Cerebral Involvement in Systemic Capillary Leak Syndrome.
Authors: Yamagami K, Miyaichi T, Kanki R PMID: 33431729 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 14, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Corticobasal Syndrome with Supplementary Motor Area Aphasia.
Authors: Yajima R, Naruse S PMID: 33431730 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 14, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Rapid Eye Movement Sleep Behavior Disorder-like Symptoms Due to Arousal Responses Associated with Severe Obstructive Sleep Apnea-hypopnea.
Authors: Deguchi K, Doi T, Takata T, Kokudo Y, Kobara H, Yamamoto M, Touge T, Masaki T Abstract A 78-year-old man suspected of having α-synucleinopathies received a high score on a validated questionnaire for rapid eye movement (REM) sleep behavior disorder (RBD). Although he did in fact have unpleasant dreams and vigorous behaviors, polysomnography (PSG) found only obstructive sleep apnea-hypopnea (OSAH). The RBD-like symptoms corresponded with arousal responses, namely augmented inspiratory effort and leg movements, to his frequent apnea-hypopnea events during REM sleep. Thus, severe OSAH might cause RBD-li...
Source: Internal Medicine - January 14, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Vancomycin Intoxication and Cefepime-induced Encephalopathy Treated by Abdominal Drainage of Massive Ascites in Addition to Online Hemodiafiltration: A Case Report.
Authors: Taniguchi T, Inoue Y, Itoh M, Tomita M, Kamata T, Iehara N Abstract A patient with recurrent plasmacytoma with massive ascites exhibited vancomycin intoxication and cefepime-induced encephalopathy due to renal dysfunction. The ascitic accumulation of these drugs was suspected because of the refractory intoxicated state. To remove these drugs that had accumulated in the blood and ascites, abdominal drainage was performed in addition to online hemodiafiltration. If patients with renal dysfunction and massive ascites develop vancomycin intoxication and cefepime-induced encephalopathy that cannot be improved b...
Source: Internal Medicine - January 14, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Clinical Studies on Potassium Iodide-induced Painless Thyroiditis in 11 Graves' Disease Patients.
Conclusion We encountered 11 GD patients who developed PT during treatment with KI, which was initiated after ATD had been discontinued due to side effects. PMID: 33431733 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 14, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

A Superinfection of Salmonella typhi and Hepatitis E Virus Causes Biphasic Acute Hepatitis.
Authors: Suda T, Iguchi R, Ishiyama T, Kanefuji T, Hoshi T, Abe S, Morita S, Yagi K Abstract A 47-year-old Japanese man was referred to our hospital because of a sustained high fever with diarrhea 12 days after a flight from India. Liver enzymes were elevated with rose spots, hepatosplenomegaly, relative bradycardia, and acute cholecystitis. A liver biopsy depicted the dense infiltration of lymphocytes and Kupffer cells in sinusoids and the granulomatous formation in the parenchyma. The liver damage was initially resolved with the administration of ceftriaxone for 16 days but flared up 1 week later. Laboratory test...
Source: Internal Medicine - January 14, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Recurrent Aseptic Meningitis Associated with Kikuchi's Disease (Histiocytic Necrotizing Lymphadenitis): A Case Report and Literature Review.
Authors: Sekiguchi S, Yamamoto Y, Hatakeyama S, Matsumura M Abstract We herein report a 31-year-old man with recurrent aseptic meningitis associated with Kikuchi's disease. Although aseptic meningitis is the most common neurological complication of Kikuchi's disease, its characteristics remain unclear, especially in recurrent cases. A literature review revealed that aseptic meningitis associated with Kikuchi's disease was more likely to occur in men and was associated with a low cerebrospinal fluid (CSF)/serum glucose ratio. Lymphadenopathy tended to occur simultaneously or after the onset of meningitis. When encou...
Source: Internal Medicine - January 14, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Two Cases of Severe COVID-19 Pneumonia Effectively Treated with Extracorporeal Membrane Oxygenation in Addition to Favipiravir and Corticosteroid.
Authors: Shinoda M, Kamachi K, Ota S, Yoshimatsu L, Boku R, Yoshida Y, Hirouchi T, Shinada K, Sato T, Morikawa M, Iwata K, Matsumoto T, Shinkai M Abstract Case 1: A 65-year-old man with novel coronavirus infection (COVID-19) complicated with acute respiratory failure. On admission, the patient was started on favipiravir and corticosteroid. However, due to a lack of significant improvement, he was introduced to mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Although iliopsoas hematoma occurred as a complication, the patient recovered. Case 2: A 49-year-old man with COVID-19 had been started o...
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Prospective Memory Deficits in Multiple Sclerosis: Voxel-based Morphometry and Double Inversion Recovery Analysis.
Conclusion The left inferior frontal gyrus, the left hippocampus, and the right parahippocampus were associated with PM in MS, whereas these atrophic GM regions were not associated with GM plaque. Regardless of the location of plaques on DIR, both PM deficit and GM atrophy should be detected using neuropsychological tests and VBM in MS patients. PMID: 33390470 [PubMed - in process] (Source: Internal Medicine)
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

An Infected Popliteal Aneurysm after Plain Old Balloon Angioplasty.
Authors: Senda K, Yoda H, Shoin K, Oguchi Y, Aizawa K, Aso S, Shirai E, Kikuchi N, Ohtsu Y, Tsunemoto H, Suzuki C Abstract The case was a 76-year-old man with chronic limb-threatening ischemia. Plain old balloon angioplasty (POBA) was performed on the popliteal artery. Subsequently, he suffered from cellulitis around the POBA site, followed by reocclusion. Staphylococcus aureus was detected in a blood culture. After re-revascularization with POBA, both purulent gonitis and an infected popliteal aneurysm were observed to occur. We performed aneurysmectomy and bypass grafting with the saphenous vein and then continue...
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Unusual Overlapping Cardiac Sarcoidosis and Long-QT Type 3 Induced Ventricular Fibrillation.
Authors: Nishikawa T, Aiba T, Ueda N, Nakajima K, Yamada-Inoue Y, Kamakura T, Wada M, Yamagata K, Ishibashi K, Tateishi E, Kiso K, Ikeda Y, Ishibashi-Ueda H, Miyamoto K, Nagase S, Noda T, Kusano K Abstract A 54-year-old woman had been resuscitated after ventricular fibrillation and her electrocardiogram showed a QT prolongation (QTc=510 ms), and genetic screening revealed a missense variant, R1644C, in the SCN5A gene. She was therefore diagnosed with congenital long-QT syndrome (LQTS) type 3. However, the patient had left ventricular dysfunction, and based on the findings of cardiac magnetic resonance imaging, posi...
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

The First Case Report of Mediastinal Abscess Caused by Gemella bergeri.
Authors: Toyoshima H, Fujii K, Tanigawa M, Nakamura A, Tanabe M, Tanaka H, Nakanishi Y, Sakabe S Abstract Most cases of mediastinal abscess occur as a postoperative complication of a thoracic surgical procedure or following trauma. The most common causative microorganism is Staphylococcus aureus, but it can be rarely caused by unusual microorganisms, such as Gemella species. These are relatively difficult-to-identify commensal microorganisms of the upper respiratory and gastrointestinal tracts and may cause several infections. A 66-year-old man was diagnosed with Gemella bergeri mediastinal abscess by the molecular...
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Validity of "One-size-fits-all" Approaches for the National Health Screening and Education Program: A Large-Scale Cohort Study of Corporate Insurance Beneficiaries.
Conclusion We showed that the association between the AC or BMI and metabolic syndrome was modified by gender or age group. Further studies will be needed to customize the national health screening and education programs. PMID: 33390484 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Intracerebral Hemorrhaging Due to Coagulopathy Caused by Latent Advanced Prostate Cancer.
Authors: Johno T, Kawano H, Hirokawa T, Shibahara J, Hirano T Abstract A patient with no medical history was admitted to our hospital with consciousness disturbance and diagnosed with intracerebral hemorrhaging in the bilateral hemisphere based on computed tomography. A blood test showed an abnormal coagulation capacity. He died of intracerebral hemorrhaging 11 h after the onset. An autopsy revealed latent advanced prostate cancer metastasis to multiple organs. Notably, we found no evidence of intracerebral hemorrhaging, including arteriovenous malformation or cancer metastasis, in the brain. He was ultimately diag...
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Vitamin D Deficiency-induced Osteomalacia in a Patient with Anorexia Nervosa.
Authors: Koda R, Miyazaki S, Iino N, Sato Y, Hirano K, Sunami E, Kosugi S, Kanefuji T, Ogose A, Narita I Abstract A 48-year-old woman with a 9-year-history of anorexia nervosa (AN) was admitted complaining of generalized bone pain. Blood tests showed hypocalcemia and hyperphosphatasemia, and a radiological survey revealed multiple rib fractures, suggesting complication with osteomalacia. Two years earlier, she had undergone subtotal colectomy for colon cancer. Her serum 25-hydroxy vitamin D concentration was below the detectable level. In addition to a poor nutritional intake and insufficient sun exposure, malabsor...
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Peripheral Nerve Enlargement in Chronic Inflammatory Demyelinating Polyneuropathy.
Authors: Tanitame K, Araki M, Kunishige T PMID: 33390487 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Hypothalamic Mass Detected in Langerhans Cell Histiocytosis.
Authors: Takase R, Nakano Y, Morizane S, Otsuka F PMID: 33390488 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Readministration of Pembrolizumab after Treatment of Tuberculosis Activated by Initial Pembrolizumab Therapy.
We present the case of a patient with advanced non-small-cell lung cancer who developed active tuberculosis (TB) after initial treatment with pembrolizumab, an anti-PD-1 antibody. Pembrolizumab was resumed after completing anti-TB treatment, and no relapse of TB was observed clinically or radiologically. Checkpoint inhibitor-related pneumonitis (CIP) is first suspected when a pulmonary shadow presents during treatment with an anti-PD-1 antibody. It is sometimes difficult to diagnose CIP using computed tomographic images alone. Careful testing, including bacterial examinations and bronchoscopic biopsy, should be performed. ...
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Immediate Amelioration of Severe Respiratory Distress in Sj ögren's Syndrome with COVID-19 Treated with a Single Dose of Off-label Tocilizumab.
Immediate Amelioration of Severe Respiratory Distress in Sjögren's Syndrome with COVID-19 Treated with a Single Dose of Off-label Tocilizumab. Intern Med. 2020 Dec 29;: Authors: Kataoka H, Kodama F, Tomita T, Kondo M, Nagasaka A, Nishikawa S, Mukai M Abstract The coronavirus disease 2019 (COVID-19) pandemic has become an urgent global health issue. An older age and underlying conditions, such as diabetes, have been reported as risk factors, but whether or not autoimmune diseases increase the risk remains unknown. An 85-year-old man with Sjögren's syndrome developed a severe COVID-19 infection...
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

A Unique Case of Encephalopathy with an Elevated IgG-4 and Extremely High Interleukin-6 Level and Delayed Myelodysplastic Syndrome.
Authors: Matsumoto N, Hishikawa N, Ikegami K, Sato K, Omote Y, Takemoto M, Yamashita T, Taniguchi K, Abe K Abstract We herein report a 75-year-old man who developed disturbed consciousness with polynuclear cell dominant pleocytosis and low glucose and extremely high interleukin (IL)-6 levels in his cerebrospinal fluid. The biopsy specimen from his right supraclavicular lymph node showed the infiltration of inflammatory cells positive for IgG, IgG4 and IL-6. Prednisolone and azathioprine administered under suspicion of IgG4-related disease (IgG4-RD) or multicentric Castleman's disease (MCD) successfully remitted the...
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Heerfordt's Syndrome Associated with Trigeminal Nerve Palsy and Reversed Halo Sign.
Authors: Makimoto G, Kawakado K, Nakanishi M, Tamura T, Noda M, Makimoto S, Sato Y, Kuyama S Abstract Heerfordt's syndrome is a rare subtype of sarcoidosis and features a combination of facial palsy, parotid swelling, and uveitis, associated with a low-grade fever. Cases with two of three symptoms are called "incomplete Heerfordt's syndrome." Heerfordt's syndrome involving other cranial nerve symptoms is relatively rare. We herein report a case of incomplete Heerfordt's syndrome presenting with trigeminal nerve palsy and a reversed halo sign, a rare manifestation of pulmonary sarcoidosis. The histological...
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Drastically Progressive Ethambutol-induced Optic Neuropathy after Withdrawal of Ethambutol: A Case Report and Literature Review.
Authors: Matsumoto T, Kusabiraki R, Arisawa A, Fujiki T, Noda A, Tanaka A, Yamamoto N, Aihara K, Yamaoka S, Mishima M Abstract Ethambutol-induced optic neuropathy (EON) is a well-known complication, although low-dose ethambutol seldom causes EON. An 85-year-old man with non-tuberculous mycobacterial lung disease was taking antibiotics, including low-dose ethambutol. On day 85 of treatment, the diagnosis of EON was made. Despite prior discontinuation, his best corrected visual acuity drastically deteriorated from 20/17 (right eye) and 20/20 (left eye) to 20/330 (right eye) and 20/1000 (left eye) within 3 weeks, and ...
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Endoscopic and Upper Gastrointestinal Barium X-ray Radiography Images of Early-stage Autoimmune Gastritis: A Report of Two Cases.
Authors: Ayaki M, Aoki R, Mastunaga T, Manabe N, Fujita M, Kamada T, Kobara H, Masaki T, Haruma K Abstract We herein report two patients with early-stage autoimmune gastritis who did not exhibit complete atrophy. Endoscopic examinations showed no manifestations of severe atrophic gastritis, but revealed a mosaic pattern with slight swelling of the areae gastricae restricted to the corpus in both patients. In the patient in case 2, upper gastrointestinal barium X-ray radiography revealed a slightly protruded irregular areae gastricae throughout the gastric body, except for in the antrum. Our findings emphasize the n...
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Acute Stroke Caused by Progressive Intracranial Artery Stenosis due to Varicella Zoster Virus Vasculopathy After Chemotherapy for Malignant Lymphoma.
Authors: Saito M, Kawano H, Amano T, Hirano T Abstract Decreased cell-mediated immunity can reactivate Varicella zoster virus (VZV), which can lead to various neurological complications, including vasculopathy. We herein report the case of a patient with acute stroke with progressive internal carotid artery stenosis due to VZV vasculopathy after chemotherapy for malignant lymphoma. Treatment for VZV vasculopathy improved the stenosis and prevented recurrent stroke. VZV vasculopathy is an important treatable cause of stroke in immunosuppressed patients. PMID: 33390495 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

A Case of Effective Endoscopic Closure of Cholecysto-duodenal and Transverse Colon Fistulas due to Squamous Cell Carcinoma of the Gallbladder using Polyglycolic Acid Sheets and a Covered Metal Stent.
Authors: Sato S, Chinda D, Tanaka Y, Kaizuka N, Higuchi N, Ota S, Miyazawa K, Kikuchi H, Aizawa S, Iwamura H, Fukuda S Abstract An 81-year-old woman presented with abdominal distension and right hypochondrial pain. Abdominal contrast computed tomography and magnetic resonance imaging revealed an 11-cm gallbladder tumor. The patient was diagnosed with squamous cell carcinoma of the gallbladder by endoscopic ultrasound-guided fine-needle aspiration from the gastric antrum. Thereafter, the gallbladder tumor enlarged, and cholecysto-duodenal and transverse colon fistulas were formed. A covered metal stent was placed on...
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Development of Severe Acute Pancreatitis Following Uncovered Metallic Stent Placement: A Rare Case Report.
Authors: Takaoka M, Shimatani M, Takayama T, Miyoshi H, Mitsuyama T, Masuda M, Ito T, Nakamaru K, Miyamoto S, Tokuhara M, Ikeura T, Okazaki K, Naganuma M Abstract Self-expandable metallic stents (SEMSs) are widely used for malignant biliary stricture (MBS). Acute pancreatitis is an early complication following SEMS placement. In the present case, the patient developed severe acute pancreatitis after SEMS placement for MBS because of metastatic lymph nodes. Endoscopic retrograde cholangiopancreatography, endoscopic sphincterotomy and an endoscopic nasobiliary drainage tube placement were performed. After seven days,...
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Two Cases of Endometriosis in the Cecum Detected by Contrast-enhanced Computed Tomography with Air/Carbon Dioxide Insufflation.
Authors: Iwamuro M, Tanaka T, Sugihara Y, Harada K, Hiraoka S, Kondo Y, Okada H Abstract We herein report two patients with endometriosis in the cecum. Both patients presented with a protruding, subepithelial tumor on colonoscopy and were diagnosed with cecal endometriosis after surgical resection. It is notable that the cecal lesions were not initially identified on computed tomography (CT), while CT colonography with air/carbon dioxide insufflation resulted in the detection of the cecal tumor. These cases highlight the possibility of false-negative results on conventional CT in patients with cecal endometriosis. ...
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Isolated Right Ventricular Apical Hypertrophy.
Authors: Yamashita K, Tanaka H, Komatsu M, Hirata KI PMID: 33390499 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

The Mid-term Mortality and Mode of Death in Survivors with ST-elevation Myocardial Infarction.
Authors: Yoshioka N, Takagi K, Tanaka A, Morita Y, Yoshida R, Kanzaki Y, Nagai H, Watanabe N, Yamauchi R, Komeyama S, Sugiyama H, Shimojo K, Imaoka T, Sakamoto G, Ohi T, Goto H, Ishii H, Morishima I, Murohara T Abstract OBJECTIVE: The popularity of primary percutaneous coronary intervention (p-PCI) for ST-elevation myocardial infarction (STEMI) has increased over the past decades. Despite improvements in in-hospital mortality rates, it is clinically important to investigate the prognoses after discharge. However, data on the mode of death and prognostic factors are limited. We analyzed these factors in a Japanese c...
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Effect of Lenvatinib on a Hepatocellular Carcinoma with Fibroblast Growth Factor Receptor 4 Expression: A Case Report and Review of the Literature.
Authors: Shibata O, Kamimura K, Ko M, Sakai N, Abe H, Morita S, Mizusawa T, Sato H, Sakamaki A, Terai S Abstract Basic and clinical research have shown that the expression of molecules involved in the hepatocellular carcinoma cell signaling pathway is related to the sensitivity to molecular-targeted agents. We herein report a case of HCC that was effectively treated with lenvatinib after a poor response to sorafenib. The tumor showed a high expression of fibroblast growth factor receptor 4, which is reportedly related to the sensitivity to lenvatinib in vitro. The information obtained from this case and from our li...
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Enormous Potential of Endoscopic Ultrasound-guided Liver Biopsies.
Authors: Hijioka S, Okusaka T PMID: 33390502 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Side-hole-induced Biliary Peritonitis after Endoscopic Ultrasound-guided Gallbladder Drainage.
Authors: Kitagawa S, Kawajiri H, Ishikaia S PMID: 33390503 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 5, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

Three Cases of Food Poisoning Due to Paralepistopsis acromelalga Diagnosed from an Outbreak of Erythromelalgia.
In conclusion, asking about the dietary history is considered essential when diagnosing the cause of erythromelalgia, which has multiple causative diseases, including food poisoning due to P. acromelalga. PMID: 33361671 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - December 29, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Four Cases of Coronavirus Disease 2019 Transferred from a Cruise Ship.
Authors: Sano M, Nishioka H, Yamazaki J, Miyamoto I, Adachi T Abstract An outbreak of coronavirus disease 2019 (COVID-19) that began in Wuhan, China, has spread rapidly to many countries. We herein report four cases of COVID-19 confirmed in Japan among passengers of the cruise ship Diamond Princess and describe the clinical features, clinical course, and progression of chest computed tomographic images, chest radiographs, and treatment. Although these four patients had symptoms that included a fever, malaise, runny nose, and cough, one patient had no symptoms on admission. Two of the four patients needed mechanical...
Source: Internal Medicine - December 29, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Plastic Bronchitis Associated with Influenza: An Adult Case.
Authors: Murata Y, Ishihara S, Sato Y, Ohta T PMID: 33361673 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - December 29, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Hereditary Hemorrhagic Telangiectasia Induced Portosystemic Encephalopathy: A Case Report and Literature Review.
Authors: Kawabata H, Hamada Y, Hattori A, Tanaka K Abstract Hereditary hemorrhagic telangiectasia (HHT) is a rare disorder characterized by telangiectasias and arteriovenous malformations (AVMs), which can involve multiple organ systems. Although hepatic involvement is common, the development of portosystemic encephalopathy is extremely rare. We herein report a 72-year-old woman with HHT-induced portosystemic encephalopathy secondary to hepatic arteriovenous malformations. She presented with disturbance of consciousness, and her serum ammonia level was elevated at 270 mg/dL. Color Doppler ultrasonography and contra...
Source: Internal Medicine - December 29, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Deciduosis of the Appendix During Pregnancy.
We report the case of a 35-year-old woman in her 8th month of pregnancy who presented with impending appendiceal rupture due to deciduosis of the appendix, a progesterone-related condition, during pregnancy. This case suggests that deciduosis/stromal endometriosis should be considered as a differential diagnosis of acute abdomen during pregnancy, even if the patient is asymptomatic before pregnancy. PMID: 33361675 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - December 29, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Fabry Disease on Peritoneal Dialysis with Cardiac Involvement.
Authors: Koga-Kobori S, Sawa N, Kido R, Sekine A, Mizuno H, Yamanouchi M, Hayami N, Suwabe T, Hoshino J, Kinowaki K, Ohashi K, Fujii T, Ubara Y Abstract Fabry disease (FD) is an X-linked lysosomal storage disorder resulting from a lack of alpha-galactosidase A (AGALA) activity in lysosomes. We herein report a patient with FD revealed by a renal biopsy who survived seven years after the introduction of peritoneal dialysis despite having severe heart failure due to left ventricular hypertrophy (LVH). FD was diagnosed based on a renal biopsy and biochemical analysis showing a low enzymatic activity of AGALA. A microsc...
Source: Internal Medicine - December 29, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Efficacy of Switching from Kanamycin Sulfate to Rifaximin in Patients with Hepatic Cirrhosis.
This study evaluated the efficacy associated with switching to rifaximin in patients with hepatic cirrhosis receiving kanamycin sulfate for the treatment of hepatic encephalopathy and hyperammonemia. Methods We included 37 patients who switched from kanamycin sulfate to rifaximin at our institution from January 2017 to December 2018. The onset of hepatic encephalopathy and changes in blood ammonia values during a six-month period were retrospectively evaluated. Results There were 4 (11%) patients with hepatic encephalopathy at the time of switching from kanamycin sulfate to rifaximin. The cumulative incidence of hepatic en...
Source: Internal Medicine - December 29, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Aquaporin-4-antibody-positive Neuromyelitis Optica Spectrum Disorder in a Patient with Charcot-Marie-Tooth Disease Type 1A.
Authors: Hamada Y, Takahashi K, Kanbayashi T, Hatanaka Y, Kobayashi S, Sonoo M Abstract Charcot-Marie-Tooth disease type 1A (CMT1A) is a hereditary peripheral neuropathy, and its involvement in the central nervous system (CNS) is very rare. We herein report a 51-year-old woman with CMT1A who suffered from recurrent optic neuritis and myelopathy. Under the diagnosis of anti-aquaporin-4 antibody positive neuromyelitis optica spectrum disorder (NMOSD), we treated her successfully with corticosteroids. This is the first report of CMT1A complicated with AQP4-positive NMOSD. Although the coexistence of the two disorders ...
Source: Internal Medicine - December 29, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Intraventricular Primary Central Nervous System Lymphoma Mimicking Ventriculitis.
Authors: Hirato T, Komatsu K, Nishida N, Matsumoto S PMID: 33361679 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - December 29, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Utility of Basophil Activation Test in a Case of Daisaikoto- and Yokukansan-induced Lung Injury.
Authors: Kawahara T, Yamaguchi M, Onitsuka C, Kimura T, Homma T, Sagara H Abstract Drug-induced lung injury is defined as a respiratory disorder. The usefulness of the basophil activation test (BAT) for drug allergy-related cases was recently reported. The patient was an 82-year-old woman who had been taking Daisaikoto and Yokukansan (herbal medicines) 3 months before developing dry cough. She was admitted to our hospital with an initial diagnosis of pneumonia with elevated serum LDH, KL-6, and IgE. Chest CT showed bilateral GGOs. Her BAL fluid showed increased eosinophils. Finally, a BAT was positive for both medi...
Source: Internal Medicine - December 29, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Magnetic Resonance Neurography in a Patient with Distal Neuralgic Amyotrophy.
We report a case of idiopathic distal NA with hyperintensity and thickening in the inferior trunk extending to the posterior and medial fasciculus of the left brachial plexus, which was detected by magnetic resonance neurography (MRN) with diffusion-weighted whole-body imaging with background body signal suppression (DWIBS). The abnormal signal intensity diminished after the improvement of symptoms following corticosteroid treatment. MRN with DWI can help diagnose distal NA and evaluate the post-therapeutic response. PMID: 33361681 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - December 29, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Wandering Pneumonia Mimicked by COVID-19.
Authors: Yoshida Y, Saraya T, Fujiwara M, Ishii H PMID: 33361682 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - December 29, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Systemic Lupus Erythematosus Complicated with Listeria Monocytogenes Infection in a Pregnant Woman.
Authors: Morimoto M, Fujikawa K, Ide S, Akagi M, Fujiwara E, Mizokami A, Kawakami A Abstract A 41-year-old woman with systemic lupus erythematosus (SLE) was admitted to our hospital due to a fever at 35 weeks of pregnancy. Laboratory testing revealed a low platelet count and elevated liver enzymes. Emergency Caesarean section was performed due to the risk of SLE exacerbation or hemolytic anemia, elevated liver enzyme, and low platelet count syndrome. Based on the blood culture results, the patient was diagnosed with Listeria monocytogenes bacteremia. She was treated with ampicillin and eventually recovered, and the...
Source: Internal Medicine - December 19, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Spontaneous Pyogenic Spondylitis and Possible Infective Endocarditis Caused by Aggregatibacter actinomycetemcomitans.
Authors: Yukihira N, Hori H, Yamashita T, Kawamura A, Fukuchi T, Sugawara H Abstract Aggregatibacter actinomycetemcomitans, an etiological agent associated with periodontitis, endocarditis, and other infections, has rarely been implicated in spondylitis. A 70-year-old man with aortic valve replacement presented with a 4-month history of lower back pain and was diagnosed with spondylitis. Prolonged incubation of blood cultures and a biopsy yielded A. actinomycetemcomitans. Concurrent infective endocarditis (IE) was probable considering the infectious organism and the patients' prosthetic valve. The patient was treat...
Source: Internal Medicine - December 19, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Skin Lesions Caused by Disseminated Cryptococcosis.
Authors: Konishi K, Nakagawa H, Asaoka T, Shirano M PMID: 33328399 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - December 19, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Paraneoplastic Sensory Polyneuropathy Related to Anti-PD-L1-including Anticancer Treatment in a Patient with Lung Cancer.
Authors: Morimoto T, Orihashi T, Yamasaki K, Tahara M, Kato K, Yatera K Abstract Paraneoplastic neurological syndromes (PNS), such as sensory polyneuropathy, are rare, and serum neuronal antibodies that are used for diagnosing this syndrome are occasionally positive. Similarly, neurological immune-related adverse events due to immune checkpoint inhibitors (ICIs) are also rare. However, their etiologies and the relationship between them remain unclear. We herein report a patient with suspected small cell lung cancer who showed sensory polyneuropathy after treatment with atezolizumab in combination with cytotoxic age...
Source: Internal Medicine - December 19, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Borderline Case of TAFRO Syndrome and POEMS Syndrome.
Authors: Shibata S, Tabata S, Morita H, Endo T, Kawasaki N, Okamoto Y, Inano S, Takiuchi Y, Fukunaga A, Kitano T Abstract TAFRO syndrome and POEMS syndrome are lymphoproliferative disorders with elevated interleukin-6 and vascular endothelial growth factor (VEGF) levels; however, their underlying pathogenic mechanisms remain unclear. Similarities have been reported in the pathological findings of the lymph nodes of TAFRO syndrome, Multicentric Castleman disease (MCD), and some cases of POEMS syndrome. However, there is no consensus on the relationship among them. We encountered a case of lymphoproliferative disorde...
Source: Internal Medicine - December 19, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Speech Sounds and the Production of Droplets and Aerosols.
Authors: Hamada S, Tanabe N, Hirai T PMID: 33328402 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - December 19, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research