[A case of Kimura disease treated with interferon and general corticoid therapy].
BACKGROUND
A case of Kimura's disease that occurred in a 5-year-old Caucasian boy after a tick bite is reported. When the child was 16 years old, symptoms developed. They included voluminous bilateral neck and head lymph nodes associated with hypereosinophilia (1,640/mm3), and increased IgE levels (18,866 KU/L). Clinical and immunological effects of treatment by interferon-alpha and steroids are presented.


METHODS
Pathological and histological examination showed typical features of dense lymphoid cell infiltrates containing many eosinophils, mast cells, and vascular hyperplasia. Percentages of CD4+, CD27-, CD7- cells were increased In the blood and lymph nodes, showing a profile typical of TH2. IL-5 production by these cells was markedly increased and was inhibited by IFN-alpha and IFN-beta in vitro. No etiology was found. The role of antigens of Ixodes ricinus is discussed. Three surgical excisions of adenopathies were not successful. Treatment by IFN-alpha (Introna, Schering-Plough, 5.10(6) U/week) and a bolus of methylprednisolone hemisuccinate (1 g/month) was started. Eight months later, the size of the lymph nodes had decreased; however, eosinophil counts and ECP and IgE levels were still high. The decrease in corticosteroid induced a subsequent, slight increase in the size of the lymph nodes and a marked increase in ECP.


CONCLUSIONS
This is the first description of treatment of Kimura's disease by interferon-alpha and steroids. The disease outcome does not suggest that interferon-alpha may predominate.
Kanny
G
G
Service de médecine D, immunologie clinique et allergologie, hôpital Central, Nancy, France.
Cogan
E
E
Marie
B
B
Schandene
L
L
Moneret-Vautrin
D A
DA
D000293:Adolescent; D000796:Angiolymphoid Hyperplasia with Eosinophilia / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D004802:Eosinophilia / Q000175:diagnosis; D006801:Humans; D006942:Hypergammaglobulinemia / Q000175:diagnosis; D007074:Immunoglobulin G; D016898:Interferon-alpha / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D008776:Methylprednisolone Hemisuccinate / Q000627:therapeutic use*
D000893:Anti-Inflammatory Agents; D007074:Immunoglobulin G; D016898:Interferon-alpha; D008776:Methylprednisolone Hemisuccinate
Une observation de maladie de Kimura traitée par interféron et corticothérapie générale.