IgM Nephropathy in a Patient with Kimura’s Disease

Chan, Tak‐Mao; Chan, Patricia C.K.; Chan, Kwok Wah; Cheng, Ikp

doi:10.1159/000186489

Cited by 28 publications

(22 citation statements)

References 5 publications

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“…In most cases the onset of nephrotic syndrome occurred simultaneously with skin lesions [10]. However, there were a few cases having nephrotic syndrome before skin lesions appeared [4,11]. The present case also developed nephrotic syndrome 4 years before the appearance of the mass in the left parotid gland area.…”

Section: Discussionmentioning

confidence: 52%

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Steroid-Resistant Nephrotic Syndrome Associated with Kimura’s Disease

Chartapisak¹,

Opastirakul²

2002

Am J Nephrol

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Kimura’s disease is a chronic inflammatory disease characterized by tumor-like lesions in the soft tissue and lymph nodes of head and neck area or parotid gland. It has a high frequency of an association with nephrotic syndrome. Reported cases of nephrotic syndrome and Kimura’s disease were mostly from adult patients with only 5 children mentioned. This study reports the case of a 15-year-old-boy who manifested with steroid-resistant nephrotic syndrome for 4 years. Pathological examination of the kidney revealed mild mesangial proliferation. Subsequently, he developed a soft-tissue mass in the parotid gland area. Histopathological investigation of the mass revealed eosinophilic infiltration together with plasma cells and mast cells which is a main characteristic of Kimura’s disease. The patient, however, continued to have nephrotic-range proteinuria after removing the subcutaneous mass.

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Section: Discussionmentioning

confidence: 52%

“…Reports of adult patients also revealed various histopathologies of the kidney in those who had nephrotic syndrome associated with Kimura's disease. Membranous glomerulopathy was commonly found, but minimalchange glomerulopathy and IgM nephropathy also have been described [8,11].…”

Section: Discussionmentioning

confidence: 99%

Steroid-Resistant Nephrotic Syndrome Associated with Kimura’s Disease

Chartapisak¹,

Opastirakul²

2002

Am J Nephrol

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“…Renal biopsy has shown various forms of renal pathology, such as membranous nephropathy [16], MCD [17], MsPGN [18], IgM nephropathy [19], FSGS [20] and IgA nephropathy[21]. In the literature, MN is the commonest pathological finding; although in the present study, MsPGN was the commonest result in renal biopsy.…”

Section: Discussionmentioning

confidence: 71%

“…However, several immunopathogenetic features have been noted in this disease. The presence of high serum IgE levels and eosinophilia in Kimura disease, and the responsiveness to immunosuppressive agents in some cases, may suggest a pathogenetic alteration in the immune function [19]. Corticosteroids and immunosuppressive agents such as cyclosporine A have been reported for the treatment of Kimura disease as well as nephrotic syndrome [22], which may reflect the immunopathogenetic resemblance between the two entities.…”

Section: Discussionmentioning

confidence: 99%

Kimura Disease: A Case Report and Review of the Chinese Literature

et al. 2008

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Background: Kimura disease, often accompanied by nephrotic syndrome, is a rare, chronic inflammatory disorder of unknown cause. In this report, the clinical and histopathological characteristics of 20 Chinese patients with Kimura disease-associated nephrotic syndrome were retrospectively evaluated. Methods: We report a case of Kimura disease that was diagnosed recently in our ward, with steroid-responsive but recurrent minimal-change nephrotic syndrome. Meanwhile, we also used three powerful Chinese journal search engines (Cqvip.com, Wanfang.data and ScienceChina) to search the cases reported in Chinese from 1984 to 2007. Results: The nephrotic syndrome of our patient occurred 20 months after the onset of Kimura disease. Renal biopsy revealed minimal-change lesions. The patient was responsive to the steroid, but proteinuria recurred. In most of the 19 other cases, the onset of nephrotic syndrome occurred after subcutaneous masses. Renal biopsy in 13 cases showed mesangial proliferative glomerulonephritis in 9, minimal change disease in 2 and membrane nephropathy in 2 cases. Serum creatinine levels were elevated in 5 patients. Conclusion: Normally, Kimura disease-associated nephrotic syndrome patients are sensitive to prednisone therapy but are likely to relapse. In patients with recurrent nephrotic syndrome, renal insufficiency is not uncommon.

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“…The interval between onset of subcutaneous lesion and renal involvement may be longer than 10 years [6]. Characteristically, renal response to steroid therapy is often as good as it is in primary glomerular disease, although relapse may also occur after treatment [11,12]. However, information about the course of KD and its long-term renal outcome is limited.…”

Section: Discussionmentioning

confidence: 99%

Kimura’s Disease in a Chronic Hemodialysis Patient

Lee

Huang²,

Lam³

et al. 2001

Am J Nephrol

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Eosinophilia is not an uncommon finding in chronic dialysis patients. It is usually benign in nature although definite pathogenesis is unknown. We have encountered a young uremic Chinese adult who developed Kimura’s disease after being on maintenance hemodialysis for about 3 years. Asymptomatic eosinophilia had been noted for 1 year and 8 months prior to the development of progressively enlarged neck masses, which leads to the diagnosis of Kimura’s disease. In contrast to most cases, eosinophilia was first noticed before the neck masses appeared. There is often a close correlation between Kimura’s disease and glomerular disease, where renal involvement is considered as a systemic manifestation. However, we do not have strong evidence to support this relationship between terminal renal failure and Kimura’s disease in this patient. To our knowledge, our patient is the first reported case of Kimura’s disease occurring in chronic hemodialysis patients. Eosinophilia persisted for nearly 2 years before the neck mass developed and recurred after the excision. Besides, our patient also demonstrated a chronic and recurrent course typical of Kimura’s disease.

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IgM Nephropathy in a Patient with Kimura’s Disease

Cited by 28 publications

References 5 publications

Steroid-Resistant Nephrotic Syndrome Associated with Kimura’s Disease

Steroid-Resistant Nephrotic Syndrome Associated with Kimura’s Disease

Kimura Disease: A Case Report and Review of the Chinese Literature

Kimura’s Disease in a Chronic Hemodialysis Patient

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