DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20203585

Kimura’s disease as an uncommon cause of post auricular swelling

Chandre Gowda Bendiganahalli Venkate Gowda, Madhuri Gandham

Abstract


Kimura’s disease (KD) is a rare chronic inflammatory disorder of unknown etiology, primarily seen in young Asian males. In India, only 200 cases have been reported worldwide since its histopathological diagnosis. The disease is characterized by painless subcutaneous swelling in head & neck region, blood and tissue eosinophilia and raised Immunoglobulin E (IgE) levels. A systematic multidisciplinary approach is mandatory to rule out the other common causes of post auricular lymphadenopathy. The diagnosis of KD can be difficult and misleading and patients with this disease are often evaluated using avoidable procedures by just not being aware of KD. Here, we present a case of a 20 year old male who presented with nodular swellings in the bilateral post auricular region. The diagnosis of KD was done based on characteristic histopathologic finding in conjunction with peripheral eosinophilia.


Keywords


Bilateral post auricular lymphadenopathy, Eosinophilia, Histopathology, Kimura’s disease, Immunosuppressant’s

Full Text:

PDF

References


Chen H, Thompson LD, Aguilera NS, Abbondanzo SL. Kimura disease: a clinicopathologic study of 21 cases. Am J Surg Pathol. 2004;28:505-13.

Abhange RS, Jadhav RP, Jain NK. Kimura disease: A rare case report. Ann Pathol Lab Med. 2018;5:53-5.

Abhay H, Swapna S, Darshan T, Vishal J, Gautam P. Kimura’s disease: A rare cause of local lymphadenopathy. Int J Sci Study. 2014;2:122-5.

Tseng CF, Lin HC, Huang SC, Su CY. Kimura’s disease presenting as bilateral parotid masses. Europea Archives of Oto-Rhino-Laryngology. 2005; 262(1):8-10.

Shetty AK, Beaty MW, McGuirt WF, Woods CR, Givner LB. Kimura’s disease: a diagnostic challenge. Pediatrics.2002;110:e39.

Fouda MA, Gheith O, Refaie A, El-Saeed M, Bakr A, Wafa E, et al. Kimura disease: a case report and review of the literature with a new management protocol. Int J Nephrol. 2011;2010:673908.

Majumder A, Sen D. Kimura disease with nephrotic syndrome in a child- A rare association. Indian J Pathol Microbiol. 2019;62:437-40.

Kung IT, Chan JK. Kimura’s disease or Kimm’s disease?. Am J Surg Pathol. 1988;12:804-5.

Kimura T, Yoshimura S, Ishikawa E. On the unusual granulation combined with hyperplastic changes of lymphatic tissue. Trans Soc Pathol Jpn. 1948;37:179-80.

Dhingra H, Nagpal R, Baliyan A, Alva SR. Kimura disease: case report and brief review of literature. Med Pharm Rep. 2019;92(2):195-9.

Kimura Y, Pawankar R, Aoki M, Niimi Y, Kawana S. Mast cells and T cells in Kimura's disease express increased levels of interleukin-4, interleukin-5, eotaxin and RANTES. Clin Exp Allergy. 2002; 32:1787-93.

Kim HT, Szeto C. Eosinophilic hyperplastic lymphogranuloma, comparison with Mikulicz’s disease. Proc Chin Med Soc. 1937;1:329.

Gurram P, Chandran S, Parthasarathy P, Thiagarajan MK, Ramakrishnan K. KIMURA'S disease -An Exclusive condition. Ann Maxillofac Surg. 2019;9:183-7.

Liu C, Hu W, Chen H, Tang Z, Zeng C, Liu Z, et al. Clinical and pathological study of Kimura's disease with renal involvement. J Nephrol. 2008;21:517-25.

Maddisom P, Kiely P, Kirkham B, Lawson T, Moots R, Proudfoot D. et al. Leflunomide in rheumatoid arthritis: recommendations through a process of consensus. Rheumatology (Oxford). 2005;44:280-6.

Tam LS, Li EK, Wong CK, Lam CWK , Li WC, Szeto CC. Safety and efficacy of leflunomide in the treatment of lupus nephritis refractory or intolerant to traditional immunosuppressive therapy :an open label trial. J Ann Rheum Dis. 2006;65:417-8.

Manna SK, Aggarwal BB. Immunosuppressive leflunomide metabolite (A771726) blocks TNF-dependent nuclear factor-kappa B activation and gene expression. J Immunol. 1999;162:2095-102.

Dai L, Wei XN, Zheng DH, Mo YQ, Pessler F, Zhang BY. Effective treatment of Kimura’s disease with leflunomide in combination with glucocorticoids. Clin Rheumatol. 2011;30:859-65.

Swarnkar M, Agrawal A. Kimura's disease. Formos J Surg. 2018;51:26-8.

Zhang G, Li X, Sun G, Yitan C, Gao N, Qi W. Clinical analysis of Kimura’s disease in 24 cases from China. BMC Surg. 2020;20(1):1-5.