Kimura's disease is a granulomatous disease which develops in the skin, subcutaneous tissues and lymph nodes and is characterized histologically by the presence of lymphoid follicles, vascular proli- feration and infiltration with eosinophils. The disease shows geographical predilection to Japan, China and South East Asia. The exact etiology and pathogenesis remain uncertain. Some patients had proteinuria or nephrotic syndrome. We have recently experienced the superimposed oliguric acute renal failure associated with Kimura's disease in a male patient with chronic renal failure who had been managed conservatively. Inguinal lymph node biopsy revealed Kimura's disease. He recovered from acute renal failure after being treated with hemodialysis and prednisolone. Lymphadeno- pathy and fever subsided with steroid treatment. We report a case of Kimura's disease which was complicated by acute renal failure in the patient with chronic renal failure.
Acute Kidney Injury* ; Biopsy ; China ; Eosinophils ; Far East ; Fever ; Humans ; Japan ; Kidney Failure, Chronic* ; Lymph Nodes ; Male ; Nephrotic Syndrome ; Prednisolone ; Proteinuria ; Renal Dialysis ; Skin ; Subcutaneous Tissue

This study aimed to develop a UPLC-MS/MS method for determining plasma levels of L-aspartic acid and L-asparagine and the activity of L-asparaginase. L-aspartic acid, L-asparagine, and L-aspartic acid-2,3,3-d3 were extracted from human plasma by protein precipitation with sulfosalicylic acid (30%, v/v). The plasma samples were analyzed using an Imtakt Intrada amino acid analysis column with 25 mM ammonium formate and 0.5% formic acid in acetonitrile as the mobile phase with step gradient method at a flow rate of 0.5 mL/min. The injection volume was 5 µL, and the total run time was 15 min. Inter- and intra-batch accuracies (%) ranged from 96.62–106.0% for L-aspartic acid and 89.85–104.8%, for L-asparagine, and the coefficient of variation (CV%) did not exceed 7%. The validation results for L-aspartic acid and L-asparagine satisfied the specified criterion, however, the results for L-asparaginase activity assay showed a borderline validity. This study could be a foundation for further development of therapeutic drug monitoring systems using UPLC-MS/MS.
Ammonium Compounds ; Asparagine ; Aspartic Acid ; Drug Monitoring ; Humans ; Methods ; Plasma