Goncalves Allan Christian Pieroni, Moritz Rodrigo B, Aldred Vera L, Monteiro Mário Luiz Ribeiro
Department of Ophthalmology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Department of Pathology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Indian J Ophthalmol. 2016 Jul;64(7):538-40. doi: 10.4103/0301-4738.118424.
Kimura's disease (KD) is a rare chronic inflammatory disease of unclear etiology, characterized by subcutaneous nodules, mainly in the head and neck region, frequently associated with regional lymphadenopathy. Orbital involvement is infrequent and when it occurs, usually affects the eyelid or the lacrimal gland. We report a case of a 44-year-old man that presented with bilateral slowly progressive proptosis that was initially misdiagnosed as Graves' Ophthalmopathy. 15 months of worsening proptosis and the development of facial and temporal swelling led to further investigation. Computed tomography and magnetic resonance imaging showed enlargement of all recti muscles and diffuse orbital infiltration. An orbital biopsy was performed and was consistent with the diagnosis of KD. Long term oral corticosteroid showed marked improvement of proptosis and facial swelling. This case serves to emphasize that KD should be included in the differential diagnosis of inflammatory diseases of the orbit, even when characterized by predominant involvement of the extraocular muscles.
木村病（KD）是一种病因不明的罕见慢性炎症性疾病，其特征为皮下结节，主要位于头颈部区域，常伴有局部淋巴结肿大。眼眶受累较少见，一旦发生，通常累及眼睑或泪腺。我们报告一例44岁男性患者，表现为双侧缓慢进展性眼球突出，最初被误诊为格雷夫斯眼病。15个月来眼球突出加重以及面部和颞部肿胀的出现促使进一步检查。计算机断层扫描和磁共振成像显示所有直肌增粗和眼眶弥漫性浸润。进行了眼眶活检，结果与KD的诊断相符。长期口服皮质类固醇使眼球突出和面部肿胀明显改善。该病例强调，即使以眼外肌受累为主，KD也应列入眼眶炎症性疾病的鉴别诊断之中。
