Combined treatment of steroids and cyclosporine in Kimura disease.
Kimura disease is a rare but distinctive chronic eosinophilic inflammatory disorder that is characterized by tumor-like lesions in the soft tissue and lymph nodes of the head and neck or parotid gland. Recently, many immunopathogenetic features of underlying T lymphocytes and related cytokines have been noted in Kimura disease. However, few previous studies have investigated the serial levels of cytokines in children. In this report we describe an 11-year-old Japanese boy with relapsing Kimura disease. Before the diagnosis of Kimura disease, the patient had a swelling on his left neck. Steroids were effective, but the tumor relapsed within a few months as the steroids were tapered. He was treated with steroids and cyclosporine. This treatment was done by measuring serial levels of serum soluble interleukin-2 receptor, interleukin-4, interleukin-5, and eosinophil cationic protein. These results suggest the activation of T-helper cells and T-helper 2 cytokines, that after activated B cells and eosinophilic infiltration play an important role in Kimura disease, and that cyclosporine suppresses the activity of this disease.
Sato
Satoshi
S
Department of Pediatrics, Tokyo Medical University, Nishishinjuku, Tokyo, Japan. sato115@tokyo-med.ac.jp
Kawashima
Hisashi
H
Kuboshima
Shinji
S
Watanabe
Kiyoko
K
Kashiwagi
Yasuyo
Y
Takekuma
Kouji
K
Hoshika
Akinori
A
D000796:Angiolymphoid Hyperplasia with Eosinophilia / Q000188:drug therapy* / Q000276:immunology; D002648:Child; D016572:Cyclosporine / Q000627:therapeutic use*; D016207:Cytokines / Q000097:blood; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D012008:Recurrence; D013256:Steroids / Q000627:therapeutic use*; D006377:T-Lymphocytes, Helper-Inducer
D016207:Cytokines; D007166:Immunosuppressive Agents; D013256:Steroids; D016572:Cyclosporine