Kimura’s disease of the left arm

Mulla, Fahad; Bomanwar, Nitin; Sakhare, Sonika; Pinto, Christopher J.

doi:10.1136/bcr-2022-250758

Cited by 6 publications

(7 citation statements)

References 15 publications

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“…KD is frequently associated with renal involvement, including proteinuria and nephrotic syndrome (NS) as the most common presentations. [ 7 20 ] In this study, nephritis was presented in 44.4% (12/27) patients, which was consistent with the previous estimation of 10%-60%. [ 20 ] 83.3% (10/12) of KD patients with renal involvement were NS.…”

Section: Discussionsupporting

confidence: 92%

“…[ 6 ] KD often involves multiple organs such as the eye, epiglottis, kidney and blood. [ 6 7 8 9 ] Painless subcutaneous soft mass usually affecting head and neck, marked peripheral blood eosinophilia and high level of immunoglobulin E (IgE) are common presentations. [ 1 2 4 6 ] Due to rarity and atypical onset symptoms, KD often conducts a diagnostic challenge for clinicians, which can easily be confused with angiolymphoid hyperplasia with eosinophilia (ALHE).…”

Section: Introductionmentioning

confidence: 99%

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Risk of Nephritis and Recurrence in Kimura Disease: A Retrospective Study

Zhang,

Chen,

Hui

et al. 2023

Indian Journal of Dermatology

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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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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Risk of Nephritis and Recurrence in Kimura Disease: A Retrospective Study

Zhang,

Chen,

Hui

et al. 2023

Indian Journal of Dermatology

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“…KD was most frequently observed in the head and neck, which is consistent with previous studies. 15 Other less frequent sites include the arm, 16 thigh, 17 groin, 18 breast, 19 back, 10 and et al Lee et al 10 proposed a male-to-female ratio of 4.5:1 and identified the peak age at diagnosis as middle-aged (median: 41.35 years) for patients with KD. At the same time, the males accounted for 75% of all patients in this study and the mean age at diagnosis was 43 years ranging from 13–71 years, which is similar to the findings of the above-mentioned studies in the literature.…”

Section: Discussionmentioning

confidence: 99%

Kimura Disease: A Detailed Analysis of Clinical and Radiological Manifestations in a Retrospective Case Series

Zhao,

Zhou,

Mao

et al. 2024

JIR

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Background Kimura disease (KD) is a rare chronic inflammatory disease that affects mainly young Asian men and is characterized by painless subcutaneous masses, lymphadenopathy, and elevated serum IgE levels. Despite its benign nature, KD poses a diagnostic and therapeutic challenge due to its rarity and clinical variability. Objective This study aimed to provide a comprehensive analysis of the clinical and radiological features of KD in a retrospective case series, to assess treatment outcomes, and to discuss the implications for diagnosis and management. Methods We retrospectively analyzed four histologically confirmed cases of KD admitted to Zhejiang Provincial People’s Hospital from January 2018 to October 2023. Clinical and radiological data were retrospectively analyzed, and imaging findings were analyzed by two neuroradiologists to determine lesion characteristics and contrast enhancement patterns. Results Our findings showed that the patients were predominantly male, with a mean age of 43 years and an age range of 13–71 years. All patients presented with painless subcutaneous masses and three of them had peripheral blood eosinophilia and elevated serum IgE levels. Radiographically, the lesions were predominantly ill-defined with heterogeneous enhancement, accompanied by subcutaneous fat atrophy. Complete surgical excision and oral corticosteroids were effective treatments, and no recurrence was noted during follow-up. Conclusion KD should be considered in the differential diagnosis of painless subcutaneous masses in the head and neck region, especially in the presence of eosinophilia and elevated IgE levels. Our findings contribute to the understanding of KD’s clinical and radiological spectrum and highlight the need for long-term follow-up due to the risk of recurrence.

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“…The most frequently affected areas are the head and neck region, especially the parotid glands, salivary glands, and lymph nodes (9). Masses in other areas, such as the groin (10), breast (11), arm (12), thigh (13), and orbit (14), have also been reported. This study was consistent with previous studies that most lesions (14/16) were located in the head and neck region, but there were still two cases located in the back and elbow, respectively.…”

Section: Discussionmentioning

confidence: 99%

Kimura disease in children: A report of 11 cases and review of the literature

Mai

Wang²,

Sun³

et al. 2023

Front. Pediatr.

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IntroductionKimura disease (KD), also known as eosinophilic hyperplastic lymphoid granuloma, is a rare benign chronic inflammatory condition, which is featured with the painless progressive mass located in the subcutaneous area of the head and neck region, elevated peripheral blood eosinophils, and raised serum immunoglobulin E (IgE) levels. KD is uncommon in clinical practice, especially with low incidence in children, so it often leads to misdiagnosis or missed diagnosis in pediatric patients.MethodsThe clinical data of 11 pediatric patients with KD in the authors' institution were retrospectively analyzed.ResultsThere were 11 pediatric patients with KD enrolled in total, including 9 male patients and 2 female patients (sex ratio 4.5:1). The median age at diagnosis stood at 14 years (range 5-18 years), the initial symptoms in all patients included painless subcutaneous masses and focal swelling, the duration of symptoms ranged from 1 month to 10 years, and the average duration was 24.45 months. Six patients had single lesions, and 5 had multiple lesions. The highest proportion of lesion regions were parotid gland (n = 5, 31.3%) and retroauricular (n = 5, 31.3%), followed by cervical lymph nodes (n = 4, 25%), and others (n = 2,12.5; elbow n = 1; back n = 1). The eosinophil absolute count elevated in all patients, ranging from 0.71×109/L to 10.35 ×109/L (normal range 0.02-0.52×109/L). IgE levels were increased in all 7 patients who underwent serum immunoglobulin examination (normal range <100 IU/mL). Three patients received oral corticosteroid treatment while 2 relapsed. Three patients received surgical resection combined with oral corticosteroid treatment, and no patient relapsed. The other 3 patients received surgery and radiotherapy, surgery combined with corticosteroid and cyclosporin and corticosteroid combined with leflunomide respectively, and no patient relapsed.ConclusionBase on the study, it is found that Kimura disease is rare and may have the atypical symptoms in pediatric patients, combination therapy is recommended to reduce recurrence, and long-term follow-up should be performed.

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Kimura’s disease of the left arm

Cited by 6 publications

References 15 publications

Risk of Nephritis and Recurrence in Kimura Disease: A Retrospective Study

Risk of Nephritis and Recurrence in Kimura Disease: A Retrospective Study

Kimura Disease: A Detailed Analysis of Clinical and Radiological Manifestations in a Retrospective Case Series

Kimura disease in children: A report of 11 cases and review of the literature

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