Kimura Disease in Colombia. Case Report

Kimura Disease in Colombia. 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Case Report Jhon Alexander Ávila Rueda, Edgar Fabián Manrique-Hernandez, Maricel Licht-Ardila, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4076773/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction: Kimura disease is a benign, chronic, and rare entity. Its etiology and pathogenesis are unclear, posing challenges for diagnosis and management. The aim is to report the case of a Colombian patient with Kimura disease. Case Report: A 68-year-old male patient with no relevant medical history presented with a 6-month history of asthenia, night sweats, and bilateral cervical lymphadenopathy. An excisional lymph node biopsy was performed, revealing atypical paracortical hyperplasia with a Ki67 proliferation index of 60% in the paracortical region and 100% in residual germinal centers, suggesting a reactive process consistent with Kimura disease. Discussion: This case highlights the importance of considering Kimura disease as a differential diagnosis in patients with symptoms consistent with this condition. Kimura Disease Lymphadenopathy Hyperplasia Colombia case report Introduction Kimura disease (KD) is a benign, chronic, and rare entity ( 1 ), primarily affecting Asian males with an even lower incidence in other populations ( 2 ). It was identified by Kim and Szeto in 1937 and later defined by Kimura and colleagues in 1948. The etiology and pathogenesis are unknown; however, continuous antigen stimulation leading to IgE-mediated hypersensitivity or alterations in T-cell immune regulation has been described. This can be triggered by microorganisms or insect bites, resulting in eosinophil stimulation, which may lead to KD ( 3 ). This disorder is clinically characterized by painless solid masses affecting lymph nodes mainly in the head and neck, accompanied by an increase in eosinophil count and elevated levels of immunoglobulin E (IgE). Diagnosis confirmation is based on histopathological characteristics obtained through biopsy ( 4 ). KD presents challenges in understanding its clinical and pathological aspects, as well as in diagnosis and management. The objective of this manuscript is to report the case of an elderly Colombian patient with Kimura disease. Clinical Report A 68-year-old male patient with no relevant medical history presented to the Hematology service in February 2024 with a 6-month history of asthenia, night sweats, and bilateral cervical lymphadenopathy ranging from 2.5 to 3 cm in diameter. He reported having previously consulted the internal medicine service, which then requested evaluation by head and neck surgery, considering an excisional lymph node biopsy performed on October 19, 2023. The anatomopathological report of the cervical lymph node revealed morphological findings suggestive of a lymphoplasmacytic proliferative process. However, lacking immunohistochemistry studies initially, the paraffin block was sent for review to a high-complexity laboratory. Additionally, a culture was performed to detect Mycobacterium tuberculosis in the biopsied lymph node, which yielded negative results. The immunohistochemical report from December 28, 2023, indicated morphological findings consistent with atypical paracortical hyperplasia with a Ki67 proliferation index of 60% in the paracortical region and 100% in residual germinal centers, suggesting a reactive process consistent with Kimura disease. At the time of the hematology consultation, the B symptoms (systemic symptoms) had spontaneously resolved. Physical examination revealed a single cervical lymphadenopathy on the left side measuring less than 1 cm in diameter, mobile and painless, with no evidence of other abnormalities. Hemogram results were: Hb: 13 g/dL, white blood cells 7800/mm3 with preserved formula, platelets 185,000/mm3, lactate dehydrogenase 150 IU/L, normal protein electrophoresis profile with no evidence of abnormalities in liver function and negative serologies for HIV, hepatitis B, C, cytomegalovirus, and Epstein-Barr virus. Positron emission tomography was indicated to rule out metabolic foci suggestive of lymphoproliferative disease. The follow-up with PET-CT yielded negative results for pathological hypercaptation in lymph nodes. Considering the diagnosis of Kimura disease associated with spontaneous resolution of the patient's symptoms, outpatient follow-up by hematology was advised. Upon the exclusion of various differential diagnoses, including cancer, the patient exhibited a remarkable sense of tranquility and confidence during the assessment of Kimura disease. This reaction underscores the positive impact of clear and precise medical communication, offering the patient a comprehensible understanding of their condition and alleviating potential concerns associated with more severe diagnoses. Discussion The clinical findings and progression of the presented case of KD offer valuable insights into this uncommon entity. The clinical manifestations described by the patient, such as cervical lymphadenopathy, night sweats, and asthenia, are consistent with literature reports (5). Similarly, being male aligns with typical demographics, although the age of presentation differs, as reports of this disease typically occur at younger ages (2). Likewise, the initial lymph node biopsy showed morphological findings suggestive of a lymphoplasmacytic proliferative process commonly observed in this disease (6). However, the lack of immunohistochemistry studies initially may have hindered the confirmation of the diagnosis. The immunohistochemical analysis revealed atypical paracortical hyperplasia with a significant increase in the Ki67 proliferation index, confirming the diagnosis. The improvement of B symptoms in this case is consistent with the variability in clinical presentation and natural course of KD, as documented in the literature (5). Similarly, the negative result for Mycobacterium tuberculosis culture and the absence of pathological hypercaptation in tomography rule out other differential diagnoses that could be causing this clinical picture. This case underscores the importance of considering KD as a differential diagnosis in patients with cervical lymphadenopathies, asthenia, and night sweats. Likewise, the spontaneous resolution of the presented symptoms demonstrates the variability in the disease presentation, which should be considered in patient management. Further research is needed to understand its pathophysiology and management. This case contributes to the literature by showcasing the experience in a context where its presentation is even rarer, leading to challenges in timely diagnosis. Conclusions This case report sheds light on the clinical presentation, diagnostic challenges, and spontaneous resolution observed in an elderly Colombian patient with KD. The findings emphasize the importance of considering KD as a potential differential diagnosis in individuals presenting with cervical lymphadenopathies, asthenia, and night sweats, particularly in cases where conventional diagnostic procedures may initially lack immunohistochemistry studies. The variable clinical course and the absence of specific etiological markers underscore the need for further research to elucidate the pathophysiology and refine management strategies for KD. This unique case contributes to the limited literature on KD in non-Asian populations, highlighting the necessity for heightened awareness and timely diagnosis in regions where the condition is exceptionally rare. Declarations Author Contribution JA, EM-H, ML-A, AH-O, CS y DG participated in the construction, data extraction, writing, and revision of the articleAll authors reviewed the manuscript Data Availability The data contained in this case report is confidential and protected by data protection law. These details are an integral part of the patient's medical record and their disclosure is restricted by the hospital's custody policies. Therefore, it is imperative that this report remains confidential. References Parikh S, Sharma S, Shah JS. Kimura's Disease: A Confounding Condition. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 3):5342–5346. doi: 10.1007/s12070-021-02511-1 . Gupta M, Ghadge M, Hegde S. Kimura Disease: Rare Parotid Entity. Indian J Otolaryngol Head Neck Surg. 2023;75(3):2273–2276. doi: 10.1007/s12070-022-03349-x . AlGhamdi FE, Al-Khatib TA, Marzouki HZ, AlGarni MA. Kimura disease: No age or ethnicity limit. Saudi Med J. 2016;37(3):315–9. doi: 10.15537/smj.2016.3.14448 . Chang SY, Lee CC, Chang ML, Teng WC, Hsiao CY, Yu HH, et al. Comparison of Clinical Manifestations and Pathology between Kimura Disease and IgG4-Related Disease: A Report of Two Cases and Literature Review. J Clin Med. 2022;11(23):6887. doi: 10.3390/jcm11236887 . Natsha ZA, Hamarsheh IA, Utt RS, Abu Alrob B, Wahdan AA. Atypical Presentation of Kimura's Disease in a Male Patient: A Case Report and Review of Literature. Case Rep Med. 2022;2022:5103547. doi: 10.1155/2022/5103547 . E Kakehi, K Kotani, Y Otsuka, Y Fukuyasu, Y Hashimoto, S Sakurai, et al. Enfermedad de Kimura: efectos de la edad en la presentación clínica, QJM: An International Journal of Medicine; 2020,113(5):336–345, https://doi.org/10.1093/qjmed/hcz312 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4076773","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":295111791,"identity":"837c87e2-e128-4c66-91bd-13bf923049b5","order_by":0,"name":"Jhon Alexander Ávila Rueda","email":"","orcid":"","institution":"Hospital Internacional de Colombia","correspondingAuthor":false,"prefix":"","firstName":"Jhon","middleName":"Alexander Ávila","lastName":"Rueda","suffix":""},{"id":295111792,"identity":"cd3323b3-9096-437e-9e6e-46d7c409fd1a","order_by":1,"name":"Edgar Fabián Manrique-Hernandez","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA7klEQVRIiWNgGAWjYFCCBCjNDCIq5EjWcsaYFC0gwNhGhBZ+9vSLnytz7PLM25m3SXycZyBvcID52McveLRI9rwpljy7LblY5jBbmeTMbQaGGw6wJc+WwaPF4EZOgmTjNubEGcw8ZtK82/4kSDbwGDNL4NFifyMn+WfjtnqIlr9zDAhrMZBIPwa05TBEC2ODQQI/A48x4wc8WiTOvGGzbNx2HKiFrdiy55iBYT8zWzIzHh0M/O3pj282bqtOnMF/eOONHzUG8mzszYcZf+DTw8BjAHckhAJawcyDVwv7AzQtQEDAllEwCkbBKBhhAACzs0cSHjAX+AAAAABJRU5ErkJggg==","orcid":"","institution":"Hospital Internacional de Colombia","correspondingAuthor":true,"prefix":"","firstName":"Edgar","middleName":"Fabián","lastName":"Manrique-Hernandez","suffix":""},{"id":295111793,"identity":"01e2eb5a-b6ee-4a1d-aae7-d7ba9878c475","order_by":2,"name":"Maricel Licht-Ardila","email":"","orcid":"","institution":"Hospital Internacional de Colombia","correspondingAuthor":false,"prefix":"","firstName":"Maricel","middleName":"","lastName":"Licht-Ardila","suffix":""},{"id":295111795,"identity":"6185ea58-5dad-46dd-8256-8b489b77fe1f","order_by":3,"name":"Alexandra Hurtado-Ortiz","email":"","orcid":"","institution":"Hospital Internacional de Colombia","correspondingAuthor":false,"prefix":"","firstName":"Alexandra","middleName":"","lastName":"Hurtado-Ortiz","suffix":""},{"id":295111797,"identity":"cea30bbc-2c84-41b1-b16b-21bc6b5d9b35","order_by":4,"name":"Carmen Judith Suárez","email":"","orcid":"","institution":"Hospital Internacional de Colombia","correspondingAuthor":false,"prefix":"","firstName":"Carmen","middleName":"Judith","lastName":"Suárez","suffix":""},{"id":295111799,"identity":"2d613b87-2cf6-4f11-bb1c-780ab4af94f0","order_by":5,"name":"Diego Gómez Abreo","email":"","orcid":"","institution":"Hospital Internacional de Colombia","correspondingAuthor":false,"prefix":"","firstName":"Diego","middleName":"Gómez","lastName":"Abreo","suffix":""}],"badges":[],"createdAt":"2024-03-11 16:52:37","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4076773/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4076773/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":56457670,"identity":"86e1f386-ebd5-4b95-a762-e05eb8bdc8af","added_by":"auto","created_at":"2024-05-14 12:32:22","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":185582,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4076773/v1/2cbb3e66-c630-4948-9f5b-7076400c91e7.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eKimura Disease in Colombia. Case Report\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eKimura disease (KD) is a benign, chronic, and rare entity (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e), primarily affecting Asian males with an even lower incidence in other populations (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). It was identified by Kim and Szeto in 1937 and later defined by Kimura and colleagues in 1948. The etiology and pathogenesis are unknown; however, continuous antigen stimulation leading to IgE-mediated hypersensitivity or alterations in T-cell immune regulation has been described. This can be triggered by microorganisms or insect bites, resulting in eosinophil stimulation, which may lead to KD (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis disorder is clinically characterized by painless solid masses affecting lymph nodes mainly in the head and neck, accompanied by an increase in eosinophil count and elevated levels of immunoglobulin E (IgE). Diagnosis confirmation is based on histopathological characteristics obtained through biopsy (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). KD presents challenges in understanding its clinical and pathological aspects, as well as in diagnosis and management. The objective of this manuscript is to report the case of an elderly Colombian patient with Kimura disease.\u003c/p\u003e"},{"header":"Clinical Report","content":"\u003cp\u003eA 68-year-old male patient with no relevant medical history presented to the Hematology service in February 2024 with a 6-month history of asthenia, night sweats, and bilateral cervical lymphadenopathy ranging from 2.5 to 3 cm in diameter. He reported having previously consulted the internal medicine service, which then requested evaluation by head and neck surgery, considering an excisional lymph node biopsy performed on October 19, 2023.\u003c/p\u003e \u003cp\u003eThe anatomopathological report of the cervical lymph node revealed morphological findings suggestive of a lymphoplasmacytic proliferative process. However, lacking immunohistochemistry studies initially, the paraffin block was sent for review to a high-complexity laboratory. Additionally, a culture was performed to detect Mycobacterium tuberculosis in the biopsied lymph node, which yielded negative results.\u003c/p\u003e \u003cp\u003eThe immunohistochemical report from December 28, 2023, indicated morphological findings consistent with atypical paracortical hyperplasia with a Ki67 proliferation index of 60% in the paracortical region and 100% in residual germinal centers, suggesting a reactive process consistent with Kimura disease.\u003c/p\u003e \u003cp\u003eAt the time of the hematology consultation, the B symptoms (systemic symptoms) had spontaneously resolved. Physical examination revealed a single cervical lymphadenopathy on the left side measuring less than 1 cm in diameter, mobile and painless, with no evidence of other abnormalities. Hemogram results were: Hb: 13 g/dL, white blood cells 7800/mm3 with preserved formula, platelets 185,000/mm3, lactate dehydrogenase 150 IU/L, normal protein electrophoresis profile with no evidence of abnormalities in liver function and negative serologies for HIV, hepatitis B, C, cytomegalovirus, and Epstein-Barr virus. Positron emission tomography was indicated to rule out metabolic foci suggestive of lymphoproliferative disease.\u003c/p\u003e \u003cp\u003eThe follow-up with PET-CT yielded negative results for pathological hypercaptation in lymph nodes. Considering the diagnosis of Kimura disease associated with spontaneous resolution of the patient's symptoms, outpatient follow-up by hematology was advised. Upon the exclusion of various differential diagnoses, including cancer, the patient exhibited a remarkable sense of tranquility and confidence during the assessment of Kimura disease. This reaction underscores the positive impact of clear and precise medical communication, offering the patient a comprehensible understanding of their condition and alleviating potential concerns associated with more severe diagnoses.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe clinical findings and progression of the presented case of KD offer valuable insights into this uncommon entity. The clinical manifestations described by the patient, such as cervical lymphadenopathy, night sweats, and asthenia, are consistent with literature reports (5). Similarly, being male aligns with typical demographics, although the age of presentation differs, as reports of this disease typically occur at younger ages (2). Likewise, the initial lymph node biopsy showed morphological findings suggestive of a lymphoplasmacytic proliferative process commonly observed in this disease (6). However, the lack of immunohistochemistry studies initially may have hindered the confirmation of the diagnosis.\u003c/p\u003e\n\u003cp\u003eThe immunohistochemical analysis revealed atypical paracortical hyperplasia with a significant increase in the Ki67 proliferation index, confirming the diagnosis. The improvement of B symptoms in this case is consistent with the variability in clinical presentation and natural course of KD, as documented in the literature (5). Similarly, the negative result for Mycobacterium tuberculosis culture and the absence of pathological hypercaptation in tomography rule out other differential diagnoses that could be causing this clinical picture.\u003c/p\u003e\n\u003cp\u003eThis case underscores the importance of considering KD as a differential diagnosis in patients with cervical lymphadenopathies, asthenia, and night sweats. Likewise, the spontaneous resolution of the presented symptoms demonstrates the variability in the disease presentation, which should be considered in patient management. Further research is needed to understand its pathophysiology and management. This case contributes to the literature by showcasing the experience in a context where its presentation is even rarer, leading to challenges in timely diagnosis.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis case report sheds light on the clinical presentation, diagnostic challenges, and spontaneous resolution observed in an elderly Colombian patient with KD. The findings emphasize the importance of considering KD as a potential differential diagnosis in individuals presenting with cervical lymphadenopathies, asthenia, and night sweats, particularly in cases where conventional diagnostic procedures may initially lack immunohistochemistry studies. The variable clinical course and the absence of specific etiological markers underscore the need for further research to elucidate the pathophysiology and refine management strategies for KD. This unique case contributes to the limited literature on KD in non-Asian populations, highlighting the necessity for heightened awareness and timely diagnosis in regions where the condition is exceptionally rare.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eJA, EM-H, ML-A, AH-O, CS y DG participated in the construction, data extraction, writing, and revision of the articleAll authors reviewed the manuscript\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe data contained in this case report is confidential and protected by data protection law. These details are an integral part of the patient's medical record and their disclosure is restricted by the hospital's custody policies. Therefore, it is imperative that this report remains confidential.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eParikh S, Sharma S, Shah JS. Kimura's Disease: A Confounding Condition. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 3):5342\u0026ndash;5346. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s12070-021-02511-1\u003c/span\u003e\u003cspan address=\"10.1007/s12070-021-02511-1\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGupta M, Ghadge M, Hegde S. Kimura Disease: Rare Parotid Entity. Indian J Otolaryngol Head Neck Surg. 2023;75(3):2273\u0026ndash;2276. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s12070-022-03349-x\u003c/span\u003e\u003cspan address=\"10.1007/s12070-022-03349-x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlGhamdi FE, Al-Khatib TA, Marzouki HZ, AlGarni MA. Kimura disease: No age or ethnicity limit. Saudi Med J. 2016;37(3):315\u0026ndash;9. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.15537/smj.2016.3.14448\u003c/span\u003e\u003cspan address=\"10.15537/smj.2016.3.14448\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChang SY, Lee CC, Chang ML, Teng WC, Hsiao CY, Yu HH, et al. Comparison of Clinical Manifestations and Pathology between Kimura Disease and IgG4-Related Disease: A Report of Two Cases and Literature Review. J Clin Med. 2022;11(23):6887. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/jcm11236887\u003c/span\u003e\u003cspan address=\"10.3390/jcm11236887\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNatsha ZA, Hamarsheh IA, Utt RS, Abu Alrob B, Wahdan AA. Atypical Presentation of Kimura's Disease in a Male Patient: A Case Report and Review of Literature. Case Rep Med. 2022;2022:5103547. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1155/2022/5103547\u003c/span\u003e\u003cspan address=\"10.1155/2022/5103547\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eE Kakehi, K Kotani, Y Otsuka, Y Fukuyasu, Y Hashimoto, S Sakurai, et al. Enfermedad de Kimura: efectos de la edad en la presentaci\u0026oacute;n cl\u0026iacute;nica, QJM: An International Journal of Medicine; 2020,113(5):336\u0026ndash;345, \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1093/qjmed/hcz312\u003c/span\u003e\u003cspan address=\"10.1093/qjmed/hcz312\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Kimura Disease, Lymphadenopathy, Hyperplasia, Colombia, case report","lastPublishedDoi":"10.21203/rs.3.rs-4076773/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4076773/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction:\u003c/strong\u003e Kimura disease is a benign, chronic, and rare entity. Its etiology and pathogenesis are unclear, posing challenges for diagnosis and management. The aim is to report the case of a Colombian patient with Kimura disease.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCase Report: \u003c/strong\u003eA 68-year-old male patient with no relevant medical history presented with a 6-month history of asthenia, night sweats, and bilateral cervical lymphadenopathy. An excisional lymph node biopsy was performed, revealing atypical paracortical hyperplasia with a Ki67 proliferation index of 60% in the paracortical region and 100% in residual germinal centers, suggesting a reactive process consistent with Kimura disease.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiscussion:\u003c/strong\u003e This case highlights the importance of considering Kimura disease as a differential diagnosis in patients with symptoms consistent with this condition.\u003c/p\u003e","manuscriptTitle":"Kimura Disease in Colombia. Case Report","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-26 05:35:44","doi":"10.21203/rs.3.rs-4076773/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c4656523-76be-4604-8ced-560fd7b6f91e","owner":[],"postedDate":"April 26th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-05-14T12:24:16+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-26 05:35:44","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4076773","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4076773","identity":"rs-4076773","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}