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Paradoxical development of Kimura’s disease in a patient treated with mepolizumab for bronchial asthma
  1. Harsh Jain1,
  2. Abhishek Kumar1,
  3. Vikram Singh2 and
  4. Kartik Sivasami1
  1. 1 Department of Rheumatology, Army Hospital Research and Referral, New Delhi, Delhi, India
  2. 2 Department of Pathology, Army Hospital Research and Referral, New Delhi, Delhi, India
  1. Correspondence to Dr Kartik Sivasami; drskartik{at}gmail.com

Abstract

A male patient in his early 30s was diagnosed with bronchial asthma 3 years previously. He responded well to inhaled corticosteroids and long-acting beta-agonists. Approximately 18 months from the onset, the patient reported worsening symptoms. These symptoms included severe functional limitations, requiring frequent exposure to high-dose prednisolone. Mepolizumab was added to the treatment, leading to optimal control of bronchial asthma. Despite receiving seven doses of mepolizumab at monthly intervals, the patient developed cervical and postauricular lymphadenopathy and subcutaneous swelling of soft tissue. A cervical lymph node biopsy confirmed the diagnosis of Kimura disease. Following treatment with oral glucocorticoids and methotrexate, the patient experienced a complete resolution of symptoms. He has been in remission and off oral prednisolone for the last 13 months. In this case, we highlight the development of Kimura disease in a patient undergoing mepolizumab treatment.

  • Drugs: respiratory system
  • Immunology

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Footnotes

  • X @rheumatik

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: SK, HJ and VS. The following authors gave final approval of the manuscript: SK and AK.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.