Lee Jung Hyun, Kim Jeong Hee, Lee Sang Un, Kim Sung Chul
HanGil Eye Hospital, Incheon, South Korea.
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Ophthalmic Plast Reconstr Surg. 2018 Jul/Aug;34(4):e121-e123. doi: 10.1097/IOP.0000000000001135.
Kimura disease has been known as a chronic inflammatory disease of unknown etiology, since the first report in 1937 and characterized by an increased eosinophil fraction in peripheral blood, increased serum immunoglobulin E (IgE) levels, and lymphoid granuloma with eosinophilic infiltration on histopathological examination. The authors present a 30-year-old man who visited their clinic with a 3-month history of protrusion and conjunctival injection of the right eye. Surgical mass resection was performed, and initial histopathology revealed Kimura disease. Additional immunohistochemical examination revealed IgG4-related disease in another hospital, which showed more than 80 IgG4-positive plasma cells per high-power field and an IgG4+/IgG+ ratio more than 40%. There are histopathological similarities, and several reports have suggested a relationship between Kimura disease and IgG4-related disease. Thus, it is difficult to classify them as completely different diseases. Kimura disease and IgG4 can be considered a part of a clinical spectrum of abnormal immune reactions.
木村病自1937年首次报道以来，一直被认为是一种病因不明的慢性炎症性疾病，其特征为外周血嗜酸性粒细胞比例增加、血清免疫球蛋白E（IgE）水平升高，以及组织病理学检查显示嗜酸性粒细胞浸润的淋巴肉芽肿。作者报告了一名30岁男性，因右眼突出和结膜充血3个月就诊于他们的诊所。进行了手术肿块切除，初步组织病理学检查显示为木村病。在另一家医院进行的额外免疫组织化学检查显示为IgG4相关疾病，每高倍视野有超过80个IgG4阳性浆细胞，IgG4+/IgG+比值超过40%。两者在组织病理学上有相似之处，有几份报告提示木村病与IgG4相关疾病之间存在关联。因此，很难将它们归类为完全不同的疾病。木村病和IgG4可被视为异常免疫反应临床谱的一部分。
