Kimura's disease with eosinophilic panniculitis--treated with cyclosporine: a case report

Abstract

Kimura's disease is a rare, benign, slow growing chronic inflammatory swelling with a predilection for the head and neck region and almost always with peripheral blood eosinophilia and elevated serum IgE levels. Here, we report a 25-year-old male patient with asthma, Reynaud phenomenon, eosinophilic panniculitis, bilateral inguinal lymphadenopathy and peripheral blood eosinophilia.He responded initially to oral prednisolone with the subsidence of peripheral blood eosinophilia, asthma and the Reynaud phenomenon. But with tapering of prednisolone symptoms reappeared and hereby he was treated with cyclosporine. He has been symptom free for 6 months of follow up while taking cyclosporine 25 mg orally per day. Eosinophilia has resolved. This case shows that in addition to previously reported associations, Kimura disease may be associated with eosinophilic panniculitis and that cyclosporine could be effective in its treatment.

Figure 1

Inguinal lymph node biopsy. Note the diffuse interfollicular eosinophilic microabscesses in the lymph node.

Figure 2

Eosinophilic panniculitis. Dense infiltration of lymphocytes, neutrophils and eosinophils (predominantly eosinophils) in perivascular and periadnexal areas.