's disease treated with mepolizumab. BMJ Case Rep 2021; 14:14/1/e232627. [PMID: 33461987 PMCID: PMC7813409 DOI: 10.1136/bcr-2019-232627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Kimura's disease is a rare, benign, chronic inflammatory disorder characterised by its eosinophilic infiltrate. Patients often present with one or more progressively enlarging subcutaneous lymph nodes in the head and neck region or enlarging salivary glands. We describe the case of a 26-year-old man presenting with severe peripheral eosinophilia and upper airway inflammatory symptoms, who later developed cervical lymphadenopathy and formally diagnosed with Kimura's disease. Based on our English-language MEDLINE literature search, to our knowledge this is the first case report describing treatment of Kimura's disease with mepolizumab.
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Affiliation(s)
- Jacqueline Ho
- Rhinology and Skull Base Research Group, St Vincent’s Centre for Applied Medical Research, University of New South Wales, Sydney, New South Wales, Australia,St Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Sophie Walter
- Rhinology and Skull Base Research Group, St Vincent’s Centre for Applied Medical Research, University of New South Wales, Sydney, New South Wales, Australia
| | - Richard J Harvey
- Rhinology and Skull Base Research Group, St Vincent’s Centre for Applied Medical Research, University of New South Wales, Sydney, New South Wales, Australia,Macquarie University Faculty of Medicine and Health Sciences, Sydney, New South Wales, Australia
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8
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Kakehi E, Kotani K, Otsuka Y, Fukuyasu Y, Hashimoto Y, Sakurai S, Hirotani A, Simizu K, Fujita R, Shoji K, Adachi S, Matsumura M. Kimura's disease: effects of age on clinical presentation. QJM 2020; 113:336-345. [PMID: 31800058 DOI: 10.1093/qjmed/hcz312] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 11/11/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Kimura's disease (KD) is known to be dominant among young Asian men, but it can also occur in middle- and advanced-aged people. The clinical characteristics of KD, especially by age, are not well known. AIM This study was performed to investigate the effects of age on the clinical characteristics of KD. DESIGN We conducted a case series study. METHODS All case studies of patients diagnosed with KD were collected via a PubMed search of studies published until August 2018. The data were analyzed by age group. RESULTS In total, 215 studies were reviewed (238 patients; mean age of 36 years). The male:female ratio was 4:1 overall, 17:1 in patients aged <20 years, 4:1 in patients aged 20-39 years and 2:1 in patients aged ≥40 years (P = 0.01). The percentage of patients with pruritus was 15.4% overall, 3.8% in patients aged <20 years, 15.5% in patients aged 20-39 years and 21.7% in patients aged ≥40 years (P = 0.02). The time to diagnosis was 5.3 years overall, 3.2 years in patients aged <20 years, 4.7 years in patients aged 20-39 years and 7.1 years in patients aged ≥40 years (P < 0.01). CONCLUSIONS The proportion of female patients affected the incidence of pruritus, and the time to diagnosis increased as the patients' age increased. There were no significant age-related differences in region/race, complications, multiplicity, laterality, anatomical distribution, maximum size, eosinophil count, immunoglobulin E level, initial treatment, recurrence or outcomes. This may be useful information for the diagnosis of KD.
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Affiliation(s)
- E Kakehi
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - K Kotani
- Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Y Otsuka
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - Y Fukuyasu
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - Y Hashimoto
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - S Sakurai
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - A Hirotani
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - K Simizu
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - R Fujita
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - K Shoji
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - S Adachi
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - M Matsumura
- Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
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Abstract
Kimura disease is a chronic inflammatory disease that mainly manifests as a lump in the cervical region. Although the underlying pathophysiology is not clear yet, the diagnosis can be established based on specific histopathological characteristics. The first case of this disease was described in China, as well as the majority of subsequent cases that were also described in the Far East countries made Kimura disease traditionally a disease of adult patients of Asian descent. This report describes the occurrence of Kimura disease in pediatric non-Asian patient with a similar clinicopathologic presentation.
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Affiliation(s)
- Fares E AlGhamdi
- Department of Otorhinolaryngology-Head Neck Surgery, King Abdullah Medical City, Makkah, Kingdom of Saudi Arabia. E-mail.
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Ye P, Ma DQ, Yu GY, Gao Y, Peng X. Comparison of the efficacy of different treatment modalities for Kimura's disease. Int J Oral Maxillofac Surg 2016; 46:350-354. [PMID: 27614905 DOI: 10.1016/j.ijom.2016.08.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 06/18/2016] [Accepted: 08/19/2016] [Indexed: 11/15/2022]
Abstract
The objective of this study was to investigate the clinical features of Kimura's disease in the head and neck region and to compare the local recurrence rate between three therapies used for the treatment of this disease. The clinicopathological information of 46 hospitalized patients suffering from Kimura's disease in the head and neck region over a 10-year period was reviewed retrospectively. All lesions were clinically observed in the head and neck region. These 46 patients underwent a total of 58 treatments; nine patients underwent multiple treatments due to local recurrence. Of the 58 treatments, 32 involved surgical excision alone, 24 involved surgical excision and postoperative low-dose radiotherapy (20-40Gy), one was a combination of ultrasound-guided core needle biopsy and radiotherapy, and one was a combination of incisional biopsy and subsequent radiotherapy. During the follow-up period, nine patients suffered 16 local recurrences. The recurrence rate of surgical excision combined with low-dose radiotherapy was much lower than that of surgical excision alone or radiotherapy alone (both P<0.05). It is concluded that Kimura's disease is a benign condition with a good prognosis, and surgical excision combined with postoperative low-dose radiotherapy is associated with the lowest local recurrence rate in the treatment of this disease.
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Affiliation(s)
- P Ye
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - D-Q Ma
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - G-Y Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Y Gao
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, China
| | - X Peng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
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Comparison of Local Recurrence Rate of Three Treatment Modalities for Kimura Disease. J Craniofac Surg 2016; 27:170-4. [PMID: 26674917 DOI: 10.1097/scs.0000000000002337] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Eosinophilic hyperplastic lymphogranuloma, also known as Kimura disease, is a benign and chronic inflammatory condition, predominantly involving the head and neck region. Surgical excision, radiotherapy (RA), surgical resection combined with low-dose postoperative radiotherapy and oral corticosteroids are 4 treatment modalities reported to control this disease effectively. Local recurrence, however, is common and the optimum treatment for Kimura disease is controversial. Thus, the present meta-analysis was performed to identify the treatment modality associated with the lowest local recurrence. Electronic databases (Cochrane Library, Wiley Online Library, PubMed, Chinese National Knowledge Infrastructure, and Wanfang Data) were searched. Data were also obtained from other sources such as related references and communication with the relevant authors. Two reviewers screened the literature according to preselected criteria. All studies involving different treatments for Kimura disease were collected. After data extraction and research quality assessment, the meta-analysis of 22 studies involving 570 patients was conducted using STATA 12.1 software. Meta-analysis revealed that administration of RA or surgical excision alone were inferior in controlling local recurrence compared with surgical resection combined with postoperative RA (risk ratio (RR) = 2.72; 95% confidence interval (CI), 1.47-5.04 and RR = 4.72; 95% CI, 2.53-8.82). Surgical excision alone did not show significant advantage in controlling local recurrence compared with RA alone (RR = 2.13; 95% CI, 0.88-5.17). Surgical resection combined with postoperative RA is superior to either surgery or RA alone in treating Kimura disease. More large scale prospective randomized controlled trials, however, should be conducted to assess the long-term effects and safety issues.
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Pulmonary embolism as the initial clinical presentation of Kimura disease: case report and literature review. Blood Coagul Fibrinolysis 2016; 26:414-8. [PMID: 25699606 DOI: 10.1097/mbc.0000000000000278] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Pulmonary embolism is clinically critical in that if misdiagnosed or delayed, the mortality is very high. The recognition of its risk factor or underlying disease is important for prevention of recurrence. Kimura disease is a rare, chronic inflammatory disease, which is seldom associated with thrombosis. We reported a 47-year-old male case presenting with pleural pain and dyspnoea and was found to have pulmonary embolism. After successful management of pulmonary embolism, he was noticed to have eosinophilia and lymphadenopathy. Pathologic examination of a resected lymph node has confirmed the diagnosis of Kimura disease. The patient was treated with corticosteroid and cyclosporine A, with a significant improvement of the symptoms and signs of Kimura disease and no recurrence of any thromboembolism. Associated literatures were reviewed to explore the pathogenesis underlying the thrombotic event in Kimura disease cases. It is suggested that hypereosinophilia may play a key role in thrombosis formation. The control of hypereosinophilia may contribute to the prevention of thrombosis and its recurrence in patients with Kimura disease.
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Kottler D, Barète S, Quéreux G, Ingen-Housz-Oro S, Fraitag S, Ortonne N, Deschamps L, Rybojad M, Flageul B, Crickx B, Janin A, Bagot M, Battistella M. Retrospective Multicentric Study of 25 Kimura Disease Patients: Emphasis on Therapeutics and Shared Features with Cutaneous IgG4-Related Disease. Dermatology 2015; 231:367-77. [DOI: 10.1159/000439346] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 08/11/2015] [Indexed: 11/19/2022] Open
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Abstract
A 7-year-old Korean boy was referred for a nontender mass in the left arm. He had a 5-year history of a poorly defined painless mass on the medial side of the left elbow. The ultrasonogram of the left arm indicated an ill-defined, lobulating solid mass involving the deep soft tissue layer. The fat-suppressed T2-weighted magnetic resonance image showed a poorly marginated, homogeneous high-signal intensity mass. On further follow-up of 1 year and 6 months, the mass showed no change in size and nature. At surgery, a poorly demarcated inflammatory mass was dissected from a branch of the superficial radial nerve and excised completely. There was no recurrence and any dysfunction, except temporary localized hypoesthesia of the medial aspect of the left arm at the 3.6-year follow-up.
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Hu YC, Wang R, Lv XA. Kimura disease associated with IgA nephropathy. Kaohsiung J Med Sci 2014; 30:213-4. [PMID: 24656163 DOI: 10.1016/j.kjms.2013.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 02/22/2013] [Indexed: 10/26/2022] Open
Affiliation(s)
- Ying-Chun Hu
- Department of Nephrology, Taian City Central Hospital, Shandong University, Jinan, China.
| | - Rong Wang
- Department of Nephrology, Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Xue-Ai Lv
- Department of Nephrology, Taian City Central Hospital, Taian, China
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Kimura's Disease-Revisited. Photodiagnosis Photodyn Ther 2012; 9:282-3; author reply 284-5. [PMID: 22959808 DOI: 10.1016/j.pdpdt.2012.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 06/30/2012] [Indexed: 11/24/2022]
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