著者
Hiroki Mizuno Naoki Sawa Akinari Sekine Noriko Inoue Yuki Oba Daisuke Ikuma Masayuki Yamanouchi Eiko Hasegawa Tatsuya Suwabe Hisanori Suzuki Junichi Hoshino Yoshifumi Ubara
出版者
The Japanese Society of Internal Medicine
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
pp.9624-22, (Released:2022-05-31)
参考文献数
12
被引用文献数
1

A 79-year-old man was admitted with a compression fracture of the first lumbar vertebra. His alkaline phosphatase (ALP) level was 35 IU/L, and his dual energy X-ray absorptiometry T score was -3.7 standard deviations, indicating osteoporosis. A genetic analysis showed a mutation of the alkaline phosphatase biomineralization-associated gene encoding tissue-nonspecific alkaline phosphatase. Hypophosphatasia-related osteoporosis was diagnosed. Alendronate, teriparatide, and minodronate were administered in that order. The ALP level increased during teriparatide use. A bone biopsy performed after three years of teriparatide treatment showed that cancellous bone was adynamic. In cortical bone, tetracycline double-labeling indicates enhanced bone formation. Teriparatide may thus be a viable treatment option even in patients with hypophosphatasia.
著者
Takashi Horie Seiji Yamazaki Sayaka Hanada Shuzo Kobayashi Tatsuo Tsukamoto Tetsuya Haruna Katsuhiko Sakaguchi Ken Sakai Hideaki Obara Kiyofumi Morishita Kenichi Saigo Yoshiaki Shintani Kohmei Kubo Junichi Hoshino Teiji Oda Eiji Kaneko Masaharu Nishikido Tetsuya Ioji Hideaki Kaneda Masanori Fukushima for the Japan Study Group of Peripheral Vascular Regeneration Cell Therapy (JPRCT)
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-17-1220, (Released:2018-06-07)
参考文献数
25
被引用文献数
12

Background:The clinical usefulness of peripheral blood (PB) mononuclear cell (MNC) transplantation in patients with peripheral arterial disease (PAD), especially in those with mild-to-moderate severity, has not been fully clarified.Methods and Results:A randomized clinical trial was conducted to evaluate the efficacy and safety of granulocyte colony-stimulating factor (G-CSF)-mobilized PBMNC transplantation in patients with PAD (Fontaine stage II–IV and Rutherford category 1–5) caused by arteriosclerosis obliterans or Buerger’s disease. The primary endpoint was progression-free survival (PFS). In total, 107 subjects were enrolled. At baseline, Fontaine stage was II/III in 82 patients and IV in 21, and 54 patients were on hemodialysis. A total of 50 patients had intramuscular transplantation of PBMNC combined with standard of care (SOC) (cell therapy group), and 53 received SOC only (control group). PFS tended to be improved in the cell therapy group than in the control group (P=0.07). PFS in Fontaine stage II/III subgroup was significantly better in the cell therapy group than in the control group. Cell therapy-related adverse events were transient and not serious.Conclusions:In this first randomized, large-scale clinical trial of G-CSF-mobilized PBMNC transplantation, the cell therapy was tolerated by a variety of PAD patients. The PBMNC therapy was significantly effective for inhibiting disease progression in mild-to-moderate PAD.
著者
Makoto Fukuda Naoki Sawa Daisuke Ikuma Yuki Oba Hiroki Mizuno Masayuki Yamanouchi Akinari Sekine Eiko Hasegawa Tatsuya Suwabe Junichi Hoshino Kei Kono Keiichi Kinowaki Kenichi Ohashi Hiromichi Tamaki Motoaki Miyazono Yoshifumi Ubara
出版者
The Japanese Society of Internal Medicine
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
vol.62, no.1, pp.81-85, 2023-01-01 (Released:2023-01-01)
参考文献数
9
被引用文献数
2 3

A 43-year-old Japanese woman with rheumatoid arthritis treated by infliximab and methotrexate for 11 years was admitted for proteinuria and purpura. A kidney biopsy revealed endothelial damage-dominant nephritis with IgA deposition. Infliximab and methotrexate were discontinued, and tocilizumab was started; however, proteinuria persisted. Therefore, tocilizumab was discontinued, and oral prednisolone and methylprednisolone pulse therapy were administered. After 6 months, urinary protein was less than 0.1 g/day, and purpura subsided. To our knowledge, this is the first case of endothelial damage-dominant nephritis related to IgA vasculitis involving the skin and kidney after long-term use of infliximab and methotrexate.
著者
Toshiharu Ueno Koichi Kikuchi Ryo Hazue Koki Mise Keiichi Sumida Noriko Hayami Tatsuya Suwabe Junichi Hoshino Naoki Sawa Kenji Arizono Shigeko Hara Kenmei Takaichi Takeshi Fujii Kenichi Ohashi Yoshifumi Ubara
出版者
一般社団法人 日本内科学会
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
vol.55, no.20, pp.2993-2999, 2016-10-15 (Released:2016-10-15)
参考文献数
13
被引用文献数
1 3

A 58-year-old man was referred to our institution for an evaluation of nephrotic range proteinuria. Renal biopsy showed a marked expansion of the mesangial matrix and thickening of glomerular basement membrane (GBM) in periodic acid-silver methenamine (PAM). Immunofluorescence (IF) revealed strong staining for the monoclonal kappa light chain. EM demonstrated massive subendothelial and mesangial dense deposits. As a result, light chain deposition disease (LCDD) was diagnosed. Melphalan and prednisolone (MP) therapy was started, which was continued for 10 years with minimal complications. Serial evaluations of renal histology revealed the resolution of nodular lesions and the glomeruli became nearly normal. MP therapy can therefore be an effective therapeutic option for LCDD if it is continued over the long term.
著者
Motonori Nagasawa Yoshifumi Ubara Tatsuya Suwabe Masayuki Yamanouchi Noriko Hayami Keiichi Sumida Yoshinari Hattori Maki Tsukamoto Eriko Hiramatsu Eiko Hasegawa Junichi Hoshino Naoki Sawa Yuji Marui Michio Nakamura Shinji Tomikawa Kennmei Takaichi
出版者
一般社団法人 日本内科学会
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
vol.51, no.24, pp.3401-3404, 2012 (Released:2012-12-15)
参考文献数
13
被引用文献数
2 5

We herein report an unusual case of spontaneous parathyroid gland rupture. A man was admitted with respiratory distress in September 2010. He had been receiving hemodialysis since 1995. He was diagnosed secondary hyperparathyroidism in 2006 and began receiving cinacalcet therapy in 2009. His intact parathyroid hormone (iPTH) level decreased, and massive traumatic bleeding occurred, following which rupture of the parathyroid gland was detected during surgery. The ruptured gland showed nodular hyperplasia. Previous reports have indicated that parathyroid bleeding is associated with glandular hypertrophy. This is the first report of parathyroid apoplexy occurring after suppression of elevated parathyroid function caused by cinacalcet therapy.