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[A case report of Kimura's disease causing visual dysfunction with remarkable eyelid swelling]
Maki Mishima1, Yoshihiko Usui, Go Arimoto
1Department of Ophthalmology, Tokyo Medical University, Japan. maki85hor@gmail.com
Nippon Ganka Gakkai Zasshi
|September 3, 2011
Summary
Kimura's disease caused severe bilateral eyelid swelling, impairing vision. Diagnosis involved eosinophilia, elevated IgE, and characteristic histopathology, with T cell receptor gene rearrangement suggesting recurrence risk.
Area of Science:
- Ophthalmology
- Dermatology
- Pathology
Background:
- Kimura's disease is a rare inflammatory condition.
- Eyelid involvement can lead to significant morbidity.
Observation:
- A 37-year-old male presented with progressive, severe bilateral eyelid swelling, preventing eye opening.
- Physical examination revealed soft elastic tumors of the eyelids.
- Imaging showed enhancing masses consistent with orbital tumors.
Findings:
- Peripheral blood eosinophilia and elevated serum IgE levels were noted.
- Histopathology confirmed lymphoid follicles, eosinophilic infiltration, and abscesses, indicative of Kimura's disease.
- Polymerase chain reaction (PCR) identified clonal T cell receptor gene rearrangement.
Implications:
- Kimura's disease can cause profound visual impairment due to eyelid edema.
- T cell receptor gene clonality may predict disease recurrence.
- Close monitoring is crucial for patients diagnosed with Kimura's disease, especially those with identified gene rearrangements.
