Chenthilnathan PERİASAMY, Baharudin ABDULLAH, Norzaliana ZAWAWİ, Md Salzihan MD SALLEH

Kimura's disease an unusual cause of lymphadenopathy in a nephrotic syndrome child

Kimura hastalığı, doğuda endemik olan etyolojisi bilinmeyen nadir, bening, kronik inflamutuar bir hastalıktır. Hastalık, baş ve boyun bölgesinde ağrısız subkütanöz nodül, eozinofili ve yüksek serum immunoglobulin E (IgE) düzeyleri üçlüsü ile karakterizedir. Kimura hastalığının, eozinofilik lenfogranuloma, inflammatuar anjiomatöz nodül ve atipik pyojenik granuloma gibi çeşitli sinonimleri vardır. Kimura hastalığı ve renal lezyon arasında ortak etyopatogenezi oluşturan nefrotik sendrom gibi renal patoloji Kimura hastalığı ile birlikte bulunur. Biz, sol kulak arkası şişliği olan tekrarlamalı nefrotik sendromlu 11 yaşında Malezyalı bir erkek çocuğu sunuyoruz. Diyagnoz, cerrahi biyopsi sonrasındaki karakteristik histopatoloji bulgularına dayanarak Kimura hastalığı idi.

Nefrotik sendromlu bir çocukta lenfadenopatinin olağandışı nedeni olarak Kimura hastalığı

Kimura s disease is a rare, benign, chronic inflammatory disorder of unknown etiology which is endemic in Orientals. The disease is characterized by a triad of painless subcutaneous nodule in the head and neck region, blood eosinophilia and elevated serum immunoglobulin E (IgE) levels. Kimura s disease has various synonyms such as eosinophilic lymphogranuloma, inflammatory angiomatous nodule and atypical pyogenic granuloma. Renal pathology such as nephrotic syndrome has been found to be associated with Kimura s disease which states a common etiopathogenesis between renal lesion and Kimura s disease. We present an eleven years old Malay boy with recurrent nephrotic syndrome presented with left post auricular swelling. The diagnosis was based on the characteristic histopathology findings after surgical biopsy as Kimura s disease.

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1. Goldenberg D, Gatot A, Barki Y, Leiberman A, Fliss DM. Computerized tomographic and ultrasonographic features of Kimura's disease. J Laryngol Otol 1997;111(4):389-91.
2. Kung IT, Gibson JB, Bannatyne PM. Kimura's disease: a clinico-pathological study of 21 cases and its distinction from angiolymphoid hyperplasia with eosinophilia. Pathology 1984;16(1):39-44.
3. Ranka SR, Rajput A, Kantharia CV. Kimuras disease. A Case Report. Indian J Otolaryngol Head Neck Surg 2004;56(1):43-5.
4. Yuen HW, Goh YH, Low WK, Lim-Tan SK. Kimura's disease: a diagnostic and therapeutic challenge. Singapore Med J 2005;46(4):179-83.
5. Matsuda O, Makiguchi K, Ishibashi K, Chida Y, Ida T, Matsuda K, et al. Long-term effects of steroid treatment on nephrotic syndrome associated with Kimura's disease and a review of the literature. Clin Nephrol 1992;37(3):119-23.
6. Yamada A, Mitsuhashi K, Miyakawa Y, Kosaka K, Takehara K, Iijima M, et al. Membranous glomerulonephritis associated with eosinophilic lymphfolliculosis of the skin (Kimura's disease): report of a case and review of the literature. Clin Nephrol 1982;18(4):211-5.
7. Whelan TV, Maher JF, Kragel P, Dysart N, Dannenhoffer R, Prager L. Nephrotic syndrome associated with Kimura's disease. .Am J Kidney Dis 1988;11(4):353-6.
8. Atar S, Oberman AS, Ben-Izhak O, Flatau E. Recurrent nephrotic syndrome associated with Kimura's disease in a young non-Oriental male. Nephron 1994;68(2):259-61.
9. Chen H, Thompson LD, Aguilera NS, Abbondanzo SL. Kimura disease: a clinicopathologic study of 21 cases. Am J Surg Pathol 2004;28(4):505-13.
10. Kuo TT, Shih LY, Chan HL. Kimura's disease. Involvement of regional lymph nodes and distinction from angiolymphoid hyperplasia with eosinophilia. Am J Surg Pathol 1988;12(11):843-54.
11. Gumbs MA, Pai NB, Saraiya RJ, Rubinstein J, Vythilingam L, Choi YJ. Kimura's disease: A case report and literature review. J Surg Oncol 1999;70(3):190-3.
12. Deshpande AH, Nayak S, Munshi MM, Bobhate SK. Kimura's disease. Diagnosis by aspiration cytology. Acta Cytol 2002;46(2):357-63.
13. Chartapisak W, Opastirakul S. Steroid-resistant nephrotic syndrome associated with Kimuras Disease. Am J Nephrol 2002;22(4):381-4.
14. Asma A, Maizaton AA. Kimuras disease: an unusual cause of cervical tumor. Med J Malaysia 2005;60(3):373-6.
15. Sud K, Saha T, Das A, Kakkar N, Jha V, Kohli HS, et al. Kimuras disease and minimal-change nephrotic syndrome. Nephrol Dial Transplant 1996;11(7):1349-51.
16. Shahrul H, Baharudin A, Effat O. Kimuras disease in Malay patients. Med J Malaysia 2007;62(3):263-4.