- 著者
- Keisuke Nonaka Yoko Matsuda Mototsune Kakizaki Shoichiro Takakuma Akihiko Hamamatsu Yasuhiro Sakashita Tomoyasu Matsubara Shigeo Murayama Toshiyuki Ishiwata Noriko Yamanaka Mitsuyo Itabashi Takashi Takei Noriko Nakajima Hideki Hasegawa Tomio Arai
- 出版者
- National Institute of Infectious Diseases
- 雑誌
- Japanese Journal of Infectious Diseases (ISSN:13446304)
- 巻号頁・発行日
- vol.72, no.5, pp.347-349, 2019 (Released:2019-09-19)
- 参考文献数
- 10
- 被引用文献数
- 7 7
An 84-year-old man with chronic renal failure, anemia, and diabetes was admitted for hemodialysis initiation. His vital signs were stable until the eighteenth hospital day, before acquiring an influenza A virus infection. Three days later, he died of septic shock with severe liver impairment. His leukocyte count, prothrombin time (PT-INR), and liver enzyme levels such as aspartate transaminase and alanine aminotransferase, were significantly increased. Hypercytokinemia was also observed. Autopsy revealed bilateral diffuse pneumonia with neutrophil infiltration. The liver showed extensive centrilobular hepatocyte necrosis. Immunohistochemistry for influenza A nucleoprotein revealed positivity in the ciliated columnar epithelium of the bronchi and negativity in the trachea, lungs, and liver. Hypoxic hepatitis is characterized by an abrupt and massive increase in aminotransferase levels (> 20 times upper normal limit) due to anoxic centrilobular hepatocyte necrosis. The occurrence of hypoxic hepatitis requires a pre-existing, chronic condition, such as anemia, causing reduced oxygen supply to the liver, followed by an acute decrease in hepatic oxygen supply, such as septic shock. Therefore, this report suggests that hypoxic hepatitis can be an important causative factor for acute liver failure associated with influenza virus infection.
- 著者
- Ayami Ochi Takashi Takei Kayu Nakayama Chihiro Iwasaki Daigo Kamei Yuki Tsuruta Ari Shimizu Shunji Shiohira Takahito Moriyama Mitsuyo Itabashi Toshio Mochizuki Keiko Uchida Ken Tsuchiya Motoshi Hattori Kosaku Nitta
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.51, no.7, pp.759-762, 2012 (Released:2012-04-01)
- 参考文献数
- 15
- 被引用文献数
- 17 21
We present two cases with steroid-resistant nephrotic syndrome (SRNS) and two cases with steroid-dependent nephrotic syndrome (SDNS) due to focal segmental glomerulonephritis (FSGS) who were treated with a single dose of rituximab (375 mg/m2). Although the two cases with SRNS showed no response, the two cases with SDNS achieved complete remission. The patients in whom the peripheral B-cell counts subsequently increased after the administration of rituximab demonstrated a relapse. Rituximab may be an effective treatment agent for SDNS with FSGS and the peripheral B-cell count may be a useful marker in such patients for preventing disease relapse.