Published online August 14, 2006
PEDIATRICS Vol. 118 No. 3 September 2006, pp. e921-e923 (doi:10.1542/peds.2006-0487)
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EXPERIENCE & REASON

Combined Treatment of Steroids and Cyclosporine in Kimura Disease

Satoshi Sato, MD, PhD, Hisashi Kawashima, MD, PhD, Shinji Kuboshima, MD, PhD, Kiyoko Watanabe, MD, PhD, Yasuyo Kashiwagi, MD, PhD, Kouji Takekuma, MD, PhD and Akinori Hoshika, MD, PhD

Department of Pediatrics, Tokyo Medical University, Tokyo, Japan

ABSTRACT

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.

Key Words: Kimura disease • cyclosporine • interleukin • Th2 • eosinophils

Abbreviations: Ig, immunoglobulin • IL, interleukin • mRNA, messenger RNA • Th2, T-helper 2 • sIL-2R, soluble interleukin 2 receptor • ECP, eosinophil cationic protein

Accepted Mar 20, 2006.


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