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

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.Kimura's disease (KD) is a rare, chronic inflammatory disorder of unknown cause. The most common clinical feature of this disease is an asymptomatic unilateral soft-tissue mass in the head and neck. Major salivary glands and lymph nodes may also be involved. Bilateral involvement is rare. Patients almost always have marked peripheral 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.A 25-year-old man presented with bilateral inguinal lymphadenopathy. He was suffering from frequent attacks of asthma for 2 years, and Reynaud phenomenon for a few months.Laboratory findings included a leukocyte count of 13850/mm3 (Neutrophils: 4890 Lymphocytes: 1940 Eosinophils: 5980 (43%)), Hemoglobin = 16.7 g/dL and Platelet = 202000/mm3. C-reactive protein was negative and erythrocyte sedimentation ratio was 1 mm/h. Serum lactate dehydrogenase level was 322 IU/L. Liver function tests were normal. An excisional biopsy of inguinal lymph node showed lymphoid follicles with reactive germinal centers and well defined mantle zones, diffuse interfollicular eosinophilic microabscesses and apparent postcapillary venules, features associated with the diagnosis of KD (figure 1). He was discharged on treatment with oral prednisolone 1 mg/kg/day. One month later a follow up Complete blood coun