Concurrent Kidney Glomerular and Interstitial Lesions Associated with Kimura's Disease

Area of Science:

• Nephrology
• Pathology
• Immunology

Background:

• Kimura disease (KD) is a chronic inflammatory condition typically presenting as head and neck masses.
• While KD is known to be associated with various glomerulonephritis types, kidney interstitial lesions are infrequently reported.
• This study aimed to broaden the understanding of kidney pathology in KD.

Observation:

• A retrospective review of 12 KD cases with kidney involvement from 2007-2016 was conducted.
• Pathological analyses included standard staining, immunofluorescence, and electron microscopy.
• Common clinical features were subcutaneous lesions, elevated IgE, and peripheral eosinophilia, with nephrotic syndrome being the primary kidney manifestation.

Findings:

• Glomerulonephritis types observed were minimal change disease (MCD), IgA nephropathy, and membranous nephropathy (MN).
• Notably, four MCD cases exhibited concurrent glomerular and interstitial lesions, characterized by eosinophilic and lymphatic infiltration.
• Eight of ten patients responded well to steroid therapy, achieving remission of proteinuria and kidney function recovery.

Implications:

• This study highlights that interstitial lesions, beyond glomerulonephritis, are a potential kidney manifestation of Kimura disease.
• Pathologists should consider KD in differential diagnoses for patients presenting with subcutaneous masses or lymphadenopathy and concurrent kidney abnormalities.
• Recognizing these diverse kidney involvements can improve diagnostic accuracy and patient management in Kimura disease.