Steroid-resistant nephrotic syndrome associated with Kimura's disease.
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.
Chartapisak
Wattana
W
Renal Unit, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Thailand. wchartap@med.cmu.ac.th
Opastirakul
Sauwalak
S
D000293:Adolescent; D000796:Angiolymphoid Hyperplasia with Eosinophilia / Q000150:complications*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000627:therapeutic use; D004351:Drug Resistance; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007668:Kidney / Q000473:pathology; D008297:Male; D009404:Nephrotic Syndrome / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use*
D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011239:Prednisolone