Kimura's disease associated with bronchial asthma presenting eosinophilia and hyperimmunoglobulinemia E which were attenuated by suplatast tosilate (IPD-1151T)

Intern Med. 1998 Dec;37(12):1064-7. doi: 10.2169/internalmedicine.37.1064.

Abstract

A 29-year-old man developed atopic bronchial asthma in association with eosinophilia and hyperimmunoglobulinemia E (hyper-IgE). A biopsy specimen from an inguinal lymph node showed changes consistent with Kimura's disease. IPD-1151T (suplatast tosilate), an anti-allergy drug, attenuated eosinophilia and hyper-IgE as well as the serum level of eosinophil cationic protein (ECP). The drug, however, did not affect the positivity for specific IgE antibodies against common allergens or the bronchial hyperresponsiveness to acetylcholine. Interleukin (IL)-2, IL-4, IL-5, interferon (IFN)-gamma, and tumor necrosis factor (TNF)-alpha were measured to be undetectable in serum before or during therapy. However, the expressions of mRNAs for IL-2, IL-4, IL-5, IFN-gamma, and TNF-alpha in peripheral blood T-lymphocytes and the expression of IL-5 mRNA in peripheral blood eosinophils were detected before and during therapy, which were unchanged by therapy with IPD-1151T. The present results suggest that different mechanisms other than the predominance of type 2 helper (T(H2))-like T-lymphocytes may underlie Kimura's disease and atopic bronchial asthma regarding the findings of eosinophilia and hyper-IgE, which could be modulated by IPD-1151T.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Angiolymphoid Hyperplasia with Eosinophilia / complications*
  • Angiolymphoid Hyperplasia with Eosinophilia / pathology
  • Anti-Allergic Agents / therapeutic use*
  • Antibodies, Anti-Idiotypic / analysis
  • Arylsulfonates / therapeutic use*
  • Asthma / complications*
  • Asthma / drug therapy
  • Asthma / pathology
  • Biopsy
  • Blood Proteins / metabolism
  • Cytokines / genetics
  • Enzyme-Linked Immunosorbent Assay
  • Eosinophil Granule Proteins
  • Eosinophilia / drug therapy
  • Eosinophilia / etiology*
  • Eosinophilia / pathology
  • Eosinophils / metabolism
  • Eosinophils / pathology
  • Follow-Up Studies
  • Humans
  • Immunoglobulin E / immunology
  • Job Syndrome / drug therapy
  • Job Syndrome / etiology*
  • Job Syndrome / pathology
  • Male
  • Polymerase Chain Reaction
  • RNA, Messenger / biosynthesis
  • Ribonucleases*
  • Sulfonium Compounds / therapeutic use*
  • T-Lymphocytes, Helper-Inducer / immunology
  • T-Lymphocytes, Helper-Inducer / pathology

Substances

  • Anti-Allergic Agents
  • Antibodies, Anti-Idiotypic
  • Arylsulfonates
  • Blood Proteins
  • Cytokines
  • Eosinophil Granule Proteins
  • RNA, Messenger
  • Sulfonium Compounds
  • Immunoglobulin E
  • suplatast tosilate
  • Ribonucleases