journal
https://read.qxmd.com/read/37779076/intrahepatic-cholangiocarcinoma-with-high-microsatellite-instability-and-tumor-mutation-burden-that-responded-significantly-to-pembrolizumab-but-perforated-within-a-short-period-a-case-report
#1
JOURNAL ARTICLE
Shiori Yamazaki, Koji Kubota, Akira Shimizu, Tsuyoshi Notake, Kentaro Umemura, Atsushi Kamachi, Takamune Goto, Hidenori Tomida, Naho Yamashita, Midori Sato, Hiroyuki Kanno, Yuji Soejima
Cholangiocarcinoma has a poor prognosis, and resection is the only curative treatment. Pembrolizumab, a programmed death receptor 1 inhibitor, has proven effective against unresectable or metastatic solid tumors with high microsatellite instability (MSI-H) or a high tumor mutation burden (TMB-H). In the present case, pembrolizumab treatment was initiated after standard chemotherapy for MSI-H and TMB-H unresectable intrahepatic cholangiocarcinoma. Intrahepatic tumor necrosis perforated the abdominal cavity. Emergency surgery was performed, but the patient died 36 days after admission...
September 29, 2023: Internal Medicine
https://read.qxmd.com/read/37779075/herpes-simplex-virus-encephalitis-after-recovery-from-coronavirus-disease-2019-a-rare-case-report
#2
JOURNAL ARTICLE
Mari Maezawa, Junichi Ochi, Natsushi Kubota, Tatsuhiko Kamoshida, Mayumi Fuji, Yoshikazu Tsukada
An 85-year-old woman was diagnosed with coronavirus disease 2019 (COVID-19). The patient was treated with dexamethasone, and the infection was cured. She later developed a low-grade fever and fell unconscious. Positivity for herpes simplex virus deoxyribonucleic acid polymerase chain reaction (HSV-DNA PCR) was detected in the cerebrospinal fluid, so she was diagnosed with HSV encephalitis. The patient was treated with antiviral drugs and recovered from the HSV encephalitis. This case suggests that, in patients with COVID-19 and disorders of consciousness, the possibility of HSV encephalitis should be considered along with COVID-19 encephalitis...
September 29, 2023: Internal Medicine
https://read.qxmd.com/read/37779074/comparison-of-the-serial-humoral-immune-response-according-to-the-immunosuppressive-treatment-after-sars-cov-2-mrna-vaccination
#3
JOURNAL ARTICLE
Hiroya Menjo, Midori Hasegawa, Hidetsugu Fujigaki, Takuma Ishihara, Shun Minatoguchi, Shigehisa Koide, Hiroki Hayashi, Midori Saito, Kazuo Takahashi, Hiroyasu Ito, Yukio Yuzawa, Kuniaki Saito, Naotake Tsuboi
Objective The objective of this study was to estimate the humoral immune response evaluated by immunoglobulin G (IgG) against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike receptor-binding domain (RBD-IgG) following the third mRNA COVID-19 vaccination in patients with kidney disease who received immunosuppressive treatment. Methods The primary outcome was RBD-IgG levels after the third SARS-CoV-2 vaccination. The primary comparison was the RBD-IgG levels between patients with kidney disease who received immunosuppressive treatment (n=124) and those who did not (n=33)...
September 29, 2023: Internal Medicine
https://read.qxmd.com/read/37779073/successful-pregnancy-outcome-in-a-patient-with-juvenile-idiopathic-arthritis-in-adulthood-amyloid-a-amyloidosis-and-chronic-kidney-disease-using-tocilizumab-with-strict-blood-pressure-control
#4
JOURNAL ARTICLE
Taro Akira, Yukiko Shimazu, Nobuhiro Hashimoto, Hiroki Okushima, Takehiro Suzuki, Tomomi Tada, Makiko Ikoma, Takashi Hosokawa, Yoshiyasu Ueda, Masahiko Takemura, Hiroshi Fujiwara
Pregnancies with chronic kidney disease (CKD) and high disease activity in rheumatic diseases are high-risk events with adverse outcomes for both the mother and fetus. We herein report a 35-year-old woman with juvenile idiopathic arthritis (JIA), amyloid A (AA) amyloidosis related to JIA, and CKD stage G4A2 who wished to have children. She achieved a successful pregnancy, even in the presence of these multiple risk factors, using tocilizumab to control the disease activity of JIA and AA amyloidosis, along with antihypertensive drugs to control her blood pressure before and during pregnancy...
September 29, 2023: Internal Medicine
https://read.qxmd.com/read/37779072/an-autopsy-case-of-post-covid-19-interstitial-lung-disease-with-acute-exacerbation
#5
JOURNAL ARTICLE
Akifumi Tsuzuku, Fumihiro Asano, Masaki Katayama, Kosuke Mori, Yui Sasaki, Yutaro Kuzunishi, Mayuka Taguchi, Yuya Muto, Yasutomo Baba, Akimasa Tsuchida, Tomoya Kato, Anri Murakami, Atsunori Masuda, Takashi Yoshizane, Jun Suzuki
The prognosis of patients with post-COVID-19 interstitial lung disease remains unclear. We herein report an autopsy case in which serial progression after the onset of post-COVID-19 interstitial lung disease resulted in an acute exacerbation, leading to a fatal outcome. Autopsy findings included hyaline membrane formation/interstitial inflammatory cell infiltration, suggestive of acute lesions, and severe regional fibrosis, indicating a preexisting chronic condition. In the present case, we histopathologically confirmed the acute exacerbation of post-COVID-19 interstitial lung disease...
September 29, 2023: Internal Medicine
https://read.qxmd.com/read/37779071/cataract-surgery-and-chronic-kidney-disease-a-hospital-based-prospective-cohort-study
#6
JOURNAL ARTICLE
Minako Wakasugi, Akio Yokoseki, Masakazu Wada, Takaiko Yoshino, Takeshi Momotsu, Kenji Sato, Hiroyuki Kawashima, Kazutoshi Nakamura, Takeo Fukuchi, Osamu Onodera, Ichiei Narita
Objective Cataract and chronic kidney disease (CKD) occur with increasing frequency with age and share common risk factors including smoking, diabetes, and hypertension. We evaluated the risk of incident cataract surgery in patients with non-dialysis-dependent CKD and dialysis-dependent CKD compared to non-CKD patients, while taking into account the competing risk of death. Methods The participants included 1,839 patients from Sado General Hospital enrolled in the Project in Sado for Total Health (PROST) between June 2008 and December 2016 (54% men; mean age, 69 years)...
September 29, 2023: Internal Medicine
https://read.qxmd.com/read/37779070/a-comparison-of-alanine-aminotransferase-normalization-between-pemafibrate-and-bezafibrate-in-patients-with-nonalcoholic-fatty-liver-disease
#7
JOURNAL ARTICLE
Michiko Yamada-Shimizu, Nobuharu Tamaki, Masayuki Kurosaki, Naoki Uchihara, Keito Suzuki, Yuki Tanaka, Haruka Miyamoto, Shun Ishido, Tsubasa Nobusawa, Hiroaki Matsumoto, Taisei Keitoku, Mayu Higuchi, Kenta Takaura, Shohei Tanaka, Chiaki Maeyashiki, Yutaka Yasui, Yuka Takahashi, Kaoru Tsuchiya, Hiroyuki Nakanishi, Namiki Izumi
Objective Pemafibrate is a recently developed selective peroxisome proliferator-activated receptor alpha modulator that can improve alanine aminotransferase (ALT) levels in patients with nonalcoholic fatty liver disease (NAFLD). However, the effectiveness of ALT normalization with pemafibrate and bezafibrate, a traditional fibrate, has not been compared. Methods In this retrospective study, we compared the effects of pemafibrate and bezafibrate on ALT normalization in patients with NAFLD. The primary endpoint was the ALT normalization rate at 12 months after administration...
September 29, 2023: Internal Medicine
https://read.qxmd.com/read/37779069/streptococcus-agalactiae-meningitis-in-an-immunocompetent-adult-a-case-report-and-literature-review
#8
JOURNAL ARTICLE
Ryunosuke Ide, Takafumi Kubota, Azusa Ohtomo, Mizuki Ohtomo, Genya Watanabe, Kenichi Tsukita, Yasushi Suzuki
Streptococcus agalactiae is a rare cause of meningitis in healthy adults. We herein report a case of culture-negative Streptococcus agalactiae meningitis in a healthy adult which was diagnosed using the FilmArray Meningitis and Encephalitis Panel. A healthy 22-year-old man presented with a fever, headache, and neck stiffness. Despite negative results from blood and cerebrospinal fluid cultures, the diagnosis was confirmed using the FilmArray Meningitis and Encephalitis Panel. The patient was treated with dexamethasone, vancomycin, and ceftriaxone, and thereafter recovered completely...
September 29, 2023: Internal Medicine
https://read.qxmd.com/read/37779068/disease-flares-following-covid-19-vaccination-in-patients-with-inflammatory-bowel-disease
#9
JOURNAL ARTICLE
Yuichiro Yoshida, Shin Fujioka, Tomohiko Moriyama, Junji Umeno, Keisuke Kawasaki, Yuta Fuyuno, Yuichi Matsuno, Yutaro Ihara, Takehiro Torisu, Takanari Kitazono
Objective Flares of inflammatory bowel disease (IBD) can occur infrequently after vaccination for coronavirus disease 2019 (COVID-19), although the details of this phenomenon are poorly understood. To clarify the possibility of an unfavorable response in patients with IBD, we investigated IBD-related symptoms during the COVID-19 vaccination. Methods Between October 2021 and February 2022, we obtained the COVID-19 vaccination status of 411 IBD patients who were being treated at our institution. The disease course of IBD after vaccination was investigated in 188 patients with ulcerative colitis (UC) and 119 patients with Crohn's disease (CD) who had received at least one dose of the vaccine during the clinical remission phase...
September 29, 2023: Internal Medicine
https://read.qxmd.com/read/37779067/a-case-of-stat1-mutations-in-chronic-mucocutaneous-candidiasis-diagnosed-in-an-adult
#10
JOURNAL ARTICLE
Miya Andou, Masaki Tominaga, Ryuta Nishikomori, Kenji Gotou, Nobukazu Komatsu, Masanobu Matsuoka, Tomotaka Kawayama, Tomoaki Hoshino
A 30-year-old man presented with oral candidiasis and a history of lung abscess. He experienced recurring oral and skin candidiasis in childhood but spent long periods without any infections. Therefore, immunodeficiency was suspected. T and B lymphocyte and natural killer cell counts as well as immunoglobulin levels were normal. Human immunodeficiency virus test results were negative. Therefore, we suspected chronic mucocutaneous candidiasis (CMC). The signal transducer and activator of transcription (STAT) mutation, the leading cause of CMC, was detected by exome sequencing...
September 29, 2023: Internal Medicine
https://read.qxmd.com/read/37779066/the-evaluation-of-lipoma-arborescens-with-intermittent-knee-joint-effusion-based-on-an-analysis-of-serum-cytokine-levels-and-an-immunohistological-examination-a-case-report
#11
JOURNAL ARTICLE
Ayaka Umetsu, Katsumi Eguchi, Tomohiro Koga, Takeshi Araki, Ayuko Takatani, Toshiyuki Aramaki, Kaoru Terada, Naoki Iwamoto, Kenji Miyahara, Nobuhisa Yonemitsu, Hideki Nakamura, Atsushi Kawakami, Yukitaka Ueki
We herein report a 27-year-old woman who presented with recurrent knee pain. Laboratory findings revealed minimal inflammation. Arthrography revealed structures resembling adipose tissues. Magnetic resonance imaging showed a high signal intensity of these structures, leading to the diagnosis of lipoma arborescens (LA). Synovectomy was performed. Pathology revealed adipocyte proliferation and B-cell clusters but no T-cell infiltration. A serum cytokine analysis revealed low levels of interleukin-6 and tumor necrosis factor-α compared with patients with rheumatoid arthritis...
September 29, 2023: Internal Medicine
https://read.qxmd.com/read/37779065/histologic-characteristics-and-clinical-courses-of-primary-viral-pneumonia-other-than-covid-19
#12
JOURNAL ARTICLE
Takashi Ishiguro, Riho Toriba, Ryuji Uozumi, Hidehiro Numagami, Yoshihiko Shimizu
Objective To clarify both the histologic changes in primary viral pneumonia other than COVID-19 and whether patients with severe lung injury (SLI) on biopsy specimens progress to severe respiratory insufficiency. Methods Patients with primary viral pneumonia other than COVID-19, who underwent lung tissue biopsy, were retrospectively studied. Patients Forty-three patients (41 living patients and 2 autopsied cases) were included in the study. Results Nine patients had SLI, whereas most of patients who recovered from primary viral pneumonia showed a nonspecific epithelial injury pattern...
September 29, 2023: Internal Medicine
https://read.qxmd.com/read/37779064/lithium-induced-nephrogenic-diabetes-insipidus-with-efficacy-of-desmopressin-in-combination-with-thiazide-diuretics-and-non-steroidal-anti-inflammatory-drugs-a-case-report-with-a-review-of-the-literature
#13
JOURNAL ARTICLE
Takanobu Jinnouchi, Munehiro Yoshimoto, Kei Ogino, Tomoatsu Oji, Michio Hayashi
Nephrogenic diabetes insipidus (NDI) is characterized by excessive urination and an inability to concentrate urine. Lithium is the most common cause of acquired NDI. Treatment typically involves thiazide diuretics and nonsteroidal anti-inflammatory drugs (NSAIDs). However, the efficacy of desmopressin in NDI remains unclear. We herein report a case of lithium-induced NDI in a 71-year-old woman with lithium-induced NDI. Thiazide diuretics and NSAIDs reduced the urine output by approximately 40% compared to pretreatment, while the addition of desmopressin reduced it by approximately 70%...
September 29, 2023: Internal Medicine
https://read.qxmd.com/read/37779063/two-cases-of-disseminated-alveolar-echinococcosis-the-diagnosis-management-and-differential-considerations-for-liver-lesions
#14
JOURNAL ARTICLE
Kazuki Hirano, Yuta Maruki, Daiki Yamashige, Osamu Kobayashi, Mika Shiotsuka, Chigusa Morizane, Tsunao Imamura, Nobuyoshi Hiraoka, Takuji Okusaka
Alveolar echinococcosis (AE), caused by Echinococcus multilocularis, is an aggressive and potentially critical infestation that primarily affects the liver and can metastasize to any part of the body. We herein report two cases of echinococcosis, which could be differentiated from malignancy on imaging studies, with infections of the liver and mediastinal lymph nodes, and also associated with systemic disseminated lesions. AE is a very invasive infectious disease, and in order to detect such lesions at an early stage when they are still resectable, it is necessary to understand the characteristic imaging findings and determine the patient's current medical history...
September 29, 2023: Internal Medicine
https://read.qxmd.com/read/37779062/varicella-zoster-virus-meningitis-besides-bacterial-otitis
#15
JOURNAL ARTICLE
Takafumi Abe, Satoko Maruyama, Kenta Kaneyoshi, Shuichiro Neshige
No abstract text is available yet for this article.
September 29, 2023: Internal Medicine
https://read.qxmd.com/read/37779061/septic-shock-associated-with-severe-pelvic-organ-prolapse
#16
JOURNAL ARTICLE
Aki Aoyama, Jumpei Yamamoto, Yukio Hiroi
No abstract text is available yet for this article.
September 29, 2023: Internal Medicine
https://read.qxmd.com/read/37779060/cerebral-venous-thrombosis-in-a-neuromyelitis-optica-patient
#17
JOURNAL ARTICLE
Takahiro Shimizu, Hideyuki Matsumoto, Keiko Hatano, Hideji Hashida
No abstract text is available yet for this article.
September 29, 2023: Internal Medicine
https://read.qxmd.com/read/37779059/a-case-of-bile-duct-mixed-neuroendocrine-nonendocrine-neoplasm-with-a-complete-response-to-chemoradiotherapy
#18
JOURNAL ARTICLE
Yosuke Horita, Yoshiaki Mihara, Masafumi Mizuide, Shin-Ei Noda, Tomonori Kawasaki, Masanori Yasuda, Shingo Kato, Shomei Ryozawa, Tetsuya Hamaguchi
The incidence of neuroendocrine carcinomas arising from the bile duct is low, and that of mixed neuroendocrine-non-neuroendocrine neoplasms (MiNENs) is even lower; therefore, there is no standard treatment for MiNENs. Choosing the appropriate treatment in clinical practice is difficult. We herein report a case of unresectable extrahepatic bile duct MiNEN in a 66-year-old man who received curative chemoradiotherapy and achieved a complete response, remaining recurrence-free for 2.5 years. We consider the findings of this case to be valuable in selecting a treatment strategy for unresectable bile duct MiNENs...
September 29, 2023: Internal Medicine
https://read.qxmd.com/read/37779058/clock-drawing-test-and-cube-copying-test-to-quickly-screen-dementia-in-combination-with-the-mini-mental-state-examination-scores
#19
JOURNAL ARTICLE
Yuji Higaki
Objective Due to the increasing elderly population and number of dementia patients, the current number of psychiatrists and neurologists remains insufficient to treat dementia in Japan. Therefore, a simple method for accurately performing a dementia diagnosis, including that of primary care physicians, is sought in clinical practice. Methods A retrospective study was conducted on patients who made their first visit due to amnesia between October 2020 and October 2022. The sensitivities and specificities of four spatial recognition and planning ability evaluation methods (fox finger imitation test, pentagon-copying test (PCT), cube-copying test (CCT), and clock-drawing test (CDT) ) were calculated...
September 29, 2023: Internal Medicine
https://read.qxmd.com/read/37779057/clinical-utility-of-flow-cytometry-for-detection-of-anti-jk-b-igm-in-acute-haemolytic-transfusion-reaction-a-case-report
#20
JOURNAL ARTICLE
Keiki Nagaharu, Takuya Izumi, Mitsuko Maruyama, Yuka Sugimoto, Kohshi Ohishi, Isao Tawara, Eiji Usui, Shigehisa Tamaki
Acute hemolytic transfusion reaction (AHTR) is a rare but life-threatening complication of transfusion. We herein report a case of anti-Jkb IgM-related AHTR. Two hours after an 80-year-old man with myelodysplastic syndrome received a packed red blood cell (RBC) A+ /Rh- /Jkb+/ c- transfusion, he developed acute respiratory failure and a fever. Although he had tested negative in routine screening tests, the 37 °C normal saline test was weakly positive for Jkb . We confirmed the presence of anti-Jkb IgM in the patient's serum by flow cytometry...
September 29, 2023: Internal Medicine
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