Lee C T, Huang C C, Lam K K, Chen J B
Division of Nephrology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Am J Nephrol. 2001 Jan-Feb;21(1):47-50. doi: 10.1159/000046218.
Eosinophilia is not an uncommon finding in chronic dialysis patients. It is usually benign in nature although definite pathogenesis is unknown. We have encountered a young uremic Chinese adult who developed Kimura's disease after being on maintenance hemodialysis for about 3 years. Asymptomatic eosinophilia had been noted for 1 year and 8 months prior to the development of progressively enlarged neck masses, which leads to the diagnosis of Kimura's disease. In contrast to most cases, eosinophilia was first noticed before the neck masses appeared. There is often a close correlation between Kimura's disease and glomerular disease, where renal involvement is considered as a systemic manifestation. However, we do not have strong evidence to support this relationship between terminal renal failure and Kimura's disease in this patient. To our knowledge, our patient is the first reported case of Kimura's disease occurring in chronic hemodialysis patients. Eosinophilia persisted for nearly 2 years before the neck mass developed and recurred after the excision. Besides, our patient also demonstrated a chronic and recurrent course typical of Kimura's disease.
嗜酸性粒细胞增多在慢性透析患者中并不少见。其本质通常为良性，尽管确切发病机制尚不清楚。我们遇到一名年轻的中国尿毒症成年患者，在维持性血液透析约3年后患上了木村病。在逐渐增大的颈部肿块出现前1年零8个月就已发现无症状性嗜酸性粒细胞增多，这导致了木村病的诊断。与大多数病例不同的是，嗜酸性粒细胞增多在颈部肿块出现之前就首先被注意到。木村病与肾小球疾病之间通常存在密切关联，其中肾脏受累被视为一种全身表现。然而，在该患者中，我们没有有力证据支持终末期肾衰竭与木村病之间的这种关系。据我们所知，我们的患者是慢性血液透析患者中首例报告的木村病病例。嗜酸性粒细胞增多在颈部肿块出现前持续了近2年，并在切除后复发。此外，我们的患者还表现出木村病典型的慢性和复发性病程。
