Serum Endocrine Fibroblast Growth Factors as Potential Biomarkers for Chronic Kidney Disease and Various Metabolic Dysfunctions in Aged Patients.
Conclusion The measurement of FGF21 and FGF23 may be useful for evaluating CKD and its complications. Using serum endocrine FGFs as biomarkers for age-related conditions may help prevent elderly patients from entering a bedridden state. PMID: 32009088 [PubMed - in process] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Anti-MDA5 Antibody-positive Clinically Amyopathic Dermatomyositis Complicated by Unilateral Right-sided Interstitial Lung Disease.
Authors: Kori M, Awano N, Inomata M, Kuse N, Tone M, Yoshimura H, Jo T, Takada K, Kumasaka T, Takemura T, Izumo T Abstract We herein report a case of anti-MDA5 antibody-positive, clinically amyopathic dermatomyositis complicated by unilateral interstitial lung disease (ILD) in a 78-year-old man with a history of left lung tumor resection. He was admitted due to a persistent fever and abnormal right pulmonary opacity. A transbronchial lung cryobiopsy revealed pulmonary fibrosis, and combined immunosuppressive therapy was initiated. Findings from multiple evaluations, including dynamic breathing magnetic resonance im...
Source: Internal Medicine - February 6, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Promising Effects of Benralizumab on Chronic Eosinophilic Pneumonia.
Authors: Isomoto K, Baba T, Sekine A, Aiko N, Ogura T Abstract We herein report a case of refractory chronic eosinophilic pneumonia (CEP) complicated with uncontrolled bronchial asthma, in which remission was successfully induced with single dose of benralizumab, a monoclonal antibody against the alpha-chain of the interleukin-5 receptor. Resolution of the patient's symptoms and consolidation on chest X-ray were observed at 2 weeks and lasted for 8 weeks after the administration of benralizumab. Benralizumab would be a novel alternative choice of treatment for CEP patients who are at risk of potential toxicity due ...
Source: Internal Medicine - February 6, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Lenalidomide Treatment for Thalidomide-refractory POEMS Syndrome: A Prospective Single-arm Clinical Trial.
Discussion Lenalidomide is a therapeutic option for thalidomide-refractory patients with POEMS syndrome. PMID: 32009091 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Invasive Tracheobronchial Aspergillosis with Bronchial Ulcers Complicated by Nontuberculous Mycobacterial Disease: A Case Report.
Authors: Kanai T, Samejima Y, Noda Y, Kim SH, Tamura K, Umakoshi T, Shimizu K, Kashiwa Y, Morishita H, Ueda K, Kawahara K, Yaguchi T, Matsuoka H Abstract Invasive tracheobronchial aspergillosis (ITBA) complicated by nontuberculous mycobacteria (NTM) is rare. An 88-year-old man was admitted for hemoptysis. Bronchoscopy revealed bronchial ulcers, and a tissue biopsy showed Aspergillus fumigatus. He was diagnosed with ITBA, which improved with voriconazole. During treatment, infiltrative shadows appeared in his lungs, and bronchoscopy was performed once again. A non-necrotic epithelioid granuloma and Mycobacterium int...
Source: Internal Medicine - February 6, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Hemophagocytic Lymphohistiocytosis in a Patient with Rheumatoid Arthritis on Pembrolizumab for Lung Adenocarcinoma.
Authors: Akagi Y, Awano N, Inomata M, Kuse N, Tone M, Yoshimura H, Jo T, Takada K, Kumasaka T, Izumo T Abstract Immune checkpoint inhibitors have changed the landscape of classic cancer treatment. However, their use is associated with the emergence of new adverse events. An elderly man with rheumatoid arthritis was started on pembrolizumab for newly diagnosed advanced lung cancer. He subsequently developed hemophagocytic lymphohistiocytosis (HLH), which is potentially fatal but has not been properly established as an immune checkpoint inhibition-induced event. We herein report the case of a patient with pembrolizum...
Source: Internal Medicine - February 6, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Safe Use of Nivolumab in a Patient with Epipharyngeal Carcinoma and Preexisting Ulcerative Colitis: A Histologically Proven Case Report.
Authors: Hijikata Y, Matsubara Y, Ota Y, Lim LA, Tani K, Hirata Y, Yotsuyanagi H Abstract Nivolumab, an antibody against human programmed cell death 1 (PD-1), enhances pre-existing immune responses and has antitumor activity. However, it may also cause undesirable immune-related adverse events (irAEs), such as anti-PD-1-related colitis. In addition, Nivolumab can worsen pre-existing autoimmune diseases. Ulcerative colitis (UC) is a chronic inflammatory disease of the colon. Its exact cause is unknown, but it may involve the dysregulation of the mucosal immune response. Thus, it is of great interest whether nivoluma...
Source: Internal Medicine - February 6, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Beh çet's Disease with Severe Autonomic Disorders Developing after Herpes Zoster.
Behçet's Disease with Severe Autonomic Disorders Developing after Herpes Zoster. Intern Med. 2020 Feb 01;: Authors: Koto S, Umeda M, Kawano H, Endo Y, Shimizu T, Koga T, Ichinose K, Nakamura H, Mukaino A, Higuchi O, Nakane S, Kawakami A Abstract A 58-year-old Japanese woman with herpes zoster developed Behçet's disease (BD) with symptoms including orthostatic intolerance as an autonomic disorder. Multiple immune-suppressive therapies and a β-blocker successfully controlled both the disease activity of BD and the autonomic disorders. A cytokine multiplex analysis of her serum revealed...
Source: Internal Medicine - February 6, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

A Case of Intractable Hepatic Encephalopathy with a Large Portosystemic Shunt Successfully Treated Using Shunt-preserving Disconnection of the Portal and Systemic Circulation.
Authors: Haraguchi M, Hirai S, Nakamura Y, Otsuka T, Ishimaru H, Sasaki R, Fukushima M, Miuma S, Miyaaki H, Nakao K Abstract Hepatic encephalopathy (HE) is a significant symptom of decompensated liver cirrhosis. Occlusion of portosystemic shunts is used to treat refractory HE. Nevertheless, these treatments often cause adverse events, such as ascites and esophageal varices. We treated a 57-year-old man with refractory HE using shunt-preserving disconnection of the portal and systemic circulation (SPDPS). After SPDPS, there were no obvious complications, and the patient's ammonia level significantly decreased. To da...
Source: Internal Medicine - February 6, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Transcatheter Atrial Septal Defect Closure in a 'Nonagenarian' with Intractable Heart Failure: A Case Report.
Authors: Suzuki M, Matsumoto K, Suto M, Taniguti Y, Tanaka H, Otake H, Shinke T, Hirata KI Abstract A 92-year-old man was referred to our hospital with decompensated heart failure. He was treated with diuretics and inotropic agents, but the clinical response was unsatisfactory. Echocardiography incidentally revealed an atrial septal defect (ASD) with a significant left-to-right shunt and pulmonary-to-systemic-blood-flow ratio of 2.36. Because the ASD was considered to be the primary cause of his treatment-resistant heart failure, the patient underwent transcatheter ASD closure. Shortly after shunt closure, his hemo...
Source: Internal Medicine - February 6, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Extracranial Pseudoaneurysm Arising from the Internal Carotid Artery.
Authors: Maeda Y PMID: 32009098 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Relapsing Polychondritis with a Cobble-stone Appearance of the Tracheal Mucosa, Preceded by Posterior Reversible Encephalopathy Syndrome.
Authors: Ikeda T, Asano M, Kitada Y, Taguchi K, Hayashi Y, Kajita K, Morita H Abstract A 25-year-old woman had convulsions and disturbance of consciousness. Head magnetic resonance imaging (MRI) showed punctate areas in the occipital lobes with increased signals on T2-weighted imaging. The MRI abnormalities responded well to steroid pulse therapy, so we made a diagnosis of posterior reversible encephalopathy syndrome (PRES). Three months later, she developed a fever and dyspnea. Chest computed tomography revealed marked thickness of the tracheal and bronchial wall, and bronchoscopy showed a cobble-stone appearance ...
Source: Internal Medicine - February 6, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Molecular Pathogenesis and Treatment of Myelodysplastic Syndromes.
Authors: Nakajima H Abstract Myelodysplastic syndromes (MDS) are clonal hematological disorders arising from hematopoietic stem cells that have accumulated various genetic abnormalities. MDS are heterogeneous in nature but uniformly characterized by chronic and progressive cytopenia from ineffective hematopoiesis, dysplasia in single or multiple lineages, and transformation to acute leukemia in a subset of patients. The genomic landscape revealed by next-generation sequencing has provided a comprehensive picture of the molecular pathways involved in MDS pathogenesis. Recurrent mutational targets in MDS are the gene...
Source: Internal Medicine - February 6, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

An Oculopharyngeal Subtype of Guillain-Barr é Syndrome Sparing the Trochlear and Abducens Nerves.
An Oculopharyngeal Subtype of Guillain-Barré Syndrome Sparing the Trochlear and Abducens Nerves. Intern Med. 2020 Feb 05;: Authors: Arakawa M, Yamazaki M, Toda Y, Ozawa A, Kimura K Abstract Guillain-Barré syndrome (GBS) comprises a group of polyneuropathies characterized by rapid progression of limb paralysis. Various subtypes of GBS have been reported. The oculopharyngeal subtype of GBS is currently understood to be primarily a cranial polyneuropathy without limb weakness or cerebellar ataxia. In our case of 62-year-old man, gastrointestinal infection was followed by paranesthesia of the...
Source: Internal Medicine - February 6, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Head and Neck Paraganglioma Atypically Carrying a Succinate Dehydrogenase Subunit B Mutation (L157X).
Authors: Takeshima K, Ariyasu H, Uraki S, Kitahara C, Morita S, Inaba H, Iwakura H, Warigaya K, Murata SI, Yamazaki Y, Sasano H, Akamizu T Abstract A 53-year-old woman was admitted to a hospital for gradual left-ear hearing loss over 2 years. Head computed tomography revealed a 2-cm mass along the left jugular bulb and another at the right carotid bulb. The right tumor was resected; the pathological diagnosis was carotid body paraganglioma. Mutations of succinate dehydrogenase (SDH) were suspected, but SDHB staining remained in the tumor. Genetic testing identified a known SDHB mutation (L157X). The patient had hea...
Source: Internal Medicine - February 6, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Clinical Characteristics and Risk Factors for Rebleeding in Patients with Obscure Gastrointestinal Bleeding.
Conclusion Patients with OGIB with overt previous bleeding, vascular lesions, and/or chronic kidney disease had a higher risk of rebleeding. PMID: 32023585 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Successful Treatment of Life-threatening Bleeding Caused by Acquired Factor X Deficiency Associated with Respiratory Infection.
Authors: Ichikawa S, Saito K, Fukuhara N, Tanaka Y, Lee Y, Onodera K, Onishi Y, Yokoyama H, Fujiwara M, Harigae H Abstract Acquired factor X deficiency (AFXD) is a very rare coagulation disorder. A 40-year-old man with no comorbidities suffering from a fever, malaise, and severe hemorrhagic symptoms, including massive hematuria, was emergently admitted. His platelet count was normal, but his prothrombin time and activated partial thromboplastin time were markedly prolonged, which was thought to be due to autoantibody against a coagulation factor in the common pathway. Despite severe massive hematuria resulting in t...
Source: Internal Medicine - February 6, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

A Case of Remitting Seronegative Symmetrical Synovitis with Pitting Edema Syndrome Complicated with Organizing Pneumonia.
Authors: Hosoda C, Ishiguro T, Morimoto Y, Furube A, Isono T, Shimizu Y, Takayanagi N Abstract We herein report a 62-year-old man with idiopathic pulmonary fibrosis who developed remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome during follow-up. Pulmonary infiltrations were detected concomitantly with the development of RS3PE syndrome, and prednisolone improved both the pulmonary and extrapulmonary lesions. Recognizing the pulmonary manifestations of RS3PE syndrome is necessary to provide an appropriate diagnosis and disease management. PMID: 31956200 [PubMed - as supplied by pub...
Source: Internal Medicine - January 21, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Refractory Myositis Affecting the Intrinsic Muscles of the Hand: A Case Report.
Authors: Nakamura K, Sugai A, Saji E, Kasuga K, Onodera O Abstract Myositis generally affects the proximal muscles. However, we herein report a case of a 48-year-old woman with intractable myositis affecting the intrinsic muscles of the hands. Her myositis, which developed in childhood, was refractory to treatment with steroids and several immunosuppressants, causing walking disability. After experiencing pain and swelling in the hands for six months, she was diagnosed with myositis of the intrinsic muscles of the hands and tested positive for the anti-signal recognition particle antibody. Intravenous immunoglobuli...
Source: Internal Medicine - January 21, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Hepatitis B Virus Reactivation after Receiving Cancer Chemotherapy under Administration of Leuprorelin Acetate.
Authors: Yamauchi R, Takeyama Y, Takata K, Fukunaga A, Sakurai K, Tanaka T, Fukuda H, Fukuda S, Kunimoto H, Umeda K, Morihara D, Yokoyama K, Irie M, Shakado S, Sakisaka S, Hirai F Abstract An 88-year-old man was admitted for elevated liver enzyme levels. Nine years earlier, the patient had been diagnosed with diffuse large B-cell lymphoma (DLBCL) and undergone rituximab, cyclophosphamide, doxorubicin hydrochloride, oncovin, prednisone (R-CHOP) therapy. This patient previously had had a hepatitis B virus (HBV) infection before chemotherapy. After the chemotherapy, he was administered an LHRH agonist for prostate can...
Source: Internal Medicine - January 21, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Apparent Diffusion Coefficient in the Resolution of Renal Ischemia after Angioplasty on Diffusion-weighted Imaging: A Case of Renal Artery Stenosis Caused by Progressive Thrombosis in Residual Chronic Aortic Dissection.
We report a case in which diffusion-weighted magnetic resonance imaging (DWI) demonstrated renal artery stenosis-related renal ischemia and the therapeutic efficacy of revascularization. The patient was a 73-year-old man, who underwent descending thoracic aortic replacement due to DeBakey IIIb chronic aortic dissection, and who showed progressive renal dysfunction due to right renal artery stenosis caused by false lumen thrombosis. DWI demonstrated a decreased apparent diffusion coefficient (ADC) in the right kidney, indicating renal ischemia. Angioplasty with stenting restored renal perfusion and improved the renal functi...
Source: Internal Medicine - January 21, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Erythromelalgic Symptoms in Left Subclavian Artery Stenosis.
Authors: Kametani T, Otani Y, Kanno K, Tazuma S PMID: 31956204 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 21, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

X-linked Hypophosphatemia (XLH) Mimicking Rheumatic Disease.
Authors: Takase R, Nakano Y, Hasegawa K, Otsuka F PMID: 31956205 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 21, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

IgG4-related Disease with a Cardiac Mass.
Authors: Matsumura I, Mitsui T, Tahara K, Shimizu H, Yanagisawa K, Ishizaki T, Koiso H, Takizawa M, Yokohama A, Saitoh T, Hirato J, Murakami H, Handa H, Tsukamoto N Abstract A 69-year-old man with palpitations and decreased blood pressure was referred. Echocardiography showed a mass in the right atrium and cardiac septum. The serum IgG4 level was 1450 mg/dl. A biopsy of the cardiac mass showed fibrosis with inflammatory cells and increased IgG4-positive plasma cells and lymphocytes. Flow cytometry and polymerase chain reaction of the immunoglobulin heavy chain did not demonstrate monoclonality. He was diagnosed wit...
Source: Internal Medicine - January 21, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Superior Vena Cava Lymphoma.
Authors: Ogasawara F, Nakatani Y, Kojima K PMID: 31956207 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 21, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

The Relationship between Remitting Seronegative Symmetrical Synovitis with Pitting Edema and Vascular Endothelial Growth Factor and Matrix Metalloproteinase 3.
Authors: Kenzaka T PMID: 31956208 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 21, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Effects of Nutritional Treatment on the Frequency of Pneumonia in Bedridden Patients Receiving Oral Care.
We examined the effects of nutritional treatment on the prevention of pneumonia. Patients and Methods We retrospectively examined the effects of nutritional treatment on the prevention of pneumonia by analyzing the records of bedridden patients (n=68; mean age: 68.0 years) who stayed in a hospital for 2 years or longer. Results Among the analyzed patients, pneumonia developed in 52 (76%) patients, and the mean frequency of pneumonia was 1.6 times per year during the first year of stay. In a multivariate analysis, the serum albumin level at admission in the pneumonia group was lower than that in the non-pneumonia group. The...
Source: Internal Medicine - January 17, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Clinical Characteristics of Rapidly Progressive Fatal Hemorrhagic Pneumonia Caused by Stenotrophomonas maltophilia.
Conclusion Patients with SM bacteremia who have hematologic malignancy, thrombocytopenia, and a history of using quinolone within the past 30 days should be treated with deliberation. PMID: 31941869 [PubMed - in process] (Source: Internal Medicine)
Source: Internal Medicine - January 17, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

The Administration of Tenofovir Disoproxil Fumarate for Pregnant Japanese Women with Chronic Hepatitis B.
Authors: Suoh M, Tamori A, Amano-Teranishi Y, Nakai T, Enomoto M, Kawasaki Y, Kioka K, Kawada N Abstract The appropriate management of hepatitis B virus (HBV) infection during pregnancy has not been established in Japan. We herein report five HBV-infected pregnant Japanese women who received tenofovir disoproxil fumarate (TDF). Two of them had been born after the introduction of nationwide immunoprophylaxis and were vertically infected with HBV, highlighting the need to address mother-to-child transmission further. In both entecavir-experienced and nucleoside/nucleotide analog-naïve mothers, TDF suppressed HBV...
Source: Internal Medicine - January 17, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Chest Computed Tomography Abnormalities and Their Relationship to the Clinical Manifestation of Respiratory Syncytial Virus Infection in a Genetically Confirmed Outbreak.
Authors: Nabeya D, Kinjo T, Parrott GL, Nakachi S, Yamashiro T, Ikemiyagi N, Arakaki W, Masuzaki H, Fujita J Abstract Studies reporting chest images of respiratory syncytial virus (RSV)-induced lower respiratory tract infection (LRTI) in an outbreak setting and their relationship to the clinical manifestation are limited. During a genetically confirmed RSV outbreak, eight patients underwent both chest X-ray and computed tomography (CT). Among these, 5 cases had newly appearing abnormalities on CT, although chest X-ray was able to detect abnormalities in only 2 cases (40%). Although bronchial wall thickening was com...
Source: Internal Medicine - January 17, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

A Radical Approach to Acute Lymphoblastic Leukemia Treatment: A Case Study of a Veterinarian Specializing in Livestock who Developed Disseminated Mucormycosis during Induction Therapy.
Authors: Sakai T, Sato K, Kikuchi T, Obata M, Konuma Y Abstract Mucormycosis has emerged as the third-most common fungal mycosis and is one of the most fatal molds. We herein report a case study of a 30-year-old woman who was a veterinarian, specializing in livestock, who developed disseminated mucormycosis during induction therapy for acute lymphoblastic leukemia. We successfully used a radical approach for treatment, including a surgical procedure and allogeneic transplantation, with continuous administration of antifungal agents. Reports of successful treatments are extremely rare, and our case has had the longe...
Source: Internal Medicine - January 17, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Anti-leucine-rich Glioma Inactivated-1 Encephalitis Associated with Essential Thrombocythemia.
Authors: Yuan X, Man X, Zhang J, Sun J, Liang J, Ma H, Tao S, Guo D, Liu L Abstract Anti-leucine-rich glioma inactivated-1 (anti-LGI1) encephalitis is a subgroup of autoimmune encephalitis. We herein report the case of a 60-year-old man who presented with typical symptoms, including short-term memory loss, mental abnormalities, hyponatremia and seizures characterized by faciobrachial dystonic seizures and who was diagnosed with anti-LGI1 encephalitis. At the same time, he was diagnosed with essential thrombocythemia. A significant improvement was obtained by treatment with corticosteroid, immunoglobulin, mycophenol...
Source: Internal Medicine - January 17, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Heat Stroke Lesions in the Globus Pallidus.
Authors: Hirayama I, Inokuchi R, Ueda Y, Doi K PMID: 31915313 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 11, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Multiple Carcinomas and Intraepithelial Neoplasms in a Case of Familial Pancreatic Cancer: Rapid Morphological Changes in the Pancreatic Cyst and Pathological Lesions Undetected by Clinical Images.
Authors: Matsubayashi H, Notohara K, Hruban RH, Satoh T, Kaneko J, Sato J, Ishiwatari H, Ashida R, Uesaka K, Kiyozumi Y, Ono H Abstract A 69-year-old woman with a family history of pancreatic cancer was referred because of imaging changes of a pancreas cyst. Magnetic resonance cholangiopancreatography showed a faintly dilated main pancreatic duct and a pancreas body cyst that had changed rapidly over the past year. Computed tomography demonstrated an emerging enhancing lesion in the pancreatic cyst. Endoscopic ultrasonography revealed an irregular-margined, heterogeneous-echoic pancreatic mass, without findings of ...
Source: Internal Medicine - January 11, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Shingles on the Tongue.
Authors: Yokota K, Chikasawa Y, Kimura Y, Shirai K PMID: 31915315 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 11, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

MRI Mapping of Muscle Denervation in Metastatic Myelopathy.
Authors: Matsuda N, Minemura H, Kobayashi S, Kanai K PMID: 31915316 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 11, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Aortic Arch Aneurysm in Beh çet Disease Successfully Treated with Infliximab.
Aortic Arch Aneurysm in Behçet Disease Successfully Treated with Infliximab. Intern Med. 2020 Jan 09;: Authors: Nishiyama T, Kondo Y, Okamoto S, Terasaki M, Toko H, Yagishita M, Takahashi H, Yokosawa M, Tsuboi H, Matsumoto I, Sumida T Abstract Aortic arch aneurysm (AAA) is a rare involvement in Behçet disease (BD). It is often life-threatening, yet few reports related to the treatment of AAA have been published. We herein report a 27-year-old woman with AAA caused by vascular BD. She was initially treated with prednisolone 1 mg/kg/d. However, the inflammation had not subsided after three ...
Source: Internal Medicine - January 11, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Parietal Cheiro-oral Syndrome.
Authors: Takayanagi M, Shiina T, Suzuki K, Hirata K PMID: 31915318 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 11, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Patency Capsule Aspiration: A Case Report.
Authors: Takeda K, Tashimo H, Miyakawa K, Shimada M, Ohshima N, Tamura A, Nagai H, Matsui H Abstract A 77-year-old man with anemia who had undergone 2 abdominal surgeries for colon and gastric cancer experienced dyspnea after swallowing a patency capsule before endoscopy for investigating the cause of anemia. Chest radiography and computed tomography revealed that the patency capsule was located within the bronchus intermedius. It was successfully removed by flexible bronchoscopy. The balloon was placed over the capsule and inflated. Subsequently, the catheter was pulled, while thus dragging the capsule with it and...
Source: Internal Medicine - January 11, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Effectiveness of Lifestyle Intervention Using the Internet of Things System for Individuals with Early Type 2 Diabetes Mellitus.
Authors: Kato S, Ando M, Honda H, Yoshida Y, Imaizumi T, Yamamoto N, Maruyama S Abstract Objective Exercise therapy is used for glycemic control in type 2 diabetes mellitus (T2DM). We evaluated the effects of intensive health guidance using the Internet of things (IoT) among Japanese company workers with early T2DM. Methods Fifty-three men (mean age: 54 years) with glycated hemoglobin (HbA1c) levels of>6.5% were enrolled in a 6-month exercise therapy program between August 2016 and January 2017. They used activity meters, scales, and sphygmomanometers connected to the Internet by Bluetooth. These devices automat...
Source: Internal Medicine - January 7, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

A Rare Combination of Gastric Mucosa-associated Lymphoid Tissue Lymphoma, Autoimmune Gastritis, Thyroiditis, Hemolysis, and Systemic Lupus Erythematosus.
Authors: Kotera T, Itani K, Uchiyama H, Takemoto T, Ooyama K, Hirata K, Imashuku S, Nakajima S Abstract We herein report a case with the rare combination of mucosa-associated lymphoid tissue lymphoma (MALT lymphoma) of the stomach, autoimmune gastritis (AIG), autoimmune thyroiditis, autoimmune hemolytic anemia (AIHA), and systemic lupus erythematosus. A 68-year-old woman was diagnosed with gastric MALT lymphoma associated with Helicobacter pylori (H. pylori) infection and AIG. Complete remission of the MALT lymphoma was achieved by H. pylori eradication and radiotherapy. Three years after the diagnosis of MALT lymp...
Source: Internal Medicine - January 7, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Eculizumab for Severe Thrombotic Microangiopathy Secondary to Surgical Invasive Stress and Bleeding.
Authors: Fujita Y, Terashita M, Yazawa M, Yamasaki Y, Imamura T, Kibayashi J, Sawai T, Hidaka Y, Ohtani K, Inoue N, Shibagaki Y Abstract Atypical hemolytic uremic syndrome (aHUS) is an extremely rare condition caused by an excessive activation of the complement pathway based on genetic or acquired dysfunctions in complement regulation, leading to thrombotic microangiopathy (TMA). A complement-amplifying condition (CAC) can trigger aHUS occurrence along with complement abnormality. We herein report a case of severe TMA after laparoscopic myomectomy in a healthy woman. This case was eventually diagnosed as complement...
Source: Internal Medicine - January 7, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Eosinophilic Granulomatosis With Polyangiitis Initially Diagnosed as Eosinophilic Gastroenteritis - Report of Two Cases.
Authors: Itawaki A, Okada M, Kawashima K, Okimoto E, Sonoyama H, Mishima Y, Oshima N, Ishimura N, Moriyama M, Murakawa Y, Araki A, Ishikawa N, Maruyama R, Ishihara S, Kinoshita Y Abstract We herein report two cases of eosinophilic granulomatosis with polyangiitis (EGPA) initially diagnosed as eosinophilic gastroenteritis (EGE) based solely on endoscopic biopsy results. One year after the EGE diagnosis, one patient presented with multiple purpura, and skin biopsy findings resulted in a change of the diagnosis to EGPA. In another patient, multiple skin and colonic ulcerations emerged eight years after the diagnosis o...
Source: Internal Medicine - December 27, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Malignant Lymphoma Developed in the Hypothalamus.
Authors: Takase R, Nakano Y, Otsuka F PMID: 31875635 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - December 27, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Secondary Pulmonary Alveolar Proteinosis Following Treatment With Azacitidine for Myelodysplastic Syndrome.
Authors: Hashimoto M, Itonaga H, Nannya Y, Taniguchi H, Fukuda Y, Furumoto T, Fujioka M, Kasai S, Taguchi M, Taniguchi H, Sato S, Sawayama Y, Atogami S, Iwasaki K, Hata T, Soda H, Moriuchi Y, Nakata K, Ogawa S, Miyazaki Y Abstract Secondary pulmonary alveolar proteinosis (sPAP) is a complication of myelodysplastic syndrome (MDS). A 60-year-old woman was diagnosed with MDS with excess blasts-1. Fifty-four months after the initial diagnosis, treatment with azacitidine was initiated. Seventy-three months after the diagnosis, a bone marrow examination revealed increased myeloblasts, at which time computed tomography sh...
Source: Internal Medicine - December 27, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Antegrade Balloon Aortic Valvuloplasty for the Highly Frail Patient of Severe Aortic Stenosis Complicated with Transthyretin-type Cardiac Amyloidosis.
Authors: Yoshida S, Tada H, Nishikawa T, Nakagawa-Kamiya T, Nakahashi T, Sakai K, Sakata K, Kawashiri MA, Yamada M, Takamura M Abstract Transcatheter aortic valve implantation (TAVI) is widely accepted as the treatment for patient with severe aortic stenosis (AS) whose prognosis may be over one year; however, there is no consensus concerning extremely high-risk patients whose prognosis may not exceed one year. We herein report a highly frail patient with severe AS complicated with transthyretin-type cardiac amyloidosis who had a very poor prognosis. Given his condition, we treated him by percutaneous antegrade ball...
Source: Internal Medicine - December 27, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

A Case of IgG4-related Sclerosing Cholangitis Mimicking Cholangiocarcinoma Diagnosed by Endoscopic Ultrasound-guided Fine-needle Aspiration.
Authors: Matsumoto R, Miura S, Kanno A, Ikeda M, Sano T, Tanaka Y, Nabeshima T, Hongou S, Takikawa T, Hamada S, Kume K, Kikuta K, Masamune A Abstract A 58-year-old man was referred for obstructive jaundice. Imaging modalities revealed the presence of multiple pancreatic tumors and the stenosis of the middle common bile duct due to a hypoenhanced localized tumor. The multiple pancreatic tumors were histopathologically diagnosed as autoimmune pancreatitis by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). To differentiate between IgG4-related sclerosing cholangitis (IgG4-SC) and cholangiocarcinoma, we ...
Source: Internal Medicine - December 27, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Hepatitis-associated Aplastic Anemia With Rapid Progression of Liver Fibrosis Due to Repeated Hepatitis.
Authors: Sawada K, Takai A, Yamada T, Araki O, Yamauchi Y, Eso Y, Takahashi K, Shindo T, Sakurai T, Ueda Y, Seno H Abstract Hepatitis-associated aplastic anemia (HAAA) is a variant of acquired aplastic anemia and characterized by bone marrow failure that follows the development of acute hepatitis. We herein report a rare case of HAAA with rapid progression of liver fibrosis due to repeated hepatitis. A pathological examination of liver specimens revealed liver fibrosis progression over a short period. Immunosuppressive therapy with cyclosporine effectively cured both the pancytopenia and hepatitis. Our case suggest...
Source: Internal Medicine - December 27, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Knowledge of Secondary Pulmonary Alveolar Proteinosis Complicated With Myelodysplastic Syndrome.
Authors: Haruyuki I PMID: 31875640 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - December 27, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Pulmonary Mycobacterium parascrofulaceum Infection in a Patient with Chronic Progressive Pulmonary Aspergillosis: A Case Report and Literature Review.
Authors: Ikegami H, Yamasaki K, Kawanami T, Fukuda K, Akata K, Nakamura M, Ikushima I, Fukuda Y, Noguchi S, Yatera K Abstract A 67-year-old man with a pulmonary cavity was admitted to our hospital. Mycobacterial culture of the bronchoalveolar lavage fluid sample obtained from the right upper pulmonary lesion tested positive for mycobacterium, and sequencing of the 16S rRNA genes, hsp65, and rpoB revealed that the cultured mycobacterium was Mycobacterium parascrofulaceum. Treatment with antimycobacterial agents was ineffective, and repeated culturing of bronchoscopic specimens revealed that the specimens were positi...
Source: Internal Medicine - December 25, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research