- 著者
- Wakaba Fukushima Megumi Hara Yuri Kitamura Masahiko Shibata Yoshikazu Ugawa Koichi Hirata Akira Oka Shinya Miyamoto Susumu Kusunoki Satoshi Kuwabara Shuji Hashimoto Tomotaka Sobue
- 出版者
- Japan Epidemiological Association
- 雑誌
- Journal of Epidemiology (ISSN:09175040)
- 巻号頁・発行日
- vol.32, no.1, pp.34-43, 2022-01-05 (Released:2022-01-05)
- 参考文献数
- 50
- 被引用文献数
- 8
Background: Since June 2013, Japan has suspended proactive recommendation of human papillomavirus (HPV) vaccination due to self-reported diverse symptoms, including pain and motor dysfunction, as possible serious adverse events following immunization. Although these symptoms may be seen in adolescents without HPV vaccination, their frequency, taking into account disease severity, has not been examined.Methods: A two-stage, descriptive, nationwide epidemiological survey was conducted in 2016, with a 6-month target period from July 1 to December 31, 2015, to estimate the prevalence and incidence of diverse symptoms among Japanese adolescents without HPV vaccination. Participants were 11,037 medical departments in hospitals selected nationwide by stratified random sampling. Eligible patients had to satisfy four criteria: (1) aged 12–18 years upon visiting hospital; (2) having at least one of four symptoms/disorders (pain or sensory dysfunction, motor dysfunction, autonomic dysfunction, or cognitive impairment); (3) symptoms/disorders persisting for at least 3 months; and (4) both criteria (2) and (3) influence attendance at school or work. We then extracted data of patients with diverse symptoms similar to those after HPV vaccination while considering opinions of doctors in charge.Results: Estimated 6-month period prevalence of diverse symptoms among girls aged 12–18 years without HPV vaccination was 20.2 per 100,000. Annual incidence was estimated to be 7.3 per 100,000.Conclusion: Adolescent Japanese girls without HPV vaccination also visited hospitals with diverse symptoms similar to those following HPV vaccination. Our findings predict the medical demands for coincident diverse symptoms, which are temporally associated with but not caused by HPV vaccination of Japanese adolescents.
- 著者
- Marie Murakawa Kazumoto Shibuya Yukari Sekiguchi Satoshi Kuwabara
- 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.56, no.13, pp.1747-1748, 2017-07-01 (Released:2017-07-01)
- 参考文献数
- 2
- 被引用文献数
- 2
- 著者
- Akiyuki Uzawa Masahiro Mori Yuta Iwai Hiroki Masuda Satoshi Kuwabara
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.61, no.18, pp.2785-2787, 2022-09-15 (Released:2022-09-15)
- 参考文献数
- 10
- 被引用文献数
- 4
Satralizumab, a monoclonal antibody against interleukin-6 receptors, has been approved for the treatment of neuromyelitis optica spectrum disorder (NMOSD). Several reports have described the effectiveness of satralizumab against neuropathic pain in patients with NMOSD, but its effects on painful tonic seizures have not yet been reported. We herein report a Japanese woman with anti-aquaporin-4 antibody-positive NMOSD whose painful tonic seizures completely resolved after six months of satralizumab treatment. In conclusion, interleukin-6 blocking may be effective against painful tonic seizures. This effect may be due to suppression of microglial activation and the resultant neuronal hyperexcitability.
- 著者
- Michiko Izumi Akiyuki Uzawa Reiji Aoki Masahide Suzuki Koki Yoshizawa Yutaro Suzuki Akio Kimura Takayoshi Shimohata Satoshi Kuwabara
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.62, no.3, pp.465-468, 2023-02-01 (Released:2023-02-01)
- 参考文献数
- 8
Recent studies have reported that autoantibodies against glial fibrillary acidic protein (GFAP), a major cytoskeletal protein expressed in astrocytes, can lead to GFAP astrocytopathy, an autoimmune central nervous system inflammatory disease. We herein report the unique case of a 59-year-old Japanese woman with GFAP astrocytopathy who presented with characteristic symptoms, including signs of meningeal irritation, cerebellar ataxia, and bladder/rectal dysfunction, in the absence of specific findings on initial brain magnetic resonance imaging (MRI). The patient exhibited new abnormal changes mainly in the brainstem on follow-up MRI, illustrating the need to recognize that MRI abnormalities may appear later in GFAP astrocytopathy.
- 著者
- Kazumoto Shibuya Sonoko Misawa Saiko Nasu Yukari Sekiguchi Minako Beppu Yuta Iwai Satsuki Mitsuma Sagiri Isose Kimiyoshi Arimura Ryuji Kaji Satoshi Kuwabara
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.53, no.17, pp.1927-1931, 2014 (Released:2014-09-01)
- 参考文献数
- 26
- 被引用文献数
- 15 19
Objective No clinically effective treatment for promoting peripheral axonal regeneration has yet been established. Several experimental studies in vitro and in vivo have shown that a high dose of methylcobalamin (MeCbl), an analogue of vitamin B12, promotes axonal growth in peripheral nerve injury. We herein assessed the safety and efficacy of an ultra-high dose MeCbl treatment for patients with peripheral neuropathy and chronic axonal degeneration. Methods Fourteen patients with immune-mediated or hereditary neuropathy in the chronic progressive or stable phase were enrolled. MeCbl, 25 mg/day for 10 days followed by monthly 25 mg for 5 months, was intravenously administered. The patients were evaluated before and 1 year following treatment. The primary endpoints were safety and improvement in the Medical Research Council (MRC) sum score in at least two muscles of the 20 muscles. This trial is registered with the University Hospital Medical Information Network (UMIN) Center in Japan under the ID: UMIN000009359. Results There were no adverse effects in twelve of the patients, whereas treatment was discontinued in two patients who had seborrheic dermatitis at 3 months and respiratory tract infection at 2 months, respectively. Therefore, twelve patients were evaluated for the primary outcomes; the MRC sum score was improved in seven of the patients and unchanged or worsened in the remaining five patients. Conclusion Intravenous ultra-high dose MeCbl treatment is a safe and potentially efficacious therapy for patients with peripheral neuropathy and chronic axonal degeneration.
- 著者
- Atsuhiko Sugiyama Yosuke Onishi Kimiko Ito Kazumoto Shibuya Keigo Nakamura Fumiko Oda Ichizo Nishino Shigeaki Suzuki Satoshi Kuwabara
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.60, no.16, pp.2671-2675, 2021-08-15 (Released:2021-08-15)
- 参考文献数
- 26
- 被引用文献数
- 1
We herein report a case of seronegative immune-mediated necrotizing myopathy (IMNM) concurrent with anti-Kv1.4 and anti-titin antibodies. A 72-year-old Japanese woman presented with a 29-year history of fluctuating high serum creatine kinase (CK) levels followed by intermittent ptosis and respiratory muscle weakness. This case highlights the fact that marked respiratory muscle weakness requiring intubation can be seen in an ambulant patient with IMNM. Marked respiratory muscle weakness, rhabdomyolysis-like acute elevation of CK levels, and anti-striational muscle antibodies may be a characteristic constellation of findings in a distinct subgroup of patients with inflammatory myopathy with myasthenia gravis or similar symptoms.
- 著者
- Yuya Aotsuka Akiyuki Uzawa Kazutaka Nishimura Kazuho Kojima Mika Yamaguchi Takahiro Makino Kazuo Nakamichi Masayuki Saijo Satoshi Kuwabara
- 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.12, pp.1645-1647, 2016-06-15 (Released:2016-06-15)
- 参考文献数
- 13
- 被引用文献数
- 11
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease that favors the cerebrum and typically occurs in immunosuppressed patients. We herein report the case of a 66-year-old man with PML, idiopathic CD4+ T lymphocytopenia (ICL), and chronic renal failure. Cranial magnetic resonance imaging (MRI) showed a crescent-shaped lesion in the left cerebellum, brainstem, and middle cerebellar peduncle. Although the patient did not present with HIV infection, collagen diseases, or tumors, JC virus DNA was detected in the cerebrospinal fluid. Clinicians should consider PML and ICL in the differential diagnosis if the patient develops progressive ataxia and a crescent-shaped cerebellar lesion on MRI.