Unusual presentation of kimura's disease

Abstract

Kimura's disease is a rare form of chronic eosinophilic inflammatory disorder with associated lymphadenopathy in head and neck region and serous cavity effusions and marked predilection for the head and neck with a tendency to present as a discrete, enlarging mass. Although many cases of Kimura's disease with head and neck lymphadenopathy and nephrotic syndrome have been described in the literature, only two cases of Kimura's disease presenting with pleural effusion have been reported recently. There are no reports of Kimura's disease with ascites. We report the case of a 38-year-old nondiabetic, normotensive man who had undergone inguinal node biopsy consistent with Kimura's disease, 8 months before he presented to us. On admission, he had right moderate pleural effusion, but no ascites or any lymph nodal involvement. He developed recurrent pleural effusion and ascites in the ward. Initially he showed good remission with systemic steroids, but later on was refractory to further necessary treatment. He also rapidly developed signs of nephrotic syndrome. In spite of vigorous treatment, patient died of severe hypovolemia, hypoproteinemia, and nephropathy.