著者

Masaharu Tsubokura Jinichi Mori Tetsuya Tanimoto Tomoyoshi Oikawa

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.17, pp.2493-2493, 2012 (Released:2012-09-01)

参考文献数

2

被引用文献数

2 2

著者

Koji Ito Kenji Miyata Masahiro Mohri Hideki Origuchi Hideo Yamamoto

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.1, pp.23-29, 2017-01-01 (Released:2017-01-01)

参考文献数

15

被引用文献数

16

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Objective It is recommended that middle-aged and elderly individuals reduce their salt intake because of the high prevalence of hypertension. The consumption of miso soup is associated with salt intake, and the reduced consumption of miso soup has been recommended. Recent studies have demonstrated that the consumption of miso soup can attenuate an autonomic imbalance in animal models. However, it is unclear whether these results are applicable to humans. This study examined the cross-sectional association between the frequency of miso soup consumption and the blood pressure and heart rate of human subjects. Methods A total of 527 subjects of 50 to 81 years of age who participated in our hospital health examination were enrolled in the present study and divided into four groups based on the frequency of their miso soup consumption ([bowl(s) of miso soup/week] Group 1, <1; Group2, <4; Group3, <7; Group4, ≥7). The blood pressure levels and heart rates of the subjects in each group were compared. Furthermore, a multivariable analysis was performed to determine whether miso soup consumption was an independent factor affecting the incidence of hypertension or the heart rate. Results The frequency of miso soup consumption was not associated with blood pressure. The heart rate was, however, lower in the participants who reported a high frequency of miso soup consumption. A multivariable analysis revealed that the participants who reported a high frequency of miso soup consumption were more likely to have a lower heart rate, but that the consumption of miso soup was not associated with the incidence of hypertension. Conclusion These results indicate that miso soup consumption might decrease the heart rate, but not have a significant effect on the blood pressure of in middle-aged and elderly Japanese individuals.

著者

Yoshihito Nihei Monami Kishi Hitoshi Suzuki Ayako Koizumi Maiko Yoshida Sho Hamaguchi Masako Iwasaki Hiromitsu Fukuda Hisatsugu Takahara Masao Kihara Shigeki Tomita Yusuke Suzuki

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.7, pp.1033-1037, 2022-04-01 (Released:2022-04-01)

参考文献数

19

被引用文献数

15

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A 28-year-old woman experienced gross hematuria after the administration of the second dose of an messenger ribonucleic acid (mRNA) vaccine (BNT162b2). She was diagnosed with Immunogloblin A nephropathy (IgAN) by a renal biopsy two weeks after vaccination, which revealed a mild increase in mesangial cells and a matrix with co-depositions of galactose-deficient IgA1 and C3 in the mesangial region. The gross hematuria and proteinuria gradually improved without any medication, suggesting that immune activation by the mRNA vaccine may not elicit continuous disease progression of IgAN. Thus, further studies investigating the relationship between mRNA vaccines against COVID-19 and the progression of IgAN should be conducted.

著者

Joe Senda Ryosei Ashida Kyoko Sugawara Katsuhiro Kawaguchi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.8815-21, (Released:2022-03-12)

参考文献数

20

被引用文献数

5

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We herein report a 72-year-old woman with rheumatoid vasculitis who exhibited a depressed level of consciousness after receiving the first dose of the Pfizer-BioNTech mRNA BNT162b COVID-19 vaccine and was diagnosed with meningoencephalitis. Although there was no confirmatory examination, the diagnosis was based on magnetic resonance imaging (MRI) findings and etiological assessments, including microbiological and autoimmune investigations. Both intravenous steroid pulse and gammaglobulin therapies alleviated the patient's symptoms, and the MRI findings improved. Although the efficacy of COVID-19 vaccination has been widely accepted, such neurologic complications might occur in patients with rheumatoid diseases or vasculitis syndromes.

著者

Jun Nakamura Takao Nagashima Yoichiro Akiyama Seiji Minota

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.58, no.3, pp.455, 2019-02-01 (Released:2019-02-01)

被引用文献数

2 3

著者

Takehiro Numata

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.7182-21, (Released:2021-04-05)

参考文献数

7

被引用文献数

1

著者

Yoshito Kamijo Michiko Takai Yuji Fujita Kiyotaka Usui

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.57, no.15, pp.2141-2146, 2018-08-01 (Released:2018-08-01)

参考文献数

30

被引用文献数

23

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Objective We conducted a retrospective study on the epidemiological and clinical features of patients with acute caffeine poisoning in Japan. Methods Letters requesting participation were sent to 264 emergency departments of hospitals, and questionnaires were mailed to those that agreed to participate. Patients Participants were patients transported to emergency departments of hospitals between April 2011 and March 2016 after consuming large or massive amounts of caffeinated supplements and/or energy drinks (caffeine dose ≥1.0 g). Results We surveyed 101 patients from 38 emergency departments. Since April 2013, the number of patients has markedly increased. Of these young patients (median age, 25 years), 53 were men, and 97 had consumed caffeine in tablet form. Estimated caffeine doses (n=93) ranged from 1.2 to 82.6 g (median, 7.2 g). Serum caffeine levels on admission (n=17) ranged from 2.0 to 530.0 μg/mL (median level, 106.0 μg/mL). Common abnormal vital signs and laboratory data on admission included tachypnea, tachycardia, depressed consciousness, hypercreatinekinasemia, hyperglycemia, hypokalemia, hypophosphatemia, and hyperlactatemia. Common signs and symptoms in the clinical course included nausea, vomiting, excitement/agitation, and sinus tachycardia. Seven patients (6.9%) who had consumed ≥6.0 g of caffeine, or whose serum caffeine levels on admission were ≥200 μg/mL, developed cardiac arrest. Ninety-seven patients (96.0%) recovered completely, but 3 patients (3.0%) died. Conclusion The present analysis of data from more than 100 emergency patients revealed clinical features of moderate to fatal caffeine poisoning. We recommend highlighting the toxicity risks associated with ingesting highly caffeinated tablets.

著者

Takuma Tsuzuki Wada Kazuhiro Yokota Fumito Inayoshi Sakon Sakai Nobuhito Okumura Mayumi Matsuda Iichiro Osawa Yasuto Araki Yu Funakubo Asanuma Yuji Akiyama Toshihide Mimura

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.62, no.24, pp.3699-3706, 2023-12-15 (Released:2023-12-15)

参考文献数

50

被引用文献数

3

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We present the case of a 42-year-old woman with rheumatoid arthritis and Sjögren's syndrome treated with adalimumab who developed immune-mediated necrotizing myopathy (IMNM) and trigeminal neuropathy after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccination. Trigeminal neuralgia and elevated serum creatine kinase levels emerged 12 days post-vaccination, followed by myalgia in the femoral muscles. IMNM was histologically diagnosed. The pathogenesis may involve molecular mimicry between the SARS-CoV-2 spike glycoprotein and autologous tissues triggered by vaccination. This case emphasizes the association between SARS-CoV-2 vaccination, tumor necrosis factor inhibitor, IMNM, and trigeminal neuropathy, as well as the importance of monitoring immune-mediated adverse events following SARS-CoV-2 vaccination in patients with autoimmune disease.

著者

Noriyuki Miyaue Akira Yoshida Yuki Yamanishi Satoshi Tada Rina Ando Yuko Hosokawa Hayato Yabe Masahiro Nagai

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.5, pp.739-742, 2022-03-01 (Released:2022-03-01)

参考文献数

12

被引用文献数

16

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Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed and administered worldwide. There have been reports of neurological adverse events following immunization (AEFIs). We herein report a case of refractory longitudinally extensive transverse myelitis in a 75-year-old Japanese man following the first dose of the BNT162b2 vaccine. The patient developed total sensory loss below the umbilicus and complete paralysis in both legs. Although he was treated with steroid therapy and plasma exchange, his recovery was limited, and severe sequelae remained. Further studies, including large epidemiological studies, are required to understand the association between SARS-CoV-2 vaccines and neurological AEFI.

著者

Sharon J.B. Hanley Kevin G.J. Pollock Kate Cuschieri

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.54, no.15, pp.1953, 2015 (Released:2015-08-01)

参考文献数

5

被引用文献数

4 4

著者

Eiko Kawakami Tomohisa Uchida Naoki Iwamoto Kazusato Hara Kazuhiro Egashira Atsushi Kawakami

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.1621-23, (Released:2023-05-17)

参考文献数

17

---

We herein report a case of melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis that developed in a patient with refractory gingivitis. The diagnosis of anti-MDA5 antibody-positive dermatomyositis was made based on a characteristic skin rash, weakness of proximal muscles, interstitial pneumonia, and positivity for anti-MDA5 antibody. The patient was started on triple therapy with high-dose prednisolone, tacrolimus, and intravenous cyclophosphamide. After treatment, the refractory gingivitis disappeared, and the other skin rash and interstitial lung disease also improved. In the diagnosis and treatment of anti-MDA5 antibody-positive dermatomyositis, it is necessary to pay attention to the intraoral findings, including the gingiva.

著者

Tadahisa Numakura Koji Murakami Tsutomu Tamada Chiaki Yamaguchi Chihiro Inoue Shinya Ohkouchi Naoki Tode Hirohito Sano Hiroyuki Aizawa Kei Sato Ayumi Mitsune Hajime Kurosawa Toru Nakazawa Hisatoshi Sugiura

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.20, pp.3101-3106, 2022-10-15 (Released:2022-10-15)

参考文献数

23

被引用文献数

15

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BNT162b2 (Pfizer/BioNTech) is a coronavirus disease 2019 (COVID-19) vaccine containing nucleoside-modified messenger RNA encoding the severe acute respiratory syndrome coronavirus 2 spike glycoprotein. Recently, ocular complications of mRNA vaccines have been reported increasingly frequently. However, immunological adverse events due to mRNA vaccines in real-world settings are not fully known. We herein report the novel development of sarcoidosis manifested as uveitis, bilateral hilar lymphadenopathy, angiotensin-converting enzyme elevation, and epithelioid and giant cell granuloma formation in the lung soon after the first BNT162b2 injection and review the current literature, including three reported cases of sarcoid-like reaction following COVID-19 vaccination.

著者

Kunihisa Miwa

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.2577-2584, 2021-08-15 (Released:2021-08-15)

参考文献数

47

被引用文献数

5

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Objective Central nervous system dysfunction associated with myalgic encephalomyelitis (ME) has been suggested to be the main cause of chronic fatigue syndrome. In animal models of chronic fatigue, minocycline was reported to act as a suppressor of neural inflammation. Minocycline may thus exert favorable therapeutic effects in patients with ME. Methods Oral minocycline (100 mg×2 on the first day, followed by 100 mg/day for 41 days) was administered to 100 patients with ME. The performance status score (0-9), orthostatic intolerance during the 10-min standing test, neurologic disequilibrium, and neuropathic pain were compared before and after treatment. Results After therapy completion, favorable effects were observed with a decrease in the performance status score of ≥2 points in 27 patients (27%). Before treatment, 6 of the 27 patients had orthostatic intolerance with an inability to complete the 10-min standing test; after treatment, this symptom resolved in 4 and improved in 2 patients. In addition, after treatment, postural orthostatic tachycardia resolved in five of eight patients, disequilibrium resolved in five of eight patients, and fibromyalgia or neuropathic pain was attenuated in four of five patients. The favorable effects appeared dependent on a shorter disease duration, primarily for a duration of less than three years and most frequently within six months of the disease onset. However, acute adverse effects with nausea and/or dizziness caused 38 patients (38%) to discontinue treatment in the first few days. Conclusion Oral minocycline therapy may be an effective treatment option for patients with ME, especially in the initial stage of the disease.

著者

Masanobu Tanemoto Ryosuke Oda Yuichiro Toyama Hirohiko Shizukawa Kazuki Yokokawa Taro Saito Syuuichirou Suzuki Akihiro Matsumura Shin Hisahara

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0404-22, (Released:2022-09-13)

参考文献数

15

被引用文献数

3

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A 26-year-old Japanese woman developed a fever, myalgia and gait disturbance one day after receiving the second dose of the mRNA-1273 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. A neurological examination revealed symmetrical weakness and myalgia in proximal lower limbs, and a blood examination showed prominent elevation of creatinine kinase. Magnetic resonance imaging (MRI) revealed a high signal intensity in the thigh muscles on short-tau inversion recovery images, and antibody testing revealed positive findings for anti-signal recognition particle (SRP) antibody. Thus, anti-SRP antibody-positive immune-mediated myopathy was diagnosed. We initiated immunotherapy, and she was ultimately able to walk stably.

著者

Shunsuke Ogata Yoshito Ishi Keiichiro Asano Erena Kobayashi Shun Kubota Keita Takahashi Yosuke Miyaji Yuichi Higashiyama Hideto Joki Hiroshi Doi Michiaki Koga Hideyuki Takeuchi Fumiaki Tanaka

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.8967-21, (Released:2022-03-26)

参考文献数

9

被引用文献数

10

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Guillain-Barré syndrome (GBS) has occasionally occurred in people who have received coronavirus disease 2019 (COVID-19) vaccines. Dysgeusia is rare symptom of GBS. We herein report a rare case of sensory ataxic GBS with dysgeusia just after the second dose of the Pfizer-BioNTech COVID-19 vaccine. Although autoantibodies against glycolipids were not detected, immunotherapy with intravenous immunoglobulin and methylprednisolone pulse therapy effectively ameliorated the symptoms. Our report suggests that the COVID-19 vaccine may induce various clinical subtypes of GBS, including a rare variant with sensory ataxia and dysgeusia.

著者

Hiroyuki Ishiyama Junko Ishii Hajime Yoshimura Marie Tsunogae. Satoru Fujiwara Satomi Hiya Ryoma Inui Yuma Shiomi Shinsaku Nakazawa Masamune Kimura Takehito Kuroda Yasutaka Murakami Kota Maekawa Nobuyuki Ohara Nobuo Kohara Michi Kawamoto

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.7802-21, (Released:2021-09-11)

参考文献数

40

被引用文献数

4

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Objective Various neurological manifestations have been increasingly reported in coronavirus disease 2019 (COVID-19). We determined the neurological features and long-term sequelae in hospitalized COVID-19 patients. Methods We retrospectively studied 95 consecutive hospitalized patients with COVID-19 between March 1 and May 13, 2020. Acute neurological presentations (within two weeks of the symptom onset of COVID-19) were compared between 60 non-severe and 35 severely infected patients who required high-flow oxygen. In the 12 ventilated patients (the most severe group), we evaluated neurological complications during admission, subacute neurological presentations, and neurological sequelae (51 and 137 days from the onset [median], respectively). Results Of the 95 patients (mean age 53 years old; 40% women), 63% had acute neurological presentations, with an increased prevalence in cases of severe infections (83% vs. 52%, p<0.001). Impaired consciousness and limb weakness were more frequent in severe patients than in non-severe ones (0% vs. 49%; p<0.001, and 0% vs. 54%; p<0.001, respectively). In the most severe group (mean age 72 years old; 42% women), 83% of patients had neurological complications (cerebrovascular disease [17%], encephalopathy [82%], and neuropathy [55%]), and 92% had subacute neurological presentations (impaired consciousness [17%], higher brain dysfunction [82%], limb weakness [75%], and tremor [58%]). Neurological sequelae were found in 83% of cases, including higher brain dysfunction (73%), limb weakness (50%), and tremor (58%). Conclusions Neurological manifestations are common in COVID-19, with the possibility of long-lasting sequelae.

著者

Hiroaki Satoh Tetsuya Ohira Masato Nagai Mitsuaki Hosoya Akira Sakai Tsuyoshi Watanabe Akira Ohtsuru Yukihiko Kawasaki Hitoshi Suzuki Atsushi Takahashi Gen Kobashi Kotaro Ozasa Seiji Yasumura Shunichi Yamashita Kenji Kamiya Masafumi Abe

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.18, pp.2563-2569, 2016-09-15 (Released:2016-09-15)

参考文献数

16

被引用文献数

12

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Objective We conducted the present study to evaluate the prevalence of chronic kidney disease (CKD) and CKD complications among evacuees and non-evacuees after the Great East Japan Earthquake and Fukushima Daiichi nuclear disaster. Methods Twenty-seven thousand and eighty-eight subjects who were living near the Fukushima Daiichi Nuclear Power Plant in Fukushima Prefecture in Japan, aged ≥40 years by the Heath Care Insures, were included in the analyses. Metabolic factors were compared between the evacuees and non-evacuees stratified by the eGFR and proteinuria grades. Results The prevalence of CKD with a low eGFR (<60 mL/min/1.73 m2) and proteinuria were 21.59% and 1.85%, respectively. The risk of CKD complications was classified into four grades according to the eGFR and proteinuria grades. The prevalence of diabetes, hypertension, and dyslipidemia were significantly higher in the very high risk group than in the low risk group. The prevalence of diabetes and dyslipidemia were significantly higher in evacuees than in non-evacuees in only the low risk group. However, a multivariate logistic regression analysis showed that evacuation was not significantly associated with the risk of a low eGFR or proteinuria. Conclusion This study did not reach the definitive conclusion that evacuation elevated the risk of CKD complication, although evacuation might lead to increased CKD complications in the future. We believe that this information is important for follow-up and lifestyle change recommendations for evacuees.

著者

Masao Hagihara Yui Imai Tomoyuki Uchida Shin Ohara Morihiro Inoue Tomiyuki Sugi Keiko Mitamura

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.14, pp.2215-2219, 2022-07-15 (Released:2022-07-15)

参考文献数

28

被引用文献数

4

---

A 52-year-old man with mantle cell lymphoma treated with bendamustine and rituximab developed prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Despite elevated titers of anti-spike IgG antibody, protracted pancytopenia persisted for more than six months. Finally, the anti-SARS CoV-2 vaccine, BNT162b2, was administered, which improved his blood cell count and eliminated the virus. The increased anti-spike IgG titer and lymphocyte count after vaccination suggested that both humoral and cellular immunity acted in coordination to eliminate the virus.

著者

Masatsugu Miyagawa Shunichi Yoda Riku Arai Yasuo Okumura

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.7810-21, (Released:2021-08-31)

被引用文献数

2

著者

Chih-Wei Yang Shun-Neng Hsu Jhih-Syuan Liu Dueng-Yuan Hueng

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.53, no.15, pp.1665-1668, 2014 (Released:2014-08-01)

参考文献数

23

被引用文献数

3 12

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The formation of spinal epidural abscess following acupuncture is very rare. We herein report the case of a 54-year-old woman who presented with progressive low back pain and fever with a root sign. She underwent surgical decompression, with an immediate improvement of the low back pain. A culture of the epidural abscess grew Serratia marcescens. One year postoperatively, magnetic resonance imaging revealed the almost complete eradication of the abscess. This case is the first case of Serratia marcescens-associated spinal epidural abscess formation secondary to acupuncture. The characteristics of spinal epidural abscess that develop after acupuncture and how to prevent such complications are also discussed.