journal
https://read.qxmd.com/read/36948626/improper-application-of-a-rivastigmine-patch-to-the-back-of-the-neck-induced-toxic-symptoms
#1
JOURNAL ARTICLE
Kosuke Matsuzono, Yoshinori Mita, Goro Imai, Shigeru Fujimoto
Rivastigmine is a highly effective drug for treating Alzheimer's disease. However, its addiction can be fatal, so proper use of this transdermal drug is needed. We herein report an 85-year-old woman with Alzheimer's disease who inappropriately placed rivastigmine patches on the back of her neck. She suffered from acute cholinergic syndrome, hypersalivation, anorexia, dyspnea, and vomiting. These symptoms disappeared when the improper use of rivastigmine patches was ceased. This case serves as a warning to physicians and pharmacists of the risk associated with the improper placement of rivastigmine patches...
March 22, 2023: Internal Medicine
https://read.qxmd.com/read/36948625/a-diagnostic-and-therapeutic-dilemma-concerning-exostosin-1-exostosin-2-associated-lupus-like-membranous-nephropathy-with-positive-anti-nuclear-antibody-in-an-elderly-man-with-various-immune-abnormalities
#2
JOURNAL ARTICLE
Mika Kawagoe, Kohei Odajima, Shinichiro Asakawa, Michito Nagura, Shigeyuki Arai, Osamu Yamazaki, Yoshifuru Tamura, Ryuji Ohashi, Takamasa Iwakura, Hideo Yasuda, Shigeru Shibata, Yoshihide Fujigaki
Exostosin 1 (EXT1) and exostosin 2 (EXT2)-associated membranous nephropathy (MN) may be associated with active autoimmune disease. We encountered an elderly man who presented with EXT1/EXT2-associated lupus-like MN with full house immune deposits, monoclonal gammopathy of uncertain significance and Sjögren's syndrome. The patient exhibited various other immune abnormalities. Although he did not fulfill the criteria of clinical systemic lupus erythematosus (SLE), he met a stand-alone renal criterion of SLICC 2012...
March 22, 2023: Internal Medicine
https://read.qxmd.com/read/36948624/severe-hepatitis-associated-aplastic-anemia-following-covid-19-mrna-vaccination
#3
JOURNAL ARTICLE
Michio Yamamoto, Dai Keino, Shinichiro Sumii, Tomoko Yokosuka, Hiroaki Goto, Ayano Inui, Tsuyoshi Sogo, Makio Kawakami, Mio Tanaka, Masakatsu Yanagimachi
We herein report a case of hepatitis-associated aplastic anemia (HAAA) that occurred after severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) vaccination. In this patient, progressive pancytopenia observed two months after acute hepatitis following the second dose of the SARS-Cov-2 vaccine indicated the development of HAAA. Although some reports have suggested that SARS-Cov-2 vaccination may be involved in the development of autoimmune diseases, no cases of HAAA developing after SARS-Cov-2 vaccination have been reported...
March 22, 2023: Internal Medicine
https://read.qxmd.com/read/36948623/tracheitis-associated-with-covid-19
#4
JOURNAL ARTICLE
Hiroshi Ohnishi, Yu Arakawa, Kazuki Anabuki, Akihito Yokoyama
No abstract text is available yet for this article.
March 22, 2023: Internal Medicine
https://read.qxmd.com/read/36948622/granulocyte-colony-stimulating-factor-associated-aortitis
#5
JOURNAL ARTICLE
Hiroaki Nishioka, Mari Fujii
No abstract text is available yet for this article.
March 22, 2023: Internal Medicine
https://read.qxmd.com/read/36948621/a-rare-case-of-blindness-caused-by-syphilis-with-malignant-hypertensive-nephropathy
#6
JOURNAL ARTICLE
Minami Matsumoto, Shinya Yamamoto, Takuya Morinishi, Eishin Harima, Shintaro Nakayasu, Nobuki Iwamoto, Yuki Muraoka, Ayako Takahashi, Sachiko Minamiguchi, Motoko Yanagita
The number of patients with syphilis has been rapidly increasing. Without treatment, syphilis can damage various organs and become life-threatening. We herein report a 29-year-old woman diagnosed with neurosyphilis, acute hydrocephalus, syphilitic uveitis combined with hypertensive retinopathy, and malignant hypertensive nephropathy. To our knowledge, this is the first report of syphilis complicated with malignant hypertensive nephropathy proven by a renal biopsy. Neurosyphilis was successfully treated with intravenous penicillin G, and severe hypertension subsequently resolved...
March 22, 2023: Internal Medicine
https://read.qxmd.com/read/36948620/granulocyte-colony-stimulating-factor-associated-aortitis-on-gallium-scintigraphy
#7
JOURNAL ARTICLE
Haruka Ozaki, Kohji Takemura, Rika Kizawa, Takeshi Yamaguchi, Chinatsu Komiyama, Masato Tachi, Hirotaka Maruno, Yuko Tanabe, Koichi Suyama, Yuji Miura
Aortitis is a rare adverse event associated with granulocyte colony-stimulating factor (G-CSF). Contrast-enhanced computed tomography (CECT) is widely used to diagnose G-CSF-associated aortitis. However, the usefulness of gallium scintigraphy for the diagnosis of G-CSF-associated aortitis is unknown. We herein report a set of pre- and post-treatment gallium scintigrams of a patient with G-CSF-associated aortitis. During the diagnosis, gallium scintigraphy revealed hot spots on the arterial walls that appeared inflamed on CECT...
March 22, 2023: Internal Medicine
https://read.qxmd.com/read/36948619/end-stage-hypertrophic-cardiomyopathy-with-advanced-heart-failure-in-patients-carrying-myh7-r453-variants-a-case-series
#8
JOURNAL ARTICLE
Susumu Naito, Shuichiro Higo, Satoshi Kameda, Shou Ogawa, Tomoka Tabata, Yasuhiro Akazawa, Daisuke Nakamura, Kei Nakamoto, Fusako Sera, Yuki Kuramoto, Yoshihiro Aasano, Shungo Hikoso, Shigeru Miyagawa, Yasushi Sakata
The MYH7 R453 variant has been identified in inherited hypertrophic cardiomyopathy (HCM) and is associated with sudden death and a poor prognosis. The detailed clinical course of HCM with the MYH7 R453 variant, from a preserved to a reduced left ventricular ejection fraction, has not been reported. We identified the MYH7 R453C and R453H variants in three patients who progressively developed advanced heart failure requiring circulatory support and summarized the clinical course and echocardiographic parameters of these patients over the years...
March 22, 2023: Internal Medicine
https://read.qxmd.com/read/36948618/a-case-report-of-neuro-sweet-disease-spectrum-disorder-presenting-as-encephalomeningitis-without-cerebrospinal-fluid-pleocytosis
#9
JOURNAL ARTICLE
Yasunobu Nosaki, Yoshifumi Arai, Hirofumi Oyama, Katsushige Iwai
No abstract text is available yet for this article.
March 22, 2023: Internal Medicine
https://read.qxmd.com/read/36948617/a-case-of-granulomatosis-with-polyangiitis-presenting-with-thrombovasculitic-and-necrotizing-pachy-and-leptomeningitis-accompanied-by-a-brain-tumor-like-lesion
#10
JOURNAL ARTICLE
Yuu-Ichi Kira, Yasuji Yoshikawa, Takumi Tashiro, Norihisa Maeda
We report a case of granulomatosis with polyangiitis (GPA) presenting with hypertrophic pachymeningitis with a huge brain tumor-like lesion. A 57-year-old man acutely developed consciousness disturbance. Magnetic resonance imaging revealed a right frontal lobe mass with thickened, contrast-enhanced dura. Computed tomography revealed sinusitis and multiple lung nodules. The presence of proteinase 3-anti-neutrophil cytoplasmic antibody indicated GPA. Histopathology of the excised brain tissues revealed thrombovasculitis with heavy neutrophilic infiltration in the pachy- and leptomeninges covering an ischemic cerebral cortex...
March 22, 2023: Internal Medicine
https://read.qxmd.com/read/36948616/delayed-perforation-after-endoscopic-detachable-snare-ligation-for-colonic-diverticular-hemorrhage
#11
JOURNAL ARTICLE
Takayuki Nagahashi, Koichi Hamada, Yoshinori Horikawa, Yoshiki Shiwa, Kae Techigawara, Daizo Fukushima, Noriyuki Nishino, Yukitoshi Todate, Atsushi Irisawa
A 74-year-old man was admitted to our hospital with severe hematochezia. Abdominal enhanced computed tomography (CT) demonstrated extravasation of contrast material from the descending colon. Colonoscopy revealed recent bleeding in the descending colon diverticulum. Bleeding was stopped using detachable snare ligation. Eight days later, the patient developed abdominalgia, and CT revealed free air caused by delayed perforation. The patient underwent emergency surgery. Perforation at the ligation site was detected using intraoperative colonoscopy...
March 22, 2023: Internal Medicine
https://read.qxmd.com/read/36948615/a-case-of-duodenal-diverticular-perforation-treated-conservatively-reassessing-indications-for-treatment
#12
JOURNAL ARTICLE
Yuri Sasaki, Jun Nakahodo, Tomoko Onishi, Ayu Tachibana, Ryogo Minami, Eriko Noma, Yoshiaki Moriguchi, Hiroki Tabata, Ryoko Shimizuguchi, Akinari Takao, Satomi Shibata, Kazuro Chiba, Takeo Arakawa, Toshiro Iizuka, Terumi Kamisawa
A 59-year-old woman presented with a chief complaint of melena. She had no abdominal findings, such as tenderness or tapping pain. Laboratory tests revealed a white blood cell count of 5,300 cells/μL and C-reactive protein level of 0.07 mg/dL. Inflammation and anemia (hemoglobin 12.4 g/dL) were denied. Contrast-enhanced computed tomography (CT) revealed multiple duodenal diverticula and air surrounding a descending duodenal diverticulum. Based on these findings, duodenal diverticular perforation (DDP) was suspected...
March 22, 2023: Internal Medicine
https://read.qxmd.com/read/36927976/clinical-impact-of-chronic-pulmonary-aspergillosis-in-patients-with-nontuberculous-mycobacterial-pulmonary-disease-and-role-of-computed-tomography-in-the-diagnosis
#13
JOURNAL ARTICLE
Naoto Maruguchi, Eisaku Tanaka, Nobuhiro Okagaki, Yuma Tanaka, Hiroto Sakamoto, Atsushi Takeda, Ryo Yamamoto, Satoshi Nakamura, Kazuki Matsumura, Masakuni Ueyama, Naoya Ikegami, Yusuke Kaji, Seishu Hashimoto, Takashi Hajiro, Yoshio Taguchi
Objective Chronic pulmonary aspergillosis (CPA) is an important complication of nontuberculous mycobacterial pulmonary disease (NTM-PD). However, its diagnosis is challenging, as both CPA and NTM-PD present as chronic cavitary disease. The present study evaluated the impact of CPA on the survival of patients with NTM-PD and revealed the key computed tomography findings for a prompt diagnosis. Methods We retrospectively reviewed patients newly diagnosed with NTM-PD in Tenri Hospital (Tenri City, Nara Prefecture, Japan) between January 2009 and March 2018; the patients were followed up until May 2021...
March 15, 2023: Internal Medicine
https://read.qxmd.com/read/36927975/remission-induction-of-igg4-related-membranous-nephropathy-with-multitarget-therapy
#14
JOURNAL ARTICLE
Yoshitaka Furuto, Hirotsugu Hashimoto, Akio Namikawa, Teppei Morikawa, Yuko Shibuya
IgG4-related membranous nephropathy (MN) is often refractory to glucocorticoid (GC) therapy, and treatment remains unclear. We herein report a 67-year-old Japanese man with IgG4-related MN and tubulointerstitial nephritis. A post-gastroscopy antibody test revealed Helicobacter pylori infection. After eradication, his proteinuria decreased indefinitely. We started prednisolone (30 mg/day), long-term GCs, and immunosuppressant therapy. However, remission proved challenging to achieve, with persistent proteinuria present at 1...
March 15, 2023: Internal Medicine
https://read.qxmd.com/read/36927974/successful-treatment-with-crizotinib-to-overcome-drug-resistance-possibly-due-to-mesenchymal-epithelial-transition-amplification-in-a-lung-cancer-patient-with-the-echinoderm-microtubule-associated-protein-like-4-anaplastic-lymphoma-kinase-fusion-gene
#15
JOURNAL ARTICLE
Tomoko Shiraishi, Kei Yamasaki, Moe Kidogawa, Tatsuya Shingu, Fuki Ujimiya, Takanobu Jotatsu, Shingo Matsumoto, Hiroki Izumi, Chinatsu Nishida, Koichi Goto, Kazuhiro Yatera
Amplification of the mesenchymal-epithelial transition (MET) gene plays an important role in anticancer drug resistance to anaplastic lymphoma kinase-tyrosine kinase inhibitors (ALK-TKIs) in echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK)-rearranged lung cancer cells. We encountered an ALK-rearranged lung cancer patient who developed MET amplification after alectinib treatment and showed an effective response to fifth-line crizotinib. First-line alectinib treatment was effective for 2...
March 15, 2023: Internal Medicine
https://read.qxmd.com/read/36927973/early-initiation-of-dapagliflozin-during-hospitalization-for-acute-heart-failure-is-associated-with-a-shorter-hospital-stay
#16
JOURNAL ARTICLE
Saki Mizobuchi, Yuki Saito, Masatsugu Miyagawa, Yutaka Koyama, Hidesato Fujito, Keisuke Kojima, Korehito Iida, Nobuhiro Murata, Akimasa Yamada, Daisuke Kitano, Kazuto Toyama, Daisuke Fukamachi, Yasuo Okumura
Objective Sodium-glucose co-transporter-2 inhibitors (SGLT2is), such as dapagliflozin, have a diuretic effect, and their early initiation to treat acute heart failure (AHF) may improve outcomes; however, the significance of the timing of starting dapagliflozin after hospital admission remains unclear. Methods We performed a post hoc analysis of a prospective, observational registry. Participants were divided into the early (E) group and late (L) group using the median time to the initiation of dapagliflozin (6 days) as the cut-off...
March 15, 2023: Internal Medicine
https://read.qxmd.com/read/36927972/the-onset-of-igg4-related-retroperitoneal-fibrosis-under-administration-of-a-tnf-inhibitor-in-a-rheumatoid-arthritis-patient
#17
JOURNAL ARTICLE
Takao Ogawa, Kohei Tsujimoto, Hiroshi Shimagami, Chiaki Fukuda, Toru Hirano
An 80-year-old woman with rheumatoid arthritis during treatment with etanercept, a TNF inhibitor, showed swelling of the salivary glands and retroperitoneal fibrosis, which was diagnosed as IgG4-related disease. Although some reports have shown the efficacy of TNF inhibitors for IgG4-related disease or retroperitoneal fibrosis, TNF inhibitors sometimes cause paradoxical reactions like psoriasis, and the mechanisms is considered to involve the upregulation of plasmacytoid dendritic cells and IFN-α, which is also common in patients with IgG4-related disease...
March 15, 2023: Internal Medicine
https://read.qxmd.com/read/36927971/high-sensitivity-cardiac-troponin-t-is-a-useful-biomarker-for-predicting-the-prognosis-of-patients-with-systemic-sarcoidosis-regardless-of-cardiac-involvement
#18
JOURNAL ARTICLE
Yuichi Baba, Toru Kubo, Yuri Ochi, Takayoshi Hirota, Naohito Yamasaki, Hiroshi Ohnishi, Tetsuya Kubota, Akihito Yokoyama, Hiroaki Kitaoka
Objective Cardiac involvement defines the prognosis for patients with systemic sarcoidosis. Despite advancements in techniques for diagnosing cardiac lesions, there remains significant room for improvement in cardiac screening and prognostic prediction. The present study therefore assessed the prognostic factors associated with cardiovascular events in patients with sarcoidosis. Methods We retrospectively studied 132 patients with systemic sarcoidosis and evaluated the clinical data obtained between 2009 and 2022...
March 15, 2023: Internal Medicine
https://read.qxmd.com/read/36927970/obturator-hernia-in-a-patient-undergoing-hemodialysis-a-case-report
#19
JOURNAL ARTICLE
Tomoaki Tokoyoda, Takahiro Inagaki, Yuki Aoki, Takeshi Okamoto, Takashi Nakajima, Keisuke Teramoto
Obturator hernia is a rare condition that commonly affects frail older women. A 54-year-old woman presented to our hospital with left hip joint pain. She had suffered a left pubic bone fracture and commenced maintenance hemodialysis. Pelvic computed tomography (CT) showed an incarcerated small intestine through the left obturator foramen, while abdominal CT showed marked intestinal dilatation. She underwent emergency laparotomy, and the incarcerated small intestine was found to be necrotic. Partial small intestinal resection and bilateral obturator hernioplasty were performed...
March 15, 2023: Internal Medicine
https://read.qxmd.com/read/36927969/a-case-of-human-immunodeficiency-virus-associated-immune-complex-kidney-disease-progressing-to-end-stage-kidney-disease
#20
JOURNAL ARTICLE
Yuka Shichijo, Ko Harada, Stephen C Ward, Nikolas Harbord
A 58-year-old man with human immunodeficiency virus (HIV) infection presented with a week-long history of gross hematuria, nephrotic proteinuria, and acute kidney injury. The patient was non-adherent with combination antiretroviral therapy. A kidney biopsy showed cellular crescents with disruption of Bowman's capsule, C3-dominant immune complex deposition, consistent with HIV-associated immune complex kidney disease (HIVICK). During the course, his worsening kidney function warranted initiation of hemodialysis...
March 15, 2023: Internal Medicine
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