title: Refractory hypertension and anemia in end-stage renal disease: an unusual manifestation of Kimura's disease.
abstract: Hypertension and anemia are common in uremic patients. This article describes a 35-year-old uremic Taiwanese who was admitted to our hospital with refractory hypertension and refractory anemia following chronic hemodialysis for more than two years. He was diagnosed with Kimura's disease finally. Refractory hypertension and refractory anemia were noted over two years before an enlarged inguinal lymph node was observed. The symptoms lead to the diagnosis of Kimura's disease. Unlike most cases, refractory hypertension and refractory anemia were first noted before the inguinal mass and eosinophilia were presented. The inflammatory parameters increased when the disease was active. Steroid treatment was conducted, and the symptoms including hypertension and anemia promptly decreased. To the authors' knowledge, this case is for first one in which Kimura's disease has induced refractory hypertension and anemia in an ESRD patient and in which these symptoms rapidly subsided following steroid treatment. The activity of Kimura's disease is closely related refractory hypertension, suggesting that inflammation may be involved in refractory hypertension and anemia in a dialytic patient with Kimura's disease.
authors.affiliation: Division of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Po-Yaur
authors.initials: PY
authors.lastname: Hsu
authors.forename: Huan-Yu
authors.initials: HY
authors.lastname: Yang
authors.forename: Chun-Chie
authors.initials: CC
authors.lastname: Lin
authors.forename: Ming-Chung
authors.initials: MC
authors.lastname: Kuo
authors.forename: Chun-Liang
authors.initials: CL
authors.lastname: Lin
authors.forename: Chiu-Ching
authors.initials: CC
authors.lastname: Huang
mesh_terms: D000328:Adult; D000740:Anemia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D000796:Angiolymphoid Hyperplasia with Eosinophilia / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D018450:Disease Progression; D005923:Glomerulosclerosis, Focal Segmental / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008297:Male; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011239:Prednisolone / Q000627:therapeutic use; D006435:Renal Dialysis; D013624:Taiwan
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone