Kimura disease with nephrotic syndrome in a child- A rare as
Tuberculosis (TB) is called the “great mimic;” conversely, other diseases may also rarely simulate TB. This is a case of Kimura disease (KD) in a child presenting with features of subacute intestinal obstruction, mesenteric lymphadenopathy, and nephrotic syndrome.

An 11-year-old male child presented with colicky pain abdomen of 1 week duration, associated with lethargy and anorexia. He had bilateral pedal edema with facial puffiness. Bilateral firm itchy nodular subcutaneous malar lesions were noted. Bilateral cervical lymphadenopathy and right parotid swelling were also present. Abdominal examination revealed diffuse tenderness with ascites. Ultrasonography revealed mesenteric lymphadenopathy, ascites, and dilated bowel loops. Magnetic resonance imaging (MRI) revealed bilateral subcutaneous malar nodules, cervical lymphadenopathy, and right parotid swelling.

Fine needle aspiration cytology (FNAC) of the cervical lymph nodes yielded scant cellular material even on repeated attempts. The smears were hemodiluted and showed a few ill-formed epithelioid granulomas in a background of lymphoid cells and RBCs. A provisional diagnosis of TB with nephrotic syndrome was made and he was started on antitubercular drugs.

Source: Indian J Pathol Microbiol 2019;62:437-40

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