著者
Koji Muro Naohiro Toda Shinya Yamamoto Motoko Yanagita
出版者
The Japanese Society of Internal Medicine
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
vol.60, no.4, pp.583-589, 2021-02-15 (Released:2021-02-15)
参考文献数
20
被引用文献数
3 4

Novel treatments with rituximab or direct-acting antiviral agents (DAAs) were expected to improve the clinical outcomes of hepatitis C virus (HCV)-associated cryoglobulinemia in the last decade. Recently, however, persistent cases of cryoglobulinemia have been reported, and the ideal approach to treating such cases has not been established. We herein report a case of the successful treatment of HCV-associated cryoglobulinemic glomerulonephritis with rituximab, DAAs, occasional plasmapheresis and long-term steroid, with the patient's renal function and proteinuria improving over the long term despite serologically persistent cryoglobulinemia. This case suggests the efficacy of combination treatment with rituximab, DAAs, occasional plasmapheresis and long-term steroid for persistent cryoglobulinemia.
著者
Minami Matsumoto Shinya Yamamoto Takuya Morinishi Eishin Harima Shintaro Nakayasu Nobuki Iwamoto Yuki Muraoka Ayako Takahashi Sachiko Minamiguchi Motoko Yanagita
出版者
The Japanese Society of Internal Medicine
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
pp.1436-22, (Released:2023-03-22)
参考文献数
15

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. However, delayed medical examinations and complications of syphilitic uveitis and hypertensive retinopathy resulted in irreversible visual loss. To prevent irreversible organ damage, early treatment is essential.
著者
Hiroyuki Arai Shinya Yamamoto Takeshi Matsubara Takafumi Miyake Akira Tochio Akiko Mii Akira Shimizu Sachiko Minamiguchi Eri Muso Motoko Yanagita
出版者
The Japanese Society of Internal Medicine
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
pp.1283-22, (Released:2023-01-15)
参考文献数
28
被引用文献数
2

Ponatinib is a novel multi-tyrosine kinase inhibitor (TKI) with potent inhibitory activity against refractory chronic myeloid leukemia (CML). Despite its high clinical efficacy, ponatinib induces various adverse events due to its multi-target characteristic. However, renal complications associated with ponatinib are rare. A 76-year-old woman had a history of chronic myeloid leukemia (CML) resistant to imatinib and nilotinib. Our patient developed proteinuria and renal function deterioration during treatment with ponatinib but not with imatinib or nilotinib. We herein report the first case of a patient with secondary focal segmental glomerulosclerosis (FSGS) with partial glomerular collapse induced by ponatinib treatment.
著者
Shinya Yamamoto Ken Wells Keisuke Morita Katsuya Tanigaki Koji Muro Minami Matsumoto Hirotsugu Nakai Yasuyuki Arai Shuji Akizuki Ken Takahashi Sachiko Minamiguchi Shingo Fukuma Motoko Yanagita
出版者
The Japanese Society of Internal Medicine
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
pp.1178-22, (Released:2023-02-01)
参考文献数
26
被引用文献数
2

Finding the ideal balance between efficacy and safety of immunosuppression is challenging, particularly in cases of severe TAFRO syndrome. We herein report a 60-year-old man diagnosed with grade 5 TAFRO syndrome mimicking hepatorenal syndrome that was successfully treated by glucocorticoid, tocilizumab, and cyclosporin despite virus infection. Furthermore, by examining 14 peer-reviewed remission cases, we revealed that the recovery periods among inflammation, renal dysfunction, and thrombocytopenia were quite different, with recovery from thrombocytopenia notably slow. All patients requiring dialysis were successfully withdrawn from dialysis, and the reversibility from kidney injury was good. This clinical information will help clinicians plan treatments and tailor the intensity of immunosuppression.
著者
Yuki SATO Motoko YANAGITA
出版者
The Japan Academy
雑誌
Proceedings of the Japan Academy, Series B (ISSN:03862208)
巻号頁・発行日
vol.95, no.8, pp.468-478, 2019-10-11 (Released:2019-10-11)
参考文献数
61
被引用文献数
21

Chronic kidney disease (CKD) is a global public health problem, affecting over 10% of the world’s population and more than half of the population aged over 70 years, imposing major costs on healthcare systems. Although the primary causes of CKD include various diseases such as diabetes, glomerulonephritis, and acute kidney injury (AKI), the progression of CKD is mediated by a common pathological pathway, which is mainly characterized by fibrosis and chronic inflammation. In this process, resident fibroblasts in the kidney play crucial roles. Accumulating evidence highlights the existence of functional heterogeneity and plasticity of fibroblasts and their diverse roles in kidney disease progression and resolution. In addition to renal fibrosis, renal anemia and peritubular capillary loss, two major complications of progressive CKD, are also caused by dysfunction of resident fibroblasts. Furthermore, age-dependent alterations in fibroblast behavior also contribute to age-dependent unique pathological conditions. In this article, we describe the current understanding regarding the behaviors of fibroblasts in the kidney in health, disease, and aging.