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Fenech M, Ajanaku A, McCormick A, Coupland SE, Krishna Y, Sultan Z, Ghadiri N. Orbital Kimura disease: maintenance therapy using mycophenolate mofetil. Orbit 2024:1-8. [PMID: 38815210 DOI: 10.1080/01676830.2024.2358061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 05/15/2024] [Indexed: 06/01/2024]
Abstract
Kimura disease (KD) is a rare, chronic, inflammatory condition, predominantly found in male patients of Asian ethnicity. It typically presents between 50-60 years of age and usually with bilateral disease. Angiolymphoid hyperplasia with eosinophilia (ALHE) remains the main differential diagnosis, although histological analysis is essential in differentiating from other similarly presenting pathologies. In this case, we present an atypical case of unilateral orbital KD in a middle-aged, Caucasian, male gentleman and no evidence of regional lymphadenopathy along with a literature review of orbital KD and the differential diagnoses, histological features and management modalities available, adding to the sparse literature on the topic. At present, no recognised diagnostic criteria for KD are available, with histopathological analysis through incisional or excisional biopsy being the primary diagnostic method. Complete surgical excision with or without corticosteroid management remains the most common treatment modality although management is shifting to steroid-sparing immunomodulatory therapy. To the best of our knowledge, this is the first case to describe maintenance therapy of KD using mycophenolate mofetil.
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Affiliation(s)
- Matthew Fenech
- Department of Ophthalmology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Ayodeji Ajanaku
- Department of Ophthalmology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Austin McCormick
- Department of Ophthalmology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Sarah E Coupland
- Department of Histopathology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Yamini Krishna
- Department of Ophthalmology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Ziyaad Sultan
- Department of Ophthalmology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Nima Ghadiri
- Department of Ophthalmology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
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2
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Ao S, Huang G, Tang X, Zhu Z, Han J, Wang F, Zhai W. Anti-immunoglobulin E provides an additional therapy to conventional steroids for Kimura's disease. J Dermatol 2024; 51:602-606. [PMID: 37950550 DOI: 10.1111/1346-8138.17021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 10/04/2023] [Accepted: 10/17/2023] [Indexed: 11/12/2023]
Abstract
Kimura's disease (KD) is a chronic inflammatory disease characterized by painless subcutaneous head and neck swelling, eosinophilia, and elevated serum immunoglobulin (Ig) E levels. There are various therapies, including surgery, radiation, systemic steroids, and immune suppressants, but their efficacy remains moderate due to the high recurrence rate. Biologics, like monoclonal antibodies, have shown tremendous effectiveness for chronic inflammatory diseases. Omalizumab is a monoclonal antibody against IgE and has not been approved for KD so far. We describe two refractory KD cases that responded to a small dose of steroids plus omalizumab. Additionally, we reviewed another 13 KD cases that were treated with biologics, including omalizumab, rituximab, dupilumab, and mepolizumab. The results indicate that biologics provide an alternative treatment strategy for KD.
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Affiliation(s)
- Suiting Ao
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Gege Huang
- Department of Dermatology, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xuhua Tang
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhe Zhu
- Department of Pathology and Cell Biology, New York-Presbyterian Hospital, Columbia University Irving Medical Center, New York, New York, USA
| | - Jiande Han
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Fang Wang
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Wanying Zhai
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
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3
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Negre GCMP, Regala FG, Ang CY, Tumalad MA. Kimura Disease: A case report with bilateral upper lid masses and a right parotid mass. Orbit 2023; 42:624-629. [PMID: 35436175 DOI: 10.1080/01676830.2022.2058022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 03/20/2022] [Indexed: 10/18/2022]
Abstract
A 38-year-old male presented with bilateral upper eyelid masses and a right parotid mass. Nineteen years before the consultation, the patient experienced swelling at both upper eyelids. Formerly diagnosed by an ophthalmologist, corticosteroid, an anti-inflammatory medication, was prescribed for the patient, which resulted in partial resolution of the lid swelling. However, he was lost to follow-up, and progressive enlargement of the lids was observed with the development of a right parotid mass. The visual acuity of the patient was classified as counting fingers, three feet bilaterally. A detailed examination was difficult owing to the obstructive nature of the masses. However, ocular structures appeared intact. An excisional biopsy with a reconstruction of bilateral upper lids was performed. Histopathologic findings revealed a lymphoproliferative lesion suggestive of Kimura disease (KD). The patient was subsequently referred to rheumatology for management, where they started a regimen of oral steroids and antihistamines.
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Affiliation(s)
| | - Fatima G Regala
- Department of Health Eye Center, East Avenue Medical Center, Quezon City, Metro Manila, Philippines
| | - Charmaine Y Ang
- Department of Health Eye Center, East Avenue Medical Center, Quezon City, Metro Manila, Philippines
| | - Marco A Tumalad
- Department of Health Eye Center, East Avenue Medical Center, Quezon City, Metro Manila, Philippines
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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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5
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Shang B, Hsiao C, Tsao T, Liao Y, Lin W, Lee W, Lue K. Clinical effects of dupilumab: A novel treatment for Kimura disease. Immun Inflamm Dis 2023; 11:e1084. [PMID: 38018601 PMCID: PMC10632088 DOI: 10.1002/iid3.1084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 10/22/2023] [Accepted: 10/30/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Kimura disease (KD) is a rare chronic inflammatory disorder involving the Th2 pathway. Although medical treatment with steroids or other immunosuppressants is available, they may cause developmental issues in the pediatric population. Surgical intervention has also been suggested; however, it is associated with high recurrence rates. CASE PRESENTATION A 14-year-old boy presented with left retroauricular lymph node enlargement at the age of 5 years. At the age of 7 years, he was diagnosed with nephrotic syndrome which subsided after steroid treatment for approximately 6 years. The retroauricular lymph node was surgically excised, and KD was confirmed. However, recurrent enlargement of the left retroauricular and neck lymph nodes occurred after 2 years. Persistently high IgE levels and fluctuating eosinophil counts were observed following steroid treatment. Dupilumab was prescribed because of the difficulty in tapering the steroid dosage. A loading dose of 600 mg was administered, followed by a maintenance dose of 300 mg every 2 weeks. The IgE level decreased after 3 months, and a low eosinophil count was maintained after steroid discontinuation. Follow-up computed tomography revealed a decrease in the size of the lymph nodes with no side effects such as conjunctivitis. CONCLUSION Traditional treatments have raised developmental concerns in the pediatric population and are associated with high recurrence rates. Dupilumab targets the Th2 pathway and provides effective results, with few adverse effects. Dupilumab may be a therapeutic option for KD and other diseases involving the Th2 pathway.
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Affiliation(s)
- Bing‐Shiau Shang
- Department of PediatricsChung Shan Medical University HospitalTaichung CityTaiwan
- Department of MedicineChung Shan Medical UniversityTaichung CityTaiwan
- Institute of MedicineChung Shan Medical University HospitalTaichung CityTaiwan
| | | | - Teng‐Fu Tsao
- Department of MedicineChung Shan Medical UniversityTaichung CityTaiwan
- Department of Medical ImagingChung Shan Medical University HospitalTaichung CityTaiwan
| | - Yuan‐Ya Liao
- Department of MedicineChung Shan Medical UniversityTaichung CityTaiwan
- Department of SurgeryChung Shan Medical University HospitalTaichung CityTaiwan
| | - Wea‐Lung Lin
- Department of PathologyChung Shan Medical University HospitalTaichung CityTaiwan
- Department of PathologyChung Shan Medical UniversityTaichung CityTaiwan
| | - Wen‐I Lee
- Department of Pediatrics, Division of Allergy, Asthma, Immunology and RheumatologyChang Gung Memorial Hospital and Chang Gung University College of MedicineTaoyuanTaiwan
- Primary Immunodeficiency Care and Research InstituteChang Gung University College of Medicine and Chang Gung Memorial HospitalTaoyuanTaiwan
| | - Ko‐Huang Lue
- Department of PediatricsChung Shan Medical University HospitalTaichung CityTaiwan
- Department of MedicineChung Shan Medical UniversityTaichung CityTaiwan
- Department of Biological Science & TechnologyNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
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6
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Laguna J, Rodríguez-García M, Molina A, Merino A. Kimura disease as an uncommon cause of persistent hypereosinophilia: a diagnostic challenge. Biochem Med (Zagreb) 2023; 33:020801. [PMID: 37143713 PMCID: PMC10152615 DOI: 10.11613/bm.2023.020801] [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] [Received: 11/24/2022] [Accepted: 02/26/2023] [Indexed: 05/06/2023] Open
Abstract
Kimura disease (KD) is an unusual inflammatory disease of unknown etiology. Despite being described many years ago, KD might cause diagnostic difficulty or be confused with other conditions. Here, we present a 33-year-old Filipino woman who was referred to our hospital for evaluation of persistent eosinophilia and intense pruritus. Blood analysis and peripheral blood smear review showed high eosinophil counts (3.8 x109/L, 40%) that did not show morphological abnormalities. Besides, high serum IgE concentration was detected (33,528 kU/L). Serological tests were positive for Toxocara canis and treatment with albendazol was initiated. Nevertheless, increased eosinophil counts were still present after several months, alongside with high serum IgE concentrations and intense pruritus. During her follow-up, an inguinal adenopathy was detected. The biopsy revealed lymphoid hyperplasia with reactive germinal centers and massive eosinophil infiltration. Proteinaceous deposits of eosinophilic material were also observed. All these findings, together with peripheral blood eosinophilia and high IgE concentrations, confirmed the diagnosis of KD. The diagnosis of KD should be considered in the differential diagnosis of long-standing unexplained eosinophilia in association with high IgE concentrations, pruritus and lymphadenopathies.
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Braun J, Mairinger T, Kaschke O, Behrendt K, Ramsbacher J, Karberg K. Bilateral swelling of the salivary glands and sicca symptoms: an unusual differential diagnosis-Kimura's disease, a rare allergic condition with a high IgE serum level-a case report and review of the literature. RMD Open 2023; 9:rmdopen-2023-003135. [PMID: 37164447 PMCID: PMC10173963 DOI: 10.1136/rmdopen-2023-003135] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/29/2023] [Indexed: 05/12/2023] Open
Abstract
A 68-year-old woman presented with bilateral swelling of the salivary glands, sicca symptoms of eyes and mouth, itching, fatigue and weight gain of about 5 kg in the last 2-3 years. As part of a careful diagnostic work up including lab tests for antinuclear antibodies (ANA), antibodies to extractable nuclear antigens (ENA), anti-neutrophilic cytoplasmatic antiobodies (ANCA), immunoglobulin (Ig)G4, a whole body computed tomography (CT) and a parotid biopsy several rheumatic diseases such as Sjoegren's syndrome, IgG4-related disease and sarcoidosis were ruled out and, considering a very high titre of IgE, Kimura's disease was diagnosed. The case and a short review of the literature are presented.
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Affiliation(s)
- Jüergen Braun
- Rheumapraxis Berlin, Ruhr University Bochum, Berlin, Germany
| | - Thomas Mairinger
- Dept. of Pathology, Medizinisches Versorgungszentrum am Helios Klinikum Emil von Behring, Berlin, Germany
| | - Oliver Kaschke
- Dept of Otorhinolaryngology, St.Gertrauden Krankenhaus, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Kai Behrendt
- Roentgenpraxis Radiologie Eins, Humboldt-Universitat zu Berlin, Berlin, Germany
| | - Josef Ramsbacher
- Praxis für Neurochirurgie, Humboldt-Universitat zu Berlin, Berlin, Germany
| | - Kirsten Karberg
- Rheumapraxis Berlin, Humboldt-Universitat zu Berlin, Berlin, Germany
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8
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Hemayati R, Binesh F, Pashmchi M, Mousavi Anary SMK, Mohammadi M. Challenging diagnosis of Kimura disease in a child with nephrotic syndrome: A case report. Clin Case Rep 2023; 11:e7031. [PMID: 36873072 PMCID: PMC9981570 DOI: 10.1002/ccr3.7031] [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] [Received: 12/05/2022] [Revised: 01/20/2023] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
Kimura disease (KD) is a rare condition with a challenging diagnosis because it may be misdiagnosed and not differentiated from other disorders. We reported a 13-year-old patient who presented with growing neck masses and was hospitalized due to the nephrotic syndrome relapse but was eventually diagnosed with KD.
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Affiliation(s)
- Roya Hemayati
- Department of Internal Medicine Shahid Sadoughi University of medical sciences Yazd Iran
| | - Fariba Binesh
- Department of Pathology Shahid Sadoughi University of medical sciences Yazd Iran
| | - Mohammad Pashmchi
- School of Medicine Shahid Sadoughi University of Medical Sciences Yazd Iran
| | | | - Mohammad Mohammadi
- School of Medicine Shahid Sadoughi University of Medical Sciences Yazd Iran
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9
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Fukami F, Koike Y, Murota H. Refractory Kimura's disease accompanied with prurigo responding to dupilumab administration: A case report. JOURNAL OF CUTANEOUS IMMUNOLOGY AND ALLERGY 2023. [DOI: 10.1002/cia2.12298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Fumie Fukami
- Department of Dermatology Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
| | - Yuta Koike
- Department of Dermatology Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
| | - Hiroyuki Murota
- Department of Dermatology Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
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10
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Yang B, Yu H, Jia M, Yao W, Diao R, Li B, Wang Y, Li T, Ge L, Wang H. Successful treatment of dupilumab in Kimura disease independent of IgE: A case report with literature review. Front Immunol 2022; 13:1084879. [PMID: 36591252 PMCID: PMC9794988 DOI: 10.3389/fimmu.2022.1084879] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
Kimura disease (KD) is a rare and benign chronic inflammatory disease of unknown cause. It is characterized by subcutaneous granuloma of soft tissues in the head and neck region, increased eosinophil count, and elevated serum IgE. Currently, no definitive treatments are recommended. A 57-year-old Chinese man was diagnosed with KD after 7 years of slow subcutaneous masses growth. The patient underwent treatment of oral glucocorticoids for 1 year, but the masses recurred as the dosage was tapered down. Subsequent anti-IgE therapy of omalizumab administered subcutaneously at 450 mg/day at a 4-week interval did not show improvement. The size of masses and serum IgE and circulating eosinophils did not decrease significantly after 19 cycles of continuous treatment. Ultimately, switched strategy of dupilumab was applied at an initial dose of 600 mg, followed by 300 mg every 2 weeks for 4 months. This treatment demonstrated dramatical effects with reduced masses in each area and fast dropdown of eosinophil counts, while the high level of serum IgE remained without changes. Recently, different biologics including anti-IgE, anti-IL-5, and anti-IL-4/IL-13 have been applied to treat KD with satisfied results and help to explore the pathogenesis of this rare disease. To our knowledge, this is the first report that demonstrates the effects of two different biologics in the same patient and reveals the impressive clinical efficacy of dupilumab to treat KD independent of IgE. Therefore, further investigation of the underlying mechanism and the development of diagnosis and treatment of KD is valuable.
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Affiliation(s)
- Boyun Yang
- Department of Allergy, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hanxiao Yu
- Clinical Research Center, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Minyue Jia
- Department of Ultrasound, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wo Yao
- Department of Allergy, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ran Diao
- Department of Allergy, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Bohui Li
- Department of Allergy, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yongfang Wang
- Department of Allergy, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ting Li
- Department of Allergy, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Liuya Ge
- Outpatient Care Department, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Huiying Wang
- Department of Allergy, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China,*Correspondence: Huiying Wang,
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11
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Kim WJ, Kim HK. Current concepts of Kimura disease: pathophysiology and evolution of treatment. Arch Craniofac Surg 2022; 23:249-255. [PMID: 36596747 PMCID: PMC9816637 DOI: 10.7181/acfs.2022.01053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 12/19/2022] [Indexed: 12/29/2022] Open
Abstract
Kimura disease (KD) is a chronic inflammatory disorder that frequently involves the subcutaneous tissue of the head and neck regions. It often manifests as regional lymphadenopathy or salivary gland enlargement in the affected area. The histologic architecture of the lymph nodes in KD patients is preserved, while the affected tissues show follicular hyperplasia and eosinophilic infiltration. No single modality has been adopted as an optimal treatment for KD. This article concentrates on the fundamental features of KD and reviews current approaches to its treatment.
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Affiliation(s)
- Woo Ju Kim
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University School of Medicine, Gwangmyeong,
Korea
| | - Han Koo Kim
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Chung-Ang University School of Medicine, Seoul,
Korea
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12
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Yang B, Liao H, Wang M, Long Q, Zhong H, Luo L, Liu Z, Cheng X. Kimura's disease successively affecting multiple body parts: a case-based literature review. BMC Ophthalmol 2022; 22:154. [PMID: 35366827 PMCID: PMC8977031 DOI: 10.1186/s12886-022-02378-y] [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] [Received: 08/03/2021] [Accepted: 03/29/2022] [Indexed: 11/10/2022] Open
Abstract
Background Kimura’s disease is a rare, benign, chronic inflammatory disease that presents as painless, solid masses mainly affecting the deep subcutaneous areas of the head and neck, especially the salivary glands, parotid glands and nearby lymph nodes. It is characterized by elevated peripheral blood eosinophil and Immunoglobulin E (IgE) levels. Case presentation A 31-year-old Asian male presented with an orbital space-occupying lesion lasting for 1.5 years. Ten years prior, surgical excision of bilateral fossa cubitalis and groin masses was performed, and the pathological examination showed "lymphoproliferative disease". One year later, masses reappeared near the surgical sites; they grew slowly and shrank after glucocorticoid treatment. At this point, admission examinations showed in the peripheral blood an eosinophil proportion of 13.4%, a total IgE level of 26,900.00 IU/mL, prurigo present on the whole body, and multiple palpable masses near the bilateral fossa cubitalis and groin. The left eyeball was exophthalmic. The left elbow mass was excised, and the pathological examination confirmed Kimura’s disease. Oral glucocorticoid therapy is taken and tapering regularly. The eosinophil count returned to normal, the IgE level gradually decreased, the orbital space-occupying lesion and elbow and groin masses shrank significantly, and the whole-body skin prurigo disappeared. Currently, the patient has been in a stable condition for eighteen months. Conclusion Our case provides a novel insight that Kimura’s disease should be involved in the differential diagnosis of inflammatory lesion mass of orbit and also supports systemic regular glucocorticoid as a valuable therapy of such condition, but close follow-up and long-term observation are crucial.
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13
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Zhuang S, Chen X, Chen W, Li C, Wang T, Lin Q, Wang D. A retrospective study of 20 patients with Kimura's disease from China. Acta Otolaryngol 2022; 142:357-362. [PMID: 35382684 DOI: 10.1080/00016489.2022.2055139] [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: 11/01/2022]
Abstract
BACKGROUND Kimura's disease (KD) is an eosinophilic proliferative lymphoid disease with rare incidence rate and nonspecific clinical symptoms. OBJECTIVES To investigate the clinical characteristics, diagnosis, treatment, and prognosis of KD. MATERIALS AND METHODS The clinical manifestations, laboratory examination, imaging examination, proposed treatment, and prognosis of 20 patients with KD treated in our hospital were retrospectively analyzed. RESULTS All cases showed painless masses. The proportion of peripheral blood eosinophils rose in 18 cases (90%), the eosinophil count increased in 14 cases (70%) and the serum immunoglobulin E (IgE) levels were significantly increased in 5 patients (100%). Pathological examination revealed follicular hyperplasia, eosinophils infiltration, and tiny vessels proliferation in KD samples. CONCLUSIONS KD should be considered when the patients suffered head and neck subcutaneous painless mass, increased peripheral blood eosinophils and raised serum IgE level. Pathological examination is the golden standard for diagnosing KD. Surgical intervention, medical treatments, and radiotherapy may be effective for KD treatment. SIGNIFICANCE This study might shed a light on improving the diagnosis and treatment for KD.
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Affiliation(s)
- Suling Zhuang
- Department of Otolaryngology, Fujian Medical University Union Hospital, Fujian, PR China
| | - Xiaoqiang Chen
- Department of Otolaryngology, Fujian Medical University Union Hospital, Fujian, PR China
| | - Wei Chen
- Department of Otolaryngology, Fujian Medical University Union Hospital, Fujian, PR China
| | - Chen Li
- Department of Otolaryngology, Fujian Medical University Union Hospital, Fujian, PR China
| | - Taiqin Wang
- Department of Otolaryngology, Fujian Medical University Union Hospital, Fujian, PR China
| | - Qin Lin
- Department of Otolaryngology, Fujian Medical University Union Hospital, Fujian, PR China
| | - Desheng Wang
- Department of Otolaryngology, Fujian Medical University Union Hospital, Fujian, PR China
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14
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Abstract
Kimura disease (KD) is a rare inflammatory disorder which involves the head and neck. Due to its rarity and various findings, definitive diagnosis can be difficult to ascertain. Kimura disease is distinguished from other conditions, including angiolymphoid hyperplasia, by histopathological features including follicular hyperplasia, reactive germinal centers, abundant eosinophilia, eosinophilic microabscesses, preserved nodal architecture, Warthin-Finkeldy polykaryocytes, and capsular fibrosis. Herein, we describe the clinical presentation, pathology, and diagnosis of a single case of a 39-year-old treated at an academic center in Texas.
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Kok KYY, Lim ECC. Kimura's disease: a rare cause of chronic neck lymphadenopathy. J Surg Case Rep 2021; 2021:rjab318. [PMID: 34290854 PMCID: PMC8289319 DOI: 10.1093/jscr/rjab318] [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: 06/16/2021] [Revised: 06/27/2021] [Accepted: 06/29/2021] [Indexed: 11/30/2022] Open
Abstract
Kimura’s disease is a rare chronic inflammatory disorder of unknown etiology which typically presents with subcutaneous nodules in the head and neck region and is frequently associated with regional lymphadenopathy or salivary gland enlargement. Peripheral blood eosinophilia and elevated serum immunoglobulin E levels are constant features of the disease. We present herein a 31-year-old male patient who presented with chronic neck lymphadenopathy. Kimura’s disease was diagnosed on fine needle aspiration cytology, the patient initially decided not to have further intervention. He presented 6 years later with lymphadenopathy and was treated with surgery. The diagnosis of Kimura’s disease was confirmed on histopathology. This patient had the disease for 6 years and did not have the typical features of peripheral eosinophilia and raise serum IgE level.
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Affiliation(s)
- Kenneth Y Y Kok
- Discipline of Medicine, Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku-Link, Brunei Darussalam
| | - Edwin C C Lim
- Department of Pathology, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei Darussalam
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16
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Kimura disease with a history of Budd-Chiari syndrome: a case report. Chin Med J (Engl) 2020; 133:2392-2394. [PMID: 32868502 PMCID: PMC7546835 DOI: 10.1097/cm9.0000000000001008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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17
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Kimura Disease Presenting with Buccal Mass: A Case Report and Literature Review. Head Neck Pathol 2020; 15:657-662. [PMID: 32712881 PMCID: PMC8134605 DOI: 10.1007/s12105-020-01206-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/17/2020] [Indexed: 10/23/2022]
Abstract
A 52-year-old man with a 2-year history of left buccal swelling was admitted to our department. An elastic hard oral mass was palpated under the intact buccal mucosa. A CT scan with enhancement revealed a solid mass measuring 2.0 × 1.5 × 1.3 cm between the left masseter muscle and the maxilla. Laboratory examination showed elevated peripheral blood eosinophil count of 1070/μL (12.3%) and serum immunoglobulin (Ig)E level of 1374 IU/mL. Histologic examination of transorally excised mass revealed lymphoid follicular hyperplasia with reactive germinal centers and eosinophilic infiltration with eosinophilic micro-abscesses in the germinal centers. Abundant IgE deposition in a reticular fashion was observed in the germinal centers and c-kit positive mast cells was observed in the paracortical area in the excised mass. The patient was diagnosed with Kimura disease (KD) and treated with oral prednisolone, tapering from 10 mg/day for approximately 8 months. Eosinophil count and serum IgE level decreased to 435/μL (5%) and 520 IU/dL, respectively. He is free from symptoms at the time of this submission. KD, a rare, benign, and chronic inflammatory disorder, occurs predominantly in young male adults in Asia. Patients with KD who presents with buccal mass are relatively rare. Immunohistologic analyses suggested that an allergic reaction played an important role in the etiology of KD in this case.
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18
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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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19
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Li X, Wang J, Li H, Zhang M. Misdiagnosed recurrent multiple Kimura's disease: A case report and review of the literature. Mol Clin Oncol 2018; 10:352-356. [PMID: 30847173 PMCID: PMC6388464 DOI: 10.3892/mco.2018.1793] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 12/07/2018] [Indexed: 11/05/2022] Open
Abstract
Kimura's disease (KD) is a rare condition, with only a few cases reported to date, mainly in Asian patients. We herein present the case of a 48-year-old man with KD who presented with recurrent masses in the right parotid gland and neck region over a 15-year period. The masses were not accompanied by pain, or significant functional or neurosensory dysfunction. The results of the laboratory tests revealed an increased eosinophil count and markedly elevated serum IgE levels. On magnetic resonance imaging examination, a widespread abnormal signal was detected in the area of the lesions; the contrast-enhanced scan revealed inhomogeneous enhancement, with partial involvement of the sternocleidomastoid muscle and the parotid gland. The patient underwent surgical resection of the right parotid and neck masses, and the postoperative pathological examination revealed eosinophilic hyperplastic lymphogranuloma, also referred to as KD. This presented case and review of the relevant literature aim to improve our understanding of KD in order to increase the accuracy of diagnosis, reduce the misdiagnosis rate and ensure proper treatment of this rare disease.
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Affiliation(s)
- Xuesheng Li
- Department of Prosthodontics, Hainan Stomatological Hospital, Haikou, Hainan 570105, P.R. China
| | - Jing Wang
- Department of Stomatology, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya, Hainan 572013, P.R. China
| | - Hongbo Li
- Department of Stomatology, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya, Hainan 572013, P.R. China
| | - Ming Zhang
- Department of Stomatology, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya, Hainan 572013, P.R. China
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20
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Incorvaia C, Mauro M, Makri E, Leo G, Ridolo E. Two decades with omalizumab: what we still have to learn. Biologics 2018; 12:135-142. [PMID: 30464389 PMCID: PMC6208531 DOI: 10.2147/btt.s180846] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
From its availability for clinical use nearly two decades ago for severe asthma, omalizumab has gained strong evidence of efficacy and safety in the treatment of severe asthma not controlled by standard-of-care therapy. It has been acknowledged by Global Initiative on Asthma guidelines as add-on therapy against severe uncontrolled asthma. Thanks to controlled trials supporting its efficacy, omalizumab has also been licensed for the treatment of chronic spontaneous urticaria. The optimal duration of treatment in either disease has not been established. Despite its high price, omalizumab appears to be cost-effective in severe uncontrolled asthma as well as in chronic urticaria. The literature suggests a wide range of applications for omalizumab in various disorders regardless of allergic or non-allergic pathophysiology.
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Affiliation(s)
| | - Marina Mauro
- Allergy Department, Sant'Anna Hospital, Como, Italy
| | - Elena Makri
- Cardiac/Pulmonary Rehabilitation, ASST Pini/CTO, Milan, Italy,
| | - Gualtiero Leo
- Pediatric Allergy and Respiratory Pathophysiology Unit, Department of Pediatrics, Vittore Buzzi Children's Hospital, Milan, Italy
| | - Erminia Ridolo
- Department of Medicine and Surgery, University of Parma, Parma, Italy
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21
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Zhang L, Yao L, Zhou WW, Ma JN, Zhang CQ. Computerized tomography features and clinicopathological analysis of Kimura disease in head and neck. Exp Ther Med 2018; 16:2087-2093. [PMID: 30186444 DOI: 10.3892/etm.2018.6431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 05/02/2018] [Indexed: 02/04/2023] Open
Abstract
The aim of the current study was to discuss and analyze computerized tomography (CT) features and clinicopathological characteristics of patients with Kimura disease in head and neck. CT and clinicopathological data of 12 patients with Kimura disease diagnosed between May 2011 and May 2015 were analyzed. The mean age was 43.9 years and the disease course varied from 1 week-20 years. The mean absolute value of eosinophil granulocytes was 1.95×109/l. Multiple nodules were detected in 4 patients with Kimura disease. Main symptoms included multiple enlarged lymph nodes in neck and submaxillary regions. CT imaging of nodular lesions revealed a clear boundary, with moderate to marked homogeneous enhancement. Diffuse mass lesions were observed in 6 patients with Kimura disease. Main symptoms included subcutaneous diffuse soft tissue mass in parotid gland and maxillofacial regions. CT imaging of diffuse mass revealed unclear boundaries, adjacent skin thickness and moderate heterogeneous enhancement. In some cases, the diffuse mass involved soft mass with unclear boundaries. Pathological symptoms of Kimura disease included infiltration of eosinophilia, lymphocytic proliferation, formation of lymphatic follicles and variable degrees of fibrosis and vascular proliferation. Diagnosis of Kimura disease in head and neck regions may be improved based on lesions with clear or unclear boundaries, homogeneous or heterogeneous enhancement, with or without lymphadenectasis and by the presence of peripheral blood eosinophilia. However, a final diagnosis relies on a pathological examination.
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Affiliation(s)
- Li Zhang
- Department of CT Diagnosis, Cangzhou Central Hospital, Cangzhou, Hebei 061001, P.R. China
| | - Li Yao
- Department of Cardiology, Cangzhou Central Hospital, Cangzhou, Hebei 061001, P.R. China
| | - Wei-Wei Zhou
- Department of Pathology, Cangzhou Central Hospital, Cangzhou, Hebei 061001, P.R. China
| | - Jian-Nan Ma
- Department of CT Diagnosis, Cangzhou Central Hospital, Cangzhou, Hebei 061001, P.R. China
| | - Chun-Qian Zhang
- Department of CT Diagnosis, Cangzhou Central Hospital, Cangzhou, Hebei 061001, P.R. China
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22
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Glibbery N, Muscat K, Cascarini L. Kimura's disease of the parotid gland with cutaneous features in a Caucasian female patient. J Surg Case Rep 2018; 2018:rjy067. [PMID: 29657706 PMCID: PMC5890462 DOI: 10.1093/jscr/rjy067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 02/15/2018] [Accepted: 04/04/2018] [Indexed: 11/14/2022] Open
Abstract
Kimura's disease is a rare disease of unknown aetiology, commonly presenting with slow-growing head and neck subcutaneous nodules, lymphadenopathy, eosinophilia and elevated immunoglobulin E. This report describes a very rare case of a 41-year-old female, of White-British ethnicity, with a new diagnosis of Kimura's disease of the parotid gland and associated cutaneous features. The patient was investigated for 3 years before a diagnosis of Kimura's disease was reached. A superficial parotidectomy was undertaken and no recurrence was observed in the 20 months following surgery. Kimura's disease is easily misdiagnosed, owing to lack of clinical awareness. This case report highlights the troubling symptomatology as well as complexities of diagnosis and management of Kimura's disease. A high level of clinical suspicion is required, for patients of any ethnicity and sex presenting with features consistent with the disease, in order for prompt diagnosis, investigation and management to be achieved.
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Affiliation(s)
- Natalia Glibbery
- Department of Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London SE1 9RT, UK
| | - Kenneth Muscat
- Department of Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London SE1 9RT, UK
| | - Luke Cascarini
- Department of Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London SE1 9RT, UK
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23
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Stokes J. Anti-IgE Treatment for Disorders Other Than Asthma. Front Med (Lausanne) 2017; 4:152. [PMID: 28983485 PMCID: PMC5613080 DOI: 10.3389/fmed.2017.00152] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 09/05/2017] [Indexed: 12/21/2022] Open
Abstract
Immunoglobulin E (IgE) plays a key role in the pathogenesis of many allergic diseases. Thus, IgE-mediated immunologic pathways are an attractive target for intervention in allergic diseases. Omalizumab is a recombinant humanized monoclonal antibody that binds IgE and has been used treat allergic asthma for over a decade. Currently, omalizumab is approved for the treatment of both allergic asthma and chronic spontaneous urticaria. Since IgE plays a critical role in other allergic diseases, anti-IgE therapy has been evaluated in other allergic diseases in small clinical trials and case reports. Omalizumab has demonstrated efficacy in treating allergic rhinitis, atopic dermatitis, physical urticarias, mast cell disorders, food allergy, and other allergic diseases. In addition, the use of omalizumab with conventional allergen immunotherapy improves both safety and effectiveness.
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Affiliation(s)
- Jeffrey Stokes
- Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO, United States
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24
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Abstract
The off-label use of medicines is a common and extensive clinical practice. Omalizumab has been licensed for use in severe allergic asthma and chronic urticaria. Omalizumab dosing was based on body weight and baseline serum IgE concentration. All patients are required to have a baseline IgE between 30 and 700 IU/ml and body weight not more than 150 kg. The use of off-label drugs may lead to several problems including adverse effects and an increased risk/benefit balance. In this article, there are summarized off-label uses of omalizumab in the last recent years in diseases in which IgE maybe or certainly has a corner role such as allergic rhinitis, allergic bronchopulmonary aspergillosis, anaphylaxis, keratoconjunctivitis, food allergy, drug allergy, urticaria, angioedema, non-atopic asthma, atopic dermatitis, nasal polyps, Churg-Strauss syndrome, eosinophilic otitis media, chronic rhinosinusitis, bullous pemphigoid, contact dermatitis, and others. Use in pregnancy asthmatic women and pre-co-administration with specific immunotherapy will also be revised.
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Affiliation(s)
- David El-Qutob
- Unit of Allergy, University Hospital of La Plana in Vila-Real, Carretera Vila-Real-Burriana Km. 0.5, Vila-Real, Castellon, 12540, Spain.
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25
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Miki H, Tsuboi H, Kaneko S, Takahashi H, Yokosawa M, Asashima H, Hirota T, Hagiwara S, Umeda N, Kondo Y, Nishimura B, Sugano M, Matsumoto I, Sumida T. A case of refractory Kimura disease with a buccal bulky mass successfully treated with low-dose cyclosporine A: report and review of the literature. Allergol Int 2016; 65:212-214. [PMID: 26666475 DOI: 10.1016/j.alit.2015.10.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 10/17/2015] [Accepted: 10/22/2015] [Indexed: 11/25/2022] Open
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26
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Abstract
The Kimura disease is a benign rare inflammatory condition of the soft tissue, especially of the head and neck region presenting as painless nodule with or without lymphadenopathy. This condition with unknown etiology is seen mainly in Asian males, in their thirties. The authors' present a 39-year-old man with the Kimura disease in the inner canthus of his OS and no lymphadenopathy. The subcutaneous nodule was excised, and on histopathological study it was confirmed as the Kimura disease. He presented with a larger recurrence after 1 year. It was fixed to the underlying bone. Excision biopsy proved it to be the Kimura disease. To the authors' knowledge, this is the first report of the Kimura disease affecting ocular structures. The Kimura disease, although a rare condition, should be considered in the differential diagnosis of the primary and recurrent masses arising from the inner canthus of the eye.
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27
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Stokes JR, Casale TB. The Use of Anti-IgE Therapy Beyond Allergic Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2015; 3:162-6. [DOI: 10.1016/j.jaip.2014.10.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Revised: 10/08/2014] [Accepted: 10/10/2014] [Indexed: 11/29/2022]
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28
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Benazzou S, Boulaadas M, Sefiani S, Essakalli L. [Melolabial subcutaneous nodule]. ACTA ACUST UNITED AC 2014; 115:e37-8. [PMID: 24894553 DOI: 10.1016/j.revsto.2014.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 04/14/2014] [Indexed: 11/26/2022]
Affiliation(s)
- S Benazzou
- Service d'ORL et de chirurgie maxillo-faciale, hôpital des spécialités, Rabat Institut Madinat Al Irfane, BP 6626, Rabat, Maroc.
| | - M Boulaadas
- Service d'ORL et de chirurgie maxillo-faciale, hôpital des spécialités, Rabat Institut Madinat Al Irfane, BP 6626, Rabat, Maroc
| | - S Sefiani
- Centre d'anatomopathologie, Agdal, Rabat, Maroc
| | - L Essakalli
- Service d'ORL et de chirurgie maxillo-faciale, hôpital des spécialités, Rabat Institut Madinat Al Irfane, BP 6626, Rabat, Maroc
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