An Unusual Case of Systemic Lymphadenopathy - Kimura’s Disease

Yongchang Liu,1 Shichang Liu,2 Jia Xu,3 Xiaocheng Xu,3 Meiyun Wang3 1Department of Vascular Surgery, Affiliated Hangzhou First People’s Hospital, ZheJiang University School of Medicine, Hangzhou, Zhejiang Province, People’s Republic of China; 2Department of Pharmacy, Weifang Mental Health Center, We...

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Main Authors: Liu Y, Liu S, Xu J, Xu X, Wang M
Format: Article
Language:English
Published: Dove Medical Press 2023-02-01
Series:Journal of Inflammation Research
Subjects:
Online Access:https://www.dovepress.com/an-unusual-case-of-systemic-lymphadenopathy---kimuras-disease-peer-reviewed-fulltext-article-JIR
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author Liu Y
Liu S
Xu J
Xu X
Wang M
author_facet Liu Y
Liu S
Xu J
Xu X
Wang M
author_sort Liu Y
collection DOAJ
description Yongchang Liu,1 Shichang Liu,2 Jia Xu,3 Xiaocheng Xu,3 Meiyun Wang3 1Department of Vascular Surgery, Affiliated Hangzhou First People’s Hospital, ZheJiang University School of Medicine, Hangzhou, Zhejiang Province, People’s Republic of China; 2Department of Pharmacy, Weifang Mental Health Center, Weifang, Shandong Province, People’s Republic of China; 3Department of Oncology, The First People’s Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang Province, People’s Republic of ChinaCorrespondence: Meiyun Wang, Department of Oncology, The First People’s Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang Province, People’s Republic of China, Email meiyun_828@126.comBackground: Kimura’s disease (KD) is a rare, chronic inflammatory disease. Clinically, subcutaneous nodules of the head and neck are typical manifestations, often accompanied by local lymphadenopathy or salivary gland enlargement, but there is also systemic damage, such as kidney involvement. Due to the lack of specific markers and imaging examination is not specific, it is difficult to clinically diagnose accurately and can be easy to misdiagnose. The treatment of KD is still not standardized and overtreatment can affect the quality of life.Case Presentation: The case of a 26-year-old man complaining of chest pain with self-conscious progressive lymphadenopathy after receiving Pfizer BioNTech COVID-19 vaccine for more than 1 month is presented. Eosinophil levels were normal and IgE elevated and the final diagnosis of KD was eventually confirmed by lymph node biopsy, which revealed lymphadenopathy with extensive eosinophilic infiltration in the right neck. Treatment was prednisone combined with methotrexate, resulting in satisfactory control.Conclusion: This case demonstrates that that Kimura disease can involve systemic lymphadenopathy, not only in the head and face or regional lymphadenopathy, suggested that KD should be excluded in patients with systemic lymphadenopathy. The current patient’s response to treatment suggested that corticosteroid combined with disease-modifying antirheumatic drugs (DENARDs) was a promising treatment for KD patients with systemic damage. It is worth noting that the mechanism of immunity in the pathogenesis of KD still needs to be further studied.Keywords: Kimura’s disease, lymphadenopathy, COVID-19 vaccine, granulomatous disease, lymphadenopathy
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spelling doaj.art-c3e5de19f9154fb3a36e6e916c337e702023-02-19T13:56:56ZengDove Medical PressJournal of Inflammation Research1178-70312023-02-01Volume 1670170581745An Unusual Case of Systemic Lymphadenopathy - Kimura’s DiseaseLiu YLiu SXu JXu XWang MYongchang Liu,1 Shichang Liu,2 Jia Xu,3 Xiaocheng Xu,3 Meiyun Wang3 1Department of Vascular Surgery, Affiliated Hangzhou First People’s Hospital, ZheJiang University School of Medicine, Hangzhou, Zhejiang Province, People’s Republic of China; 2Department of Pharmacy, Weifang Mental Health Center, Weifang, Shandong Province, People’s Republic of China; 3Department of Oncology, The First People’s Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang Province, People’s Republic of ChinaCorrespondence: Meiyun Wang, Department of Oncology, The First People’s Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang Province, People’s Republic of China, Email meiyun_828@126.comBackground: Kimura’s disease (KD) is a rare, chronic inflammatory disease. Clinically, subcutaneous nodules of the head and neck are typical manifestations, often accompanied by local lymphadenopathy or salivary gland enlargement, but there is also systemic damage, such as kidney involvement. Due to the lack of specific markers and imaging examination is not specific, it is difficult to clinically diagnose accurately and can be easy to misdiagnose. The treatment of KD is still not standardized and overtreatment can affect the quality of life.Case Presentation: The case of a 26-year-old man complaining of chest pain with self-conscious progressive lymphadenopathy after receiving Pfizer BioNTech COVID-19 vaccine for more than 1 month is presented. Eosinophil levels were normal and IgE elevated and the final diagnosis of KD was eventually confirmed by lymph node biopsy, which revealed lymphadenopathy with extensive eosinophilic infiltration in the right neck. Treatment was prednisone combined with methotrexate, resulting in satisfactory control.Conclusion: This case demonstrates that that Kimura disease can involve systemic lymphadenopathy, not only in the head and face or regional lymphadenopathy, suggested that KD should be excluded in patients with systemic lymphadenopathy. The current patient’s response to treatment suggested that corticosteroid combined with disease-modifying antirheumatic drugs (DENARDs) was a promising treatment for KD patients with systemic damage. It is worth noting that the mechanism of immunity in the pathogenesis of KD still needs to be further studied.Keywords: Kimura’s disease, lymphadenopathy, COVID-19 vaccine, granulomatous disease, lymphadenopathyhttps://www.dovepress.com/an-unusual-case-of-systemic-lymphadenopathy---kimuras-disease-peer-reviewed-fulltext-article-JIRkimura's disease;lymphadenopathy;covid-19 vaccinegranulomatous diseaselymphadenopathy
spellingShingle Liu Y
Liu S
Xu J
Xu X
Wang M
An Unusual Case of Systemic Lymphadenopathy - Kimura’s Disease
Journal of Inflammation Research
kimura's disease;lymphadenopathy;covid-19 vaccine
granulomatous disease
lymphadenopathy
title An Unusual Case of Systemic Lymphadenopathy - Kimura’s Disease
title_full An Unusual Case of Systemic Lymphadenopathy - Kimura’s Disease
title_fullStr An Unusual Case of Systemic Lymphadenopathy - Kimura’s Disease
title_full_unstemmed An Unusual Case of Systemic Lymphadenopathy - Kimura’s Disease
title_short An Unusual Case of Systemic Lymphadenopathy - Kimura’s Disease
title_sort unusual case of systemic lymphadenopathy kimura rsquo s disease
topic kimura's disease;lymphadenopathy;covid-19 vaccine
granulomatous disease
lymphadenopathy
url https://www.dovepress.com/an-unusual-case-of-systemic-lymphadenopathy---kimuras-disease-peer-reviewed-fulltext-article-JIR
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