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Kimura's disease and membranous nephropathy
A B Akosa1, A Sherif, C G Maidment
1Department of Histopathology, Wexham Park Hospital, Slough, UK.
Nephron
|January 1, 1991
Summary
Kimura disease is linked with membranous nephropathy in a Chinese patient presenting with high IgE and eosinophilia. Candida albicans is a potential trigger for this rare association.
Area of Science:
- Nephrology
- Immunology
- Dermatology
Background:
- Kimura disease is a rare, chronic inflammatory condition characterized by head and neck swelling, eosinophilia, and elevated IgE.
- Membranous nephropathy is a leading cause of nephrotic syndrome in adults, characterized by immune complex deposition in the glomeruli.
Observation:
- A 71-year-old Chinese patient with a history of Kimura disease presented with nephrotic-range proteinuria.
- Investigations revealed significant peripheral blood eosinophilia and markedly elevated serum IgE levels, with moderate specificity to Candida albicans.
- Renal biopsy showed unremarkable light microscopy but electron microscopy revealed diffuse subepithelial deposits consistent with membranous nephropathy.
Findings:
- This case highlights an unusual association between Kimura disease and membranous nephropathy.
- The findings support the atopic nature of Kimura disease.
- Candida albicans is proposed as a potential causative agent contributing to both conditions.
Implications:
- This case expands the understanding of Kimura disease's systemic manifestations.
- It suggests a potential role for Candida albicans in the pathogenesis of Kimura disease and associated glomerulonephritis.
- Further research is warranted to explore the immunological links between Kimura disease, Candida sensitization, and membranous nephropathy.