著者

Shinichi Matsuzaki Hiroyuki Kamiya Ichiro Inoshima Yasutaka Hirasawa Osamu Tago Masashi Arai

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.8310-21, (Released:2021-10-26)

参考文献数

29

被引用文献数

12

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A 65-year-old man experienced cough and shortness of breath 3 days after receiving the first dose of the Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccine. Chest X-ray revealed bilateral infiltrates, and the desaturation deteriorated rapidly. The symptoms and radiographic abnormalities rapidly improved after the initiation of corticosteroid therapy. Intradermal testing of the Pfizer-BioNTech COVID-19 vaccine showed a delayed positive reaction. Based on these findings, the patient was diagnosed with COVID-19 vaccine-induced pneumonitis. The timing of the onset of pneumonitis after vaccination and the results of intradermal testing suggest that Type IV hypersensitivity against COVID-19 vaccine may have been responsible for this clinical condition.

著者

Masahiro Yano Tomoaki Morioka Yuka Natsuki Keyaki Sasaki Yoshinori Kakutani Akinobu Ochi Yuko Yamazaki Tetsuo Shoji Masanori Emoto

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.8, pp.1197-1200, 2022-04-15 (Released:2022-04-15)

参考文献数

15

被引用文献数

2 38

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During the ongoing coronavirus disease 2019 (COVID-19) pandemic, it is critical to ensure the safety of COVID-19 vaccines. We herein report a 51-year-old Japanese woman who developed acute-onset type 1 diabetes with diabetic ketoacidosis six weeks after receiving the first dose of a COVID-19 messenger ribonucleic acid (mRNA) vaccine. Laboratory tests indicated exhaustion of endogenous insulin secretion, a positive result for insulin autoantibody, and latent thyroid autoimmunity. Human leukocyte antigen typing was homozygous for DRB1*09:01-DQB1*03:03 haplotypes. This case suggests that COVID-19 vaccination can induce type 1 diabetes in some individuals with a genetic predisposition.

著者

Takahiro Higashi Shunichi Fukuhara

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.48, no.16, pp.1369-1375, 2009 (Released:2009-08-17)

参考文献数

25

被引用文献数

7 47

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Background The overuse of antibiotics results in the unnecessary spread of resistant strains. A common setting for antibiotic overuse is in the treatment of upper respiratory tract infections (URIs), which are predominantly due to viruses. Objective To investigate the type and frequency of antibiotic prescription for URI without apparent bacterial infection in Japan, based on both visits and facilities. Design Cross-sectional analysis of insurance claims submitted to an employer-sponsored health insurance plan in Japan between January and March, 2005 for diagnoses of URI. Claims having a potentially valid reason for antibiotic prescription (e.g., secondary diagnosis of pneumonia) were excluded. Outcome Measures Antibiotics prescribed for these URI visits. Results From a total of 24,134 claims, 2,577 claims (non-bacterial URI, one visit per claim) were analyzed; antibiotics were prescribed in 60% of these visits. Third-generation cephalosporins were the most commonly-prescribed drug class (46%), followed by macrolides (27%) and quinolones (16%). In general, visits to physician offices were more likely to result in an antibiotic prescription than visits to hospital outpatient clinics. No statistically significant difference was identified among hospital types, including private and public ownership or teaching hospital status. Analysis of the frequency of antibiotic prescription by facility revealed two peaks in distribution, with one group prescribing to about 90% of URI patients and the second appearing to prescribe to about 40% of patients. Conclusion Antibiotics are frequently prescribed to URI patients in Japan. Although overuse results from the difficulty in accurately distinguishing viral from bacterial URIs, some facilities appear to attempt to differentiate the underlying cause of the URI while others do not.

著者

Makoto Yamakawa Keiichi Nakahara Toshihito Nakanishi Toshiya Nomura Mitsuharu Ueda

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.1067-1069, 2022-04-01 (Released:2022-04-01)

参考文献数

14

被引用文献数

14

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After BNT162b2 messenger ribonucleic acid (mRNA) coronavirus disease 2019 (COVID-19) vaccination, a 30-year-old man developed bilateral lateral gaze palsy, diplopia, absent tendon reflexes, and ataxic gait. Serum anti-GQ1b and anti-GT1a immunoglobulin G (IgG) antibodies were strongly positive. Based on those findings, he was diagnosed with Miller Fisher syndrome (MFS). Intravenous immunoglobulin therapy was administered, and his symptoms fully recovered within approximately 3 months. To the best of our knowledge, this is the first report to describe the development of MFS after COVID-19 mRNA vaccination.

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

pp.0104-22, (Released:2022-08-10)

参考文献数

23

被引用文献数

15

---

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

Takehiro Numata Kazuki Miura Tetsuya Akaishi Ryutaro Arita Kota Ishizawa Natsumi Saito Hiroyo Sasaki Akiko Kikuchi Shin Takayama Muneshige Tobita Tadashi Ishii

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.3218-19, (Released:2019-09-18)

参考文献数

15

被引用文献数

5 4

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We herein report the case of a 14-year-old girl who had been experiencing chronic fatigue, febricula, and social withdrawal for 20 months. No notable abnormalities were identified during routine checkups at a general pediatric hospital; symptomatic treatments did not affect her condition. She was diagnosed with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Based on the concepts of Japanese traditional medicine, she was administered shosaikoto-based treatment. After several weeks of treatment, all of the symptoms had been dramatically alleviated, consequently resolving the issue of non-attendance at school. Shosaikoto-based medication may be a therapeutic option for treating ME/CFS in patients presenting with chronic febricula.

著者

Kanji Sato Teppei Ohmori Keiko Shiratori Kazuko Yamazaki Emiko Yamada Hironari Kimura Kazue Takano

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.46, no.7, pp.391-395, 2007 (Released:2007-04-02)

参考文献数

29

被引用文献数

7 18

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Iodine-induced hypothyroidism that develops in patients who gargle routinely with povidone iodine is well known. Usually the hypothyroidism is mild and resolves spontaneously upon cessation of gargling. Here, we report a 63-year-old patient with overt hypothyroidism that developed due to habitual gargling with povidone iodine for more than 10 years. The urinary excretion of iodine was estimated to be greater than 5 mg/day, based on values obtained from 18 normal subjects who gargled three times a day (4.6±2.1 mg, mean±SD). After discontinuation of the gargling, the patient has been euthyroid for more than 10 months.

著者

Makoto Eriguchi Kotaro Iida Shuhei Ikeda Manabu Osoegawa Kenya Nishioka Nobutaka Hattori Hiroshi Nagayama Hideo Hara

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.2028-18, (Released:2019-02-25)

参考文献数

17

被引用文献数

29

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We herein report the case of a 38-year-old man who developed parkinsonism 4 years after ingesting glyphosate. The patient presented with right-sided bradykinesia and cogwheel rigidity without autonomic symptoms. Magnetic resonance imaging of the brain and [123I]-metaiodobenzylguanidine myocardial scintigraphy were normal. A drastic response to levodopa and the presence of levodopa-induced dyskinesia without strong non-motor symptoms were seen in this patient. We considered that young-onset atypical parkinsonism was associated with a history of sublethal glyphosate ingestion. Epidemiologic investigations have shown that exposure to pesticides is a risk factor for Parkinson' s disease (PD). Our findings support the notion that glyphosate exposure might be related to the onset of PD.

著者

Sachiko Onishi Shunpei Yoshino

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.45, no.4, pp.207-210, 2006 (Released:2006-03-15)

参考文献数

16

被引用文献数

40 47

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Symptomatic hypermagnesemia is rare and can be induced by exogenous magnesiumcontaining cathartics or antacids. We report a patient with hypermagnesemia. The patient was treated with continuous hemodiafiltration (CHDF); however, he died on the 4th hospital day. Hypermagnesemia is not easily detected because the magnesium level is not examined during routine investigations, and many physicians are relatively unfamiliar with hypermagnesemia. Hypermagnesemia should be considered in elderly patients presenting with hypotension, bradycardia, hyporeflexia, or respiratory depression, and particularly in patients with abnormal renal function or small bowel hypomotility. Magnesiumcontaining cathartics or antacids should be used more carefully in the elderly.

著者

Ken Okai Masaharu Tsubokura Tetsuya Tanimoto Yukio Kanazawa

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.15, pp.2073-2073, 2012 (Released:2012-08-01)

参考文献数

2

被引用文献数

1

著者

Takashi Kurita Keiko Ishida Emiri Muranaka Hiroki Sasazawa Haruki Mito Yudai Yano Ryota Hase

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.59, no.22, pp.2951-2953, 2020-11-15 (Released:2020-11-15)

参考文献数

14

被引用文献数

7

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We herein report the first case of a fever induced by favipiravir, a potential coronavirus disease 2019 therapeutic drug. An 82-year-old man diagnosed with bilateral pneumonia was transferred to our hospital following a positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction test. He was treated with compassionate use of favipiravir. Both his oxygen demand and fever gradually improved after admission; however, his fever relapsed, and the C-reactive protein (CRP) levels increased on day 7. We diagnosed his fever as being favipiravir-induced. The fever resolved a few days after favipiravir discontinuation, demonstrating the accuracy of the diagnosis. This case revealed that favipiravir can induce a fever.

著者

Michio Yamamoto Dai Keino Shinichiro Sumii Tomoko Yokosuka Hiroaki Goto Ayano Inui Tsuyoshi Sogo Makio Kawakami Mio Tanaka Masakatsu Yanagimachi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.62, no.12, pp.1813-1816, 2023-06-15 (Released:2023-06-15)

参考文献数

17

被引用文献数

4

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We herein report a case of hepatitis-associated aplastic anemia (HAAA) that occurred after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. In this patient, progressive pancytopenia observed two months after acute hepatitis following the second dose of the SARS-CoV-2 vaccine indicated the development of HAAA. Although some reports have suggested that SARS-CoV-2 vaccination may be involved in the development of autoimmune diseases, no cases of HAAA developing after SARS-CoV-2 vaccination have been reported. SARS-CoV-2 vaccination in children has only started relatively recently, so the range of side effects in children has not yet been thoroughly described. Therefore, we need to strengthen surveillance for symptoms of children who are vaccinated.

著者

Kazuhito Kimoto Saiko Aiba Ryotaro Takashima Keisuke Suzuki Hidehiro Takekawa Yuka Watanabe Muneto Tatsumoto Koichi Hirata

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.50, no.18, pp.1923-1928, 2011 (Released:2011-09-15)

参考文献数

25

被引用文献数

12 48 5

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Objective Barometric pressure has been reported as a triggering and exacerbating factor in migraine headaches, although there are few reports concerning the association of weather change and migraine headache. The relationship between barometric pressure changes and migraine headaches was prospectively examined. Methods A total of 28 migraine patients who lived within 10 km of the Utsunomiya Local Meteorological Observatory kept a headache diary throughout the year. Daily and monthly mean barometric pressure data of the Utsunomiya Local Meteorological Observatory were obtained via the homepage of the Meteorological Office. Results The correlation between headache frequency obtained by the headache diaries for 1 year and changes in the barometric pressure during the period of 2 days before and 2 days after the headache onset were evaluated. The frequency of migraine increased when the difference in barometric pressure from the day the headache occurred to the day after was lower by more than 5 hPa, and decreased when the difference in barometric pressure from the day the headache occurred to 2 days later was higher by more than 5 hPa. Of 28 patients, weather change was associated with migraine headache development in 18 (64%) patients, 14 of which reported low barometric pressure to be a cause of headache. There was no association between the monthly mean barometric pressure and headache frequency throughout the year. Conclusion Barometric pressure change can be one of the exacerbating factors of migraine headaches.

著者

Eikan Mishima Kazuichi Maruyama Toru Nakazawa Takaaki Abe Sadayoshi Ito

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.1687-1690, 2017-07-01 (Released:2017-07-01)

参考文献数

15

被引用文献数

11

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CYP3A4-inhibitors can potentiate the hypotensive effect of calcium-channel blockers. However, insufficient attention to such drug interactions may result in serious adverse reactions. A 71-year-old hypertensive man prescribed nifedipine was hospitalized for infectious endophthalmitis. Antimicrobial therapy with voriconazole lowered the blood pressure, and then clarithromycin further lowered it through the excessively elevated nifedipine concentration, leading to ischemic acute kidney injury. After the discontinuation of clarithromycin and voriconazole, the blood pressure and renal function were recovered. The combination of CYP3A4-inhibitors such as clarithromycin plus voriconazole can synergistically potentiate calcium-channel blockers. Co-prescription of multiple CYP3A4-inhibitors with calcium-channel blockers increases the risk of hypotension and acute kidney injury.

著者

Yoshito Kamijo Michiko Takai Yuji Fujita Yasuo Hirose Yasumasa Iwasaki Satoshi Ishihara Takashi Yokoyama Keiichi Yagi Tetsuya Sakamoto

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.21, pp.2439-2445, 2014 (Released:2014-11-01)

参考文献数

33

被引用文献数

9 22

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Objective We conducted a multicenter retrospective survey of patients poisoned by synthetic chemicals (SCs) in Japan. Methods Letters were sent to 467 emergency facilities requesting participation in the study, and questionnaires were mailed to facilities that agreed to participate. Patients The study participants were patients who were transported to emergency facilities between January 2006 and December 2012 after consuming SC-containing products. Results We surveyed 518 patients from 60 (12.8%) facilities. Most patients were male (82.0%), in their 20s or 30s (80.5%), and had inhaled SCs (87.5%) contained in herbal products (86.0%). Harmful behavior was observed at the scene of poisoning for 56 patients (10.8%), including violence to others or things in 32, traffic accidents in seven, and self-injury or suicide attempts in four. Other than physical and neuropsychiatric symptoms, some patients also had physical complications, such as rhabdomyolysis (10.0%). Of the 182 patients (35.1%) admitted to hospitals, including 29 (5.6%) who needed respirators, all of the 21 (4.1%) hospitalized for at least seven days were male, and 20 had physical complications (rhabdomyolysis, 12; liver dysfunction, 5; renal dysfunction, 11; and physical injuries, 3). Most patients (95.6%) completely recovered, although 10 (1.9%) were transferred to a psychiatric department or hospital, and three (0.6%) were handed over to the police due to combative or violent behavior. SCs such as synthetic cannabinoids, synthetic cathinones, or methoxetamine were detected in 20 product samples. Conclusion Consuming products containing SCs can result in physical complications, including rhabdomyolysis, injuries, and physical or neuropsychiatric symptoms, which may require active interventions, such as respirator use or prolonged hospitalization.

著者

Nobuyasu Awano Nene Oyama Keiko Akiyama Minoru Inomata Naoyuki Kuse Mari Tone Kohei Takada Yutaka Muto Kazushi Fujimoto Yu Akagi Momoko Mawatari Akihiro Ueda Junko Kawakami Junko Komatsu Takehiro Izumo

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.59, no.21, pp.2693-2699, 2020-11-01 (Released:2020-11-01)

参考文献数

25

被引用文献数

1 81

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Objective Coronavirus disease 2019 (COVID-19) is spreading around the world. The aim of this study was to assess the degree of anxiety, depression, resilience, and other psychiatric symptoms among healthcare workers in Japan during the COVID-19 pandemic. Methods This survey involved medical healthcare workers at the Japanese Red Cross Medical Center (Tokyo, Japan) between April 22 and May 15, 2020. The degree of symptoms of anxiety, depression, and resilience was assessed using the Japanese versions of the 7-item Generalized Anxiety Disorder Scale (GAD-7), Center for Epidemiologic Studies Depression Scale (CES-D), and 10-item Connor-Davidson Resilience Scale. Furthermore, we added original questionnaires comprising three factors: (i) anxiety and fear of infection and death; (ii) isolation and unreasonable treatment; and (iii) motivation and escape behavior at work. Results In total, 848 healthcare workers participated in this survey: 104 doctors, 461 nurses, 184 other co-medical staff, and 99 office workers. Among all participants, 85 (10.0%) developed moderate-to-severe anxiety disorder, and 237 (27.9%) developed depression. Problems with anxiety and fear of infection and death, isolation and unreasonable treatment, and motivation and escape from work were higher in the depression group than in the non-depression group (total CES-D score ≥ 16 points). Being a nurse and high total GAD-7 scores were risk factors of depression. Older workers and those with higher resilience were less likely to develop depression than others. Conclusion During the COVID-19 epidemic, many healthcare workers suffered from psychiatric symptoms. Psychological support and interventions for protecting the mental health of them are needed.

著者

Kazuhiko Higashioka Hiroaki Niiro Kenji Yoshida Kensuke Oryoji Kazuo Kamada Shinichi Mizuki Eisuke Yokota

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.5, pp.467-471, 2016 (Released:2016-03-01)

参考文献数

32

被引用文献数

9

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Objective Low-dose trimethoprim-sulfamethoxazole (TMP-SMX) is commonly used to prevent pneumocystis pneumonia in daily practice. Previous reports have shown a relationship between high- or standard-dose of TMP-SMX and hyperkalemia, however it remains unclear whether this is true for low-dose TMP-SMX. In this study we sought to determine the risk factors for hyperkalemia associated with low-dose TMP-SMX. Methods In this retrospective cohort study, 186 consecutive adult patients who received TMP-SMX as prophylaxis for pneumocystis pneumonia from January 2014 to January 2015 were evaluated. Data on the patients' age, gender, baseline estimated glomerular filtration rate (eGFR), baseline serum potassium, maximum serum potassium, duration reaching the maximal serum potassium level, dosage, and concomitant use of angiotensin-converting enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARB), β-blockers, non-steroidal anti-inflammatory drugs and potassium-sparing diuretics were retrospectively collected. Hyperkalemia was defined as a serum potassium level ≥5 mEq/L. Univariate and multivariate analyses were performed. Results The median age of the patients was 66 years and 51.1% were men. Hyperkalemia associated with low-dose TMP-SMX was observed in 32 patients (17.2%). The median duration to reach the maximal serum potassium level was 12 days. The multivariate logistic regression analysis identified renal insufficiency to be a major risk factor for hyperkalemia associated with low-dose TMP-SMX (eGFR <60 mL/min/1.73 m2, adjusted OR 4.62). Moreover, in the subpopulation of patients with renal insufficiency, ACEi/ARB use was considered to be a major risk factor for hyperkalemia (adjusted OR 3.96). Conclusion Renal insufficiency in concert with ACEi/ARB use is a major risk factor for hyperkalemia induced by low-dose TMP-SMX.

著者

Hirono Homma Jiro Aoki Kengo Tanabe

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.54, no.8, pp.999-1000, 2015 (Released:2015-04-15)

被引用文献数

1 4

著者

Daisuke Ikechi Hideki Hashimoto Hidehiko Nakano Kensuke Nakamura

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.10, pp.1631, 2022-05-15 (Released:2022-05-15)

参考文献数

1

被引用文献数

1

著者

Takayuki Watanabe Yasuharu Tokuda

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.22, pp.2661-2662, 2014 (Released:2014-11-15)

参考文献数

2