Kottler Diane, Barète Stéphane, Quéreux Gaelle, Ingen-Housz-Oro Saskia, Fraitag Sylvie, Ortonne Nicolas, Deschamps Lydia, Rybojad Michel, Flageul Béatrice, Crickx Béatrice, Janin Anne, Bagot Martine, Battistella Maxime
Dx00E9;partement de Dermatologie, Hx00F4;pital Saint-Louis, AP-HP, Paris, France.
Dermatology. 2015;231(4):367-77. doi: 10.1159/000439346. Epub 2015 Oct 10.
Kimura disease (KD) is a rare lymphoproliferative inflammatory disease of unknown etiology. Data regarding therapeutic modalities and pathophysiology are scarce.
Analyze therapeutic and follow-up data and compare KD with cutaneous IgG4-related disease (IgG4-RD).
Multicentric retrospective study of 25 KD patients with analysis of treatment, follow-up and IgG4 immunostaining. Comparison with published cases of cutaneous IgG4-RD.
Patients were mostly male (84%), median-aged 42 years with lymph node, lacrimal/salivary gland and kidney involvements in 45, 24 and 12%, respectively. Surgical excision had 100% complete response and 60% relapse. Oral corticosteroids had 100% response with 50% relapse. Thalidomide, cyclosporine or interferon-α had 100% response, but 100, 20 and 50% relapse, respectively. KD showed clinicopathological similarities with 27 published cases of cutaneous IgG4-RD.
Surgery may be used in resectable KD cases, whereas cyclosporine or thalidomide may represent interesting alternatives to oral corticosteroids in other cases. KD shares features with cutaneous IgG4-RD.
木村病(KD)是一种病因不明的罕见淋巴增生性炎症性疾病。关于治疗方式和病理生理学的数据很少。
分析治疗和随访数据,并将木村病与皮肤IgG4相关疾病(IgG4-RD)进行比较。
对25例木村病患者进行多中心回顾性研究,分析治疗、随访及IgG4免疫染色情况。与已发表的皮肤IgG4-RD病例进行比较。
患者大多为男性(84%),中位年龄42岁,分别有45%、24%和12%的患者出现淋巴结、泪腺/唾液腺及肾脏受累。手术切除的完全缓解率为100%,复发率为60%。口服糖皮质激素的缓解率为100%,复发率为50%。沙利度胺、环孢素或α干扰素的缓解率均为100%,但复发率分别为100%、20%和50%。木村病与27例已发表的皮肤IgG4-RD病例在临床病理特征上相似。
手术可用于可切除的木村病病例,而在其他病例中,环孢素或沙利度胺可能是口服糖皮质激素的有趣替代方案。木村病与皮肤IgG4相关疾病有共同特征。