Mechanism of Eosinophil Infiltration in the Patient with Subcutaneous Angioblastic Lymphoid Hyperplasia with Eosinophilia (Kimura’s Disease)

Abstract

Kimura’s disease is a chronic granulomatous disease of unknown etiology. Although eosinophilia is one of the characteristic features in this disease, little is known about the mechanism of eosinophilia. In the present study it was demonstrated that interleukin-5 (IL-5) was produced and released from the site of a granuloma and lymph nodes after stimulation with Candida antigen. It was also shown that peripheral blood eosinophils from patients with Kimura’s disease contained a large proportion of hypodense eosinophils and that their viability was prolonged. These results strongly suggest that locally produced IL-5 induced by Candida antigen contributes to the eosinophilia in this disease.

Retrospective Multicentric Study of 25 Kimura Disease Patients: Emphasis on Therapeutics and Shared Features with Cutaneous IgG4-Related Disease

“…The pathogenesis of KD has not been elucidated, but some biological and pathological data (elevated serum IgE, PB eosinophilia and IgE deposition in dendritic reticulum cells in germinal centers) have oriented the hypotheses toward an allergic response to an unidentified antigen [30], for example a parasitic infection [31] or a toxin [32]. Human herpesvirus-8 and Epstein-Barr virus could not be identified in several studies [33,34].…”

A Case of Eosinophilic Myocarditis Complicated by Kimura's Disease (Eosinophilic Hyperplastic Lymphogranuloma) and Erythroderma

“…The serum concentration of eosinophil cationic protein, which is associated with cardiac damage, is higher in patients with Kimra's disease than in healthy people. 4 Unfortunately, we were not able to determine the serum eosinophilic cationic protein concentration in the present patient. In a recent Fig 5.…”

“…4 Our patient did not have Candida antigen or any other common antigens, but as his occupation had been dealing with tires and inspiring much dust every day, some kind of dust related to his environment might have stimulated his immune system. The current therapies for Kimura's disease are surgical removal of the tumor, radiation, and corticosteroid therapy.…”

Elevated Numbers of Cells Producing Interleukin-5 and Interleukin-10 in a Boy with Kimura Disease

“…Autoimmunity [10], neoplasms [11], insect bites [12] and candidal infection [13] have been implicated but not confirmed in the pathogenesis of Kimura disease; the presence of eosinophilia and increased IgE suggest an allergy [14], but no specific allergen has been identified. Gene expression levels of IL-4, IL-5 and IL-13 in PBMCs were enhanced and correlated with disease activity [2], eosinophilia and IgE [15].…”