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

Dermatology. 2015;231(4):367-77. doi: 10.1159/000439346. Epub 2015 Oct 10.

Abstract

Background: Kimura disease (KD) is a rare lymphoproliferative inflammatory disease of unknown etiology. Data regarding therapeutic modalities and pathophysiology are scarce.

Objectives: Analyze therapeutic and follow-up data and compare KD with cutaneous IgG4-related disease (IgG4-RD).

Methods: Multicentric retrospective study of 25 KD patients with analysis of treatment, follow-up and IgG4 immunostaining. Comparison with published cases of cutaneous IgG4-RD.

Results: Patients were mostly male (84%), median-aged 42 years with lymph node, lacrimal/salivary gland and kidney involvements in 45, 24 and 12%, respectively. Surgical excision had 100% complete response and 60% relapse. Oral corticosteroids had 100% response with 50% relapse. Thalidomide, cyclosporine or interferon-α had 100% response, but 100, 20 and 50% relapse, respectively. KD showed clinicopathological similarities with 27 published cases of cutaneous IgG4-RD.

Conclusion: Surgery may be used in resectable KD cases, whereas cyclosporine or thalidomide may represent interesting alternatives to oral corticosteroids in other cases. KD shares features with cutaneous IgG4-RD.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiolymphoid Hyperplasia with Eosinophilia / immunology*
  • Angiolymphoid Hyperplasia with Eosinophilia / pathology
  • Angiolymphoid Hyperplasia with Eosinophilia / therapy*
  • Cyclosporine / therapeutic use
  • Dermatologic Surgical Procedures
  • Eosinophilia / etiology
  • Female
  • Humans
  • Immunoglobulin E / blood
  • Immunoglobulin G / analysis*
  • Immunologic Factors / therapeutic use
  • Immunosuppressive Agents / therapeutic use
  • Interferon-alpha / therapeutic use
  • Male
  • Middle Aged
  • Plasma Cells / chemistry
  • Recurrence
  • Retrospective Studies
  • Thalidomide / therapeutic use
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Immunoglobulin G
  • Immunologic Factors
  • Immunosuppressive Agents
  • Interferon-alpha
  • Immunoglobulin E
  • Thalidomide
  • Cyclosporine