A Case of Multiple Cerebral Infarcts Due to Severe Anemia Preceded by Migraine-like Headache with Aura
Intern Med. 2024 May 16. doi: 10.2169/internalmedicine.3842-24. Online ahead of print.ABSTRACTWe herein report a 47-year-old woman who developed migraine-like headache with aura and subsequent multiple cerebral infarcts, likely due to severe iron deficiency anemia (IDA) from menorrhagia. The progression from IDA to ischemic stroke involves several pathophysiological mechanisms, including reduction of erythrocyte deformability, reactive thrombocytosis, and anemic hypoxia. We speculate that a microembolus first caused cortical spreading depression without infarcts and that a larger thromboembolus then caused multiple infarct...
Source: Internal Medicine - May 15, 2024 Category: Internal Medicine Authors: Kiichiro Oryu Yuji Kato Yoshiki Mochizuki Noriko Arai Ichiro Deguchi Shinichi Takahashi Satoshi Suda Source Type: research

A Case of Dupilumab-Induced Diffuse Alveolar Hemorrhage
Intern Med. 2024 May 16. doi: 10.2169/internalmedicine.3695-24. Online ahead of print.ABSTRACTEosinophilic pneumonia is a known side effect of dupilumab; however, diffuse alveolar hemorrhage has not yet been reported in association with dupilumab. We herein report a case of diffuse alveolar hemorrhage caused by dupilumab. A 57-year-old man with severe asthma was unable to discontinue oral steroids and thus was prescribed dupilumab. The patient was admitted to the hospital four weeks after treatment because of suspected eosinophilic pneumonia. Bronchoscopy revealed diffuse alveolar hemorrhage characterized by hemosiderin-ph...
Source: Internal Medicine - May 15, 2024 Category: Internal Medicine Authors: Tomoki Tamura Hiroya Okano Taisaku Koyanagi Takahiro Umeno Kazuya Nishii Shoichi Kuyama Source Type: research

Risk Factors for Bloodstream Infection in Patients Receiving Peripheral Parenteral Nutrition
Conclusion This study identified the incidence of and risk factors for developing BSI, such as a longer average daily infusion time of PPNs and all intravenous fluids, in patients receiving PPN therapy.PMID:38749727 | DOI:10.2169/internalmedicine.3692-24 (Source: Internal Medicine)
Source: Internal Medicine - May 15, 2024 Category: Internal Medicine Authors: Masafumi Shimoda Yoshiaki Tanaka Kozo Morimoto Kozo Yoshimori Ken Ohta Source Type: research

Efficacy and Safety of First-line Pembrolizumab Plus Platinum and Pemetrexed in Elderly Patients with Non-squamous Non-small-cell Lung Cancer
Conclusion First-line pemb-Plt-PEM therapy is effective and feasible in elderly patients with non-squamous NSCLC.PMID:38749728 | DOI:10.2169/internalmedicine.3649-24 (Source: Internal Medicine)
Source: Internal Medicine - May 15, 2024 Category: Internal Medicine Authors: Satoshi Wasamoto Hisao Imai Takeshi Tsuda Yoshiaki Nagai Takayuki Kishikawa Akihiro Ono Ken Masubuchi Yukihiro Umeda Yutaka Yamada Junichi Nakagawa Takaya Yui Hirokazu Taniguchi Kyoichi Kaira Hiroshi Kagamu Source Type: research

Weight and Muscle Mass Loss Associated with Acute Disease Can be Reversed with Appropriate Nutrition Therapy and Exercise in a Patient with Amyotrophic Lateral Sclerosisa: A Case Report
Conclusion In patients with ALS, a decreased body weight and muscle mass due to acute disease may be improved by appropriate nutritional therapy and physical exercise.PMID:38749729 | DOI:10.2169/internalmedicine.3622-24 (Source: Internal Medicine)
Source: Internal Medicine - May 15, 2024 Category: Internal Medicine Authors: Kenjiro Kunieda Yuichi Hayashi Ichiro Fujishima Takayoshi Shimohata Source Type: research

Magnetic Resonance Imaging/cerebrospinal Fluid-negative Myelitis Following COVID-19 with a Dramatic Response to Early Aggressive Immunosuppressive Therapy
Intern Med. 2024 May 16. doi: 10.2169/internalmedicine.3588-24. Online ahead of print.ABSTRACTA 57-year-old man presented with subacute-onset paraparesis, bilateral dysesthesia in his lower extremities, and bladder/bowel disturbance six weeks after being infected with SARS-CoV-2 infection (COVID-19). A neurological examination suggested transverse myelitis at the level of the lower thoracic spinal cord. However, repeated spinal magnetic resonance imaging (MRI) showed no abnormalities in the spinal cord. Laboratory and cerebrospinal fluid (CSF) tests ruled out other etiologies of myelitis, eventually suggesting COVID-19-ass...
Source: Internal Medicine - May 15, 2024 Category: Internal Medicine Authors: Motohiro Okumura Takeo Sato Marina Masui Tatsushi Kokubu Tadashi Umehara Tomoko Okamoto Yasuyuki Iguchi Source Type: research

Successful Treatment with Mycophenolate Mofetil in a Patieint with Anti-MDA 5 Antibody-positive Interstitial Lung Disease and Posterior Reversible Encephalopathy syndrome: A Case Report
Intern Med. 2024 May 16. doi: 10.2169/internalmedicine.3533-24. Online ahead of print.ABSTRACTA 59-year-old woman presented with a rash on the top part of her hands and pain in the wrist joint and was diagnosed with dermatomyositis complicated by interstitial pneumonia positive for anti-melanoma differentiation-associated gene 5 (MDA-5) antibody. However, the patient reported a severe headache following treatment with oral prednisolone and tacrolimus. Posterior reversible encephalopathy syndrome (PRES) was diagnosed based on the brain magnetic resonance imaging findings. Tacrolimus was discontinued, and mycophenolate mofet...
Source: Internal Medicine - May 15, 2024 Category: Internal Medicine Authors: Kentaro Tanaka Yosuke Kimura Ami Aoki Mio Toyama-Kousaka Kenjiro Shima Toshiyuki Koya Toshiaki Kikuchi Source Type: research

Young Patient with X-linked Agammaglobulinemia Presents with Advanced Gastric Cancer and Extensive Atrophic Gastritis
Intern Med. 2024 May 16. doi: 10.2169/internalmedicine.3236-23. Online ahead of print.ABSTRACTX-linked agammaglobulinemia (XLA) is associated with an increased risk of gastrointestinal cancers including gastric cancer (GC). We herein report the case of a 30-year-old male patient with XLA who developed GC and extensive atrophic gastritis. He tested positive in the urea breath test, thus indicating the presence of Helicobacter pylori. Distal gastrectomy and chemotherapy were performed without any complications; however, the died two years after this diagnosis. Immunoglobulin deficiency makes these patients susceptible to pro...
Source: Internal Medicine - May 15, 2024 Category: Internal Medicine Authors: Takashi Kon Yu Sasaki Yasuhiko Abe Makoto Yagi Naoko Mizumoto Yusuke Onozato Minami Ito Takahiro Watabe Hiroko Tsuchiya Hiroki Goto Takahiro Miura Ryo Sato Yoshiyuki Ueno Source Type: research

Neuropsychiatric Systemic Lupus Erythematosus in a Patient with Pancytopenia and Chronic Schizophrenia Requiring Hospitalisation
Intern Med. 2024 May 16. doi: 10.2169/internalmedicine.3202-23. Online ahead of print.ABSTRACTWe herein report a patient with systemic lupus erythematosus (SLE) and neuropsychiatric SLE (NPSLE), who had been misdiagnosed with schizophrenia for a long time and presented with pancytopenia. Brain magnetic resonance imaging revealed sporadic punctate hyperintense areas in the cerebral white matter. Single-photon emission computed tomography revealed a clear decrease in blood flow from the parietotemporal association area to the temporal lobe. NPSLE is a serious organ complication that significantly worsens the SLE prognosis. N...
Source: Internal Medicine - May 15, 2024 Category: Internal Medicine Authors: Taro Horino Satoshi Inotani Masahiro Komori Hiroshi Ohnishi Yoshio Terada Source Type: research

A Male Japanese Patient with Temple Syndrome Complicated by Type 2 Diabetes Mellitus
Intern Med. 2024 May 16. doi: 10.2169/internalmedicine.2743-23. Online ahead of print.ABSTRACTWe herein present the case of a 21-year-old male Japanese diabetic patient with Temple syndrome, caused by maternal uniparental disomy of chromosome 14. The patient was overweight and had type 2 diabetes, dyslipidemia, metabolic dysfunction-associated steatotic liver disease, and microalbuminuria. He had an increased fat mass in the truncal region and a decreased lean mass throughout the body. This may lead to insulin resistance due to the absence of delta-like homolog 1 (DLK1) and retrotransposon gag-like 1 (RTL1). The patient ha...
Source: Internal Medicine - May 15, 2024 Category: Internal Medicine Authors: Masanori Iwanishi Tohru Yorifuji Yukako Yamamoto Jun Ito-Kobayashi Akira Shimatsu Shingo Kikugawa Masayo Kagami Source Type: research

Successful Treatment of Ultrasound-confirmed Synovitis in Anti-MDA5 Antibody-positive Clinically Amyopathic Dermatomyositis with Corticosteroid Therapy
Intern Med. 2024;63(10):1473-1478. doi: 10.2169/internalmedicine.2382-23. Epub 2024 May 15.ABSTRACTAnti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive clinically amyopathic dermatomyositis (CADM) is a subtype of dermatomyositis without severe myositis but with characteristic cutaneous manifestations and severe interstitial lung disease. Joint symptoms can occur in patients with anti-MDA5 antibody-positive CADM. However, the treatment strategy and utility of ultrasound for treating joint symptoms remain unknown. We herein report an 85-year-old man with anti-MDA5 antibody-positive CADM who presented with...
Source: Internal Medicine - May 15, 2024 Category: Internal Medicine Authors: Kenji Saito Jumpei Temmoku Yuya Sumichika Shuhei Yoshida Haruki Matsumoto Yuya Fujita Naoki Matsuoka Tomoyuki Asano Toru Yago Shuzo Sato Kiyoshi Migita Source Type: research

A Case of Multiple Cerebral Infarcts Due to Severe Anemia Preceded by Migraine-like Headache with Aura
Intern Med. 2024 May 16. doi: 10.2169/internalmedicine.3842-24. Online ahead of print.ABSTRACTWe herein report a 47-year-old woman who developed migraine-like headache with aura and subsequent multiple cerebral infarcts, likely due to severe iron deficiency anemia (IDA) from menorrhagia. The progression from IDA to ischemic stroke involves several pathophysiological mechanisms, including reduction of erythrocyte deformability, reactive thrombocytosis, and anemic hypoxia. We speculate that a microembolus first caused cortical spreading depression without infarcts and that a larger thromboembolus then caused multiple infarct...
Source: Internal Medicine - May 15, 2024 Category: Internal Medicine Authors: Kiichiro Oryu Yuji Kato Yoshiki Mochizuki Noriko Arai Ichiro Deguchi Shinichi Takahashi Satoshi Suda Source Type: research

A Case of Dupilumab-Induced Diffuse Alveolar Hemorrhage
Intern Med. 2024 May 16. doi: 10.2169/internalmedicine.3695-24. Online ahead of print.ABSTRACTEosinophilic pneumonia is a known side effect of dupilumab; however, diffuse alveolar hemorrhage has not yet been reported in association with dupilumab. We herein report a case of diffuse alveolar hemorrhage caused by dupilumab. A 57-year-old man with severe asthma was unable to discontinue oral steroids and thus was prescribed dupilumab. The patient was admitted to the hospital four weeks after treatment because of suspected eosinophilic pneumonia. Bronchoscopy revealed diffuse alveolar hemorrhage characterized by hemosiderin-ph...
Source: Internal Medicine - May 15, 2024 Category: Internal Medicine Authors: Tomoki Tamura Hiroya Okano Taisaku Koyanagi Takahiro Umeno Kazuya Nishii Shoichi Kuyama Source Type: research

Risk Factors for Bloodstream Infection in Patients Receiving Peripheral Parenteral Nutrition
Conclusion This study identified the incidence of and risk factors for developing BSI, such as a longer average daily infusion time of PPNs and all intravenous fluids, in patients receiving PPN therapy.PMID:38749727 | DOI:10.2169/internalmedicine.3692-24 (Source: Internal Medicine)
Source: Internal Medicine - May 15, 2024 Category: Internal Medicine Authors: Masafumi Shimoda Yoshiaki Tanaka Kozo Morimoto Kozo Yoshimori Ken Ohta Source Type: research

Efficacy and Safety of First-line Pembrolizumab Plus Platinum and Pemetrexed in Elderly Patients with Non-squamous Non-small-cell Lung Cancer
Conclusion First-line pemb-Plt-PEM therapy is effective and feasible in elderly patients with non-squamous NSCLC.PMID:38749728 | DOI:10.2169/internalmedicine.3649-24 (Source: Internal Medicine)
Source: Internal Medicine - May 15, 2024 Category: Internal Medicine Authors: Satoshi Wasamoto Hisao Imai Takeshi Tsuda Yoshiaki Nagai Takayuki Kishikawa Akihiro Ono Ken Masubuchi Yukihiro Umeda Yutaka Yamada Junichi Nakagawa Takaya Yui Hirokazu Taniguchi Kyoichi Kaira Hiroshi Kagamu Source Type: research