著者

Hiroaki Kawano Tetsufumi Motokawa Hirokazu Kurohama Shinji Okano Ryohei Akashi Tsuyoshi Yonekura Satoshi Ikeda Koichi Izumikawa Koji Maemura

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.15, pp.2319-2325, 2022-08-01 (Released:2022-08-01)

参考文献数

27

被引用文献数

5

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A 60-year-old Japanese woman was hospitalized for cardiogenic shock 24 days after receiving the second dose of the coronavirus disease 2019 BNT162b2 vaccine. Impella CP left ventricular assist device implantation and venoarterial peripheral extracorporeal membranous oxygenation were immediately initiated along with inotropic support and steroid pulse therapy, as an endomyocardial biopsy specimen showed myocarditis. Three weeks later, her cardiac function had recovered, and she was discharged. An immune response associated with the presence of spike protein in cardiac myocytes may be related to myocarditis in the present case because of positive immunostaining for severe acute respiratory syndrome coronavirus 2 spike protein and C4d in the myocardium.

著者

Hiroaki Kawano Tetsufumi Motokawa Hirokazu Kurohama Shinji Okano Ryohei Akashi Tsuyoshi Yonekura Satoshi Ikeda Koichi Izumikawa Koji Maemura

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.9800-22, (Released:2022-05-31)

参考文献数

26

被引用文献数

5

---

A 60-year-old Japanese woman was hospitalized for cardiogenic shock 24 days after receiving the second dose of the COVID-19 BNT162b2 vaccine. Impella-CP left ventricular assist device implantation and venoarterial peripheral extracorporeal membranous oxygenation were immediately initiated along with inotropic support and steroid pulse therapy, as an endomyocardial biopsy specimen showed myocarditis. Three weeks later, her cardiac function had recovered, and she was discharged. An immune response associated with the presence of spike protein in cardiac myocytes may be related to myocarditis in the present case because of positive immunostaining for severe acute respiratory syndrome coronavirus 2 spike protein and C4d in the myocardium.

著者

Satsuki Aochi Masaaki Uehara Motohisa Yamamoto

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.1125-22, (Released:2023-03-08)

参考文献数

22

被引用文献数

1

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A 78-year-old Japanese woman with no history of rheumatic disease received 2 doses of the BNT162b2 COVID-19 mRNA vaccine. Two weeks later, she noticed bilateral swelling in the submandibular region. Blood tests showed hyper-immunoglobulin (Ig)G4emia, and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) revealed the strong accumulation of FDG in the enlarged pancreas. She was diagnosed with IgG4-related disease (IgG4-RD) according to the American College of Rheumatology (ACR)/the European League Against Rheumatism (EULAR) classification criteria. Treatment was started with prednisolone at 30 mg/day, and the organ enlargement improved. We herein report a case of IgG4-RD that may have been associated with an mRNA vaccine.

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

pp.1308-22, (Released:2023-03-22)

参考文献数

17

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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

Takao Hoshino Yumiko Uchiyama Eiichi Ito Shunsuke Osawa Takashi Ohashi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.51, no.12, pp.1595-1598, 2012 (Released:2012-06-15)

参考文献数

19

被引用文献数

12 18

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A 36-year-old man was admitted to our hospital because of urinary retention and muscle weakness affecting all 4 limbs after receiving a H1N1 09 influenza vaccination. Magnetic resonance imaging demonstrated multiple lesions in his brain and spinal cord. Furthermore, nerve conduction study showed acute sensorimotor neuropathy, and anti-GM2 antibodies were detected in his serum. Based on the temporal association and exclusion of alternative etiologies, we made a diagnosis of acute disseminated encephalomyelitis (ADEM) and Guillain-Barré syndrome (GBS). To our knowledge, this is the first case of co-morbid ADEM and GBS after influenza vaccination with positive anti-ganglioside antibodies.

著者

Tadao Aikawa Jiro Ogino Nozomi Aikawa Noriko Oyama-Manabe

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.1623-1624, 2022-05-15 (Released:2022-05-15)

著者

Yoshiki Murakami Masaya Shinohara Yosuke Oka Ryo Wada Ryota Noike Hiroshi Ohara Tadashi Fujino Takanori Ikeda

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.8731-21, (Released:2021-11-27)

参考文献数

14

被引用文献数

10

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COVID-19 vaccine-related myocarditis has been reported worldwide. We herein report two Japanese cases with suspected vaccine-related myocarditis. A 27-year-old man was admitted with chest pain 4 days after the second vaccination. An electrocardiogram (ECG) did not reveal any significant abnormalities. The second patient, a 37-year-old man, was admitted with chest pain 9 days after the first vaccination. His ECG exhibited ST-elevation in multiple leads. In both cases, cardiac magnetic resonance imaging findings were consistent with myocarditis. They recovered with symptomatic relief within a few days. These cases suggest that the benefit of COVID-19 vaccination exceeds the risk of vaccine-related myocarditis.

著者

Tomomi Kinoshita Ryu-ta Abe Akiyo Hineno Kazuhiro Tsunekawa Shunya Nakane Shu-ichi Ikeda

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.53, no.19, pp.2185-2200, 2014 (Released:2014-10-01)

参考文献数

49

被引用文献数

57 95

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Objective To investigate the causes of neurological manifestations in girls immunized with the human papillomavirus (HPV) vaccine. Methods During the past nine months, 44 girls visited us complaining of several symptoms after HPV vaccination. Four patients with other proven disorders were excluded, and the remaining forty subjects were enrolled in this study. Results The age at initial vaccination ranged from 11 to 17 years, and the average incubation period after the first dose of the vaccine was 5.47±5.00 months. Frequent manifestations included headaches, general fatigue, coldness of the legs, limb pain and weakness. The skin temperature examined in 28 girls with limb symptoms exhibited a slight decrease in the fingers (30.4±2.6°C) and a moderate decrease in the toes (27.1±3.7°C). Digital plethysmograms revealed a reduced height of the waves, especially in the toes. The limb symptoms of four girls were compatible with the Japanese clinical diagnostic criteria for complex regional pain syndrome (CRPS), while those in the other 14 girls were consistent with foreign diagnostic criteria for CRPS. The Schellong test identified eight patients with orthostatic hypotension and four patients with postural orthostatic tachycardia syndrome. The girls with orthostatic intolerance and CRPS commonly experienced transient violent tremors and persistent asthenia. Electron-microscopic examinations of the intradermal nerves showed an abnormal pathology in the unmyelinated fibers in two of the three girls examined. Conclusion The symptoms observed in this study can be explained by abnormal peripheral sympathetic responses. The most common previous diagnosis in the studied girls was psychosomatic disease. The social problems of the study participants remained unresolved in that the severely disabled girls stopped going to school.

著者

Hirokatsu Takahashi Shoichi Ito Shigeki Hirano Masahiro Mori Yasuo Suganuma Takamichi Hattori

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.45, no.10, pp.705-706, 2006 (Released:2006-06-15)

参考文献数

2

被引用文献数

5 6

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

pp.8747-21, (Released:2021-12-11)

参考文献数

12

被引用文献数

13

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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

Akira Yokote Shinsuke Fujioka Nobutaka Takahashi Takayasu Mishima Yoshio Tsuboi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.8934-21, (Released:2022-03-26)

参考文献数

15

被引用文献数

2

---

We herein report a 71-year-old woman presented with a fever, arthralgia, general malaise and leg muscle stiffness following administration of the COVID-19 mRNA vaccine (Comirnaty, Pfizer-BioNTech). Laboratory findings showed an elevated C-reactive protein level and erythrocyte sedimentation rate. In addition, Gallium-67 scintigraphy demonstrated an increased uptake in multiple joints. Typing of HLA revealed the presence of the DRB1*0404/*0803 allele. These findings met the diagnostic criteria for polymyalgia rheumatica (PMR), and when we started steroid treatment, her symptoms improved rapidly. This patient developed PMR after receiving a COVID-19 mRNA vaccine (Comirnaty, Pfizer-BioNTech). This case is considered to be valuable, as the HLA-DRB1 allele was also confirmed.

著者

Hiroto Nakano Kazuyoshi Yamaguchi Naoyuki Hama Yasuko Matsumoto Moeko Shinohara Hisashi Ide

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0504-22, (Released:2022-12-28)

参考文献数

14

---

Anti-myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an autoimmune demyelinating disorder that mainly occurs post-infection or post-vaccination. MOGAD after inoculation with coronavirus disease 2019 (COVID-19) vaccines is rare, and we herein report a rare case of a patient with MOGAD after vaccination using the Pfizer-BioNTech COVID-19 vaccine (BNT162b2; Pfizer Japan Inc.; Tokyo). Our report highlights the fact that MOGAD following inoculation with COVID-19 vaccine may show clinical relapse during reduction of the oral steroid dose, and continuous treatments with immunological agents is needed to prevent disease recurrence.

著者

Tetsuhisa Kitamura Kazunari Satomura Takashi Kawamura Sachiko Yamada Kyoko Takashima Narufumi Suganuma Hideo Namai Yoko Komura for The Great Cold Investigators-I

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.46, no.18, pp.1623-1624, 2007 (Released:2007-09-14)

参考文献数

5

被引用文献数

25 29

著者

Makoto Yoneda

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.55, no.21, pp.3077-3078, 2016-11-01 (Released:2016-11-01)

参考文献数

14

被引用文献数

2 3

著者

Yutaro Akiyama Takeshi Inagaki Shinichiro Morioka Eiji Kusano Norio Ohmagari

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.1682-23, (Released:2023-04-21)

参考文献数

30

---

A Japanese man experienced three episodes of hypovolemic shock and was diagnosed with systemic capillary leak syndrome (SCLS). He developed SCLS exacerbation 2 days after receiving a second dose of the Pfizer-BioNTech BNT162b2 mRNA COVID-19 vaccine, 1 year after the third episode. After fluid therapy and albumin administration, we initiated terbutaline and theophylline prophylaxis for SCLS. A literature review revealed that SCLS attacks often occur 1-2 days after the second COVID-19 vaccination. Patients with a history of SCLS should avoid COVID-19 vaccination and be carefully monitored for 1-2 days if they receive the vaccine.

著者

Ryota Hikiami Hodaka Yamakado Shinsui Tatsumi Takashi Ayaki Yuichiro Hashi Hirofumi Yamashita Nobukatsu Sawamoto Teruyuki Tsuji Makoto Urushitani Ryosuke Takahashi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.57, no.13, pp.1917-1919, 2018-07-01 (Released:2018-07-01)

参考文献数

10

被引用文献数

5

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We herein report a 15-year-old girl who developed rapid progressive muscle weakness soon after the third injection of a bivalent human papilloma virus (HPV) vaccine. Although immunotherapies were performed for possible vaccine-related disorders, she died of respiratory failure 14 months after the onset of the disease. A genetic analysis identified a heterozygous p.P525L mutation of the fused in sarcoma (FUS) gene, and a histopathological analysis was also consistent with FUS-associated amyotrophic lateral sclerosis (ALS) without any evidence of neuroinflammation. We concluded the diagnosis to be FUS-ALS, although we cannot completely rule out the possibility that the vaccination worked as a trigger.

著者

Manabu Mogitate

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.9761-22, (Released:2022-09-21)

参考文献数

17

---

Objective Considering the possibility that eosinophilic inflammation is involved in the pathogenesis of chronic epipharyngitis, this study determined whether or not the exhaled nitric oxide level of patients changed after epipharyngeal abrasive therapy (EAT). The diagnosis and follow-up of patients with chronic epipharyngitis were based on the endoscopic findings. If the exhaled nitric oxide level reflects the pathology of a patient with chronic epipharyngitis, the exhaled nitric oxide test can be performed for a follow-up examination as an objective test for chronic epipharyngitis. Methods The study period was 12 months, starting from February 2020. The age distribution and patients' median age and gender were retrospectively reviewed using medical records. Exhaled nitric oxide levels were measured before and after endoscopic EAT at the initial examination and before and after blind EAT at the follow-up examination. Patients or Materials Ninety-six new patients were included in this study. Results The study included 27 men and 69 women (median age [range], 45 [17-82] years old). When patients with chronic epipharyngitis were treated using EAT, exhaled nitric oxide levels were significantly lower after EAT than before EAT at the initial visit. Six months after EAT, the exhaled nitric oxide level was significantly lower than that at the initial visit. Conclusion During the follow-up examination of patients with chronic epipharyngitis, the exhaled nitric oxide test may be an effective objective test, along with changes in endoscopic findings.

著者

Shin Takayama Tetsuhiro Yoshino Sayaka Koizumi Yasuhito Irie Tomoko Suzuki Susumu Fujii Rie Katori Mosaburo Kainuma Seiichi Kobayashi Tatsuya Nogami Kenichi Yokota Mayuko Yamazaki Satoko Minakawa Shigeki Chiba Norio Suda Yoshinobu Nakada Tatsuya Ishige Hirofumi Maehara Yutaka Tanaka Mahiko Nagase Akihiko Kashio Kazuhisa Komatsu Makoto Nojiri Osamu Shimooki Kayo Nakamoto Ryutaro Arita Rie Ono Natsumi Saito Akiko Kikuchi Minoru Ohsawa Hajime Nakae Tadamichi Mitsuma Masaru Mimura Tadashi Ishii Kotaro Nochioka Shih-Wei Chiu Takuhiro Yamaguchi Takao Namiki Akito Hisanaga Kazuo Mitani Takashi Ito

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0027-22, (Released:2022-11-02)

参考文献数

41

被引用文献数

1

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Objective Patients in whom coronavirus disease 2019 (COVID-19) was suspected or confirmed between January 1, 2020, and October 31, 2021, were enrolled from Japanese hospitals in this multicenter, retrospective, observational study. Methods Data on the treatment administered (including conventional and Kampo medicine) and changes in common cold-like symptoms (such as fever, cough, sputum, dyspnea, fatigue, and diarrhea) were collected from their medical records. The primary outcome was the number of days without a fever (with a body temperature <37 °C). The secondary outcomes were symptomatic relief and the worsening of illness, defined as the presence of a condition requiring oxygen inhalation. The outcomes of patients treated with and without Kampo medicine were compared. Patients We enrolled 962 patients, among whom 528 received conventional and Kampo treatment (Kampo group) and 434 received conventional treatment (non-Kampo group). Results Overall, after adjusting for the staging of COVID-19 and risk factors, there were no significant between-group differences in the symptoms or number of days being afebrile. After performing propensity score matching and restricting the included cases to those with confirmed COVID-19 who did not receive steroid administration and initiated treatment within 4 days from the onset, the risk of illness worsening was significantly lower in the Kampo group than in the non-Kampo group (odds ratio=0.113, 95% confidence interval: 0.014-0.928, p=0.0424). Conclusion Early Kampo treatment may suppress illness worsening risk in COVID-19 cases without steroid use. Further randomized controlled studies are needed to confirm the clinical benefit of Kampo medicine for COVID-19.

著者

Hiroaki Kawano Nobu Yamamoto Hirokazu Kurohama Shinji Okano Masaya Kurobe Tomohiro Honda Ryohei Akashi Tsuyoshi Yonekura Satoshi Ikeda Koichi Izumikawa Koji Maemura

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0680-22, (Released:2022-11-23)

参考文献数

37

---

A 19-year-old Japanese man was hospitalized for cardiogenic shock 28 days after receiving a second dose of the COVID-19 mRNA-1273 vaccine. He had had a high fever for three days with vomiting and abdominal pain before arriving at our hospital. The patient visited a local hospital and was diagnosed with heart failure and acute appendicitis. An endomyocardial biopsy specimen showed myocarditis. Thereafter, Impella CP left ventricular assist device implantation and venoarterial peripheral extracorporeal membranous oxygenation were initiated immediately along with inotropic support and steroid pulse therapy. Given these findings, he was finally diagnosed with multiple inflammatory syndrome and fulminant myocarditis.

著者

Wataru Takahashi Toshiko Mizuno Kaori Hara Yoshiaki Ara Rikiya Hurutani Toshihiko Agatsuma Minoru Fujimori

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.9699-22, (Released:2022-08-20)

参考文献数

14

被引用文献数

1

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Objectives The influential factors for anti-severe acute respiratory syndrome coronavirus 2 spike protein antibody (S-ab) levels were assessed after the administration of BNT162b2 mRNA coronavirus disease-2019 (COVID-19) vaccine at short and medium terms. Methods A total of 470 healthcare workers (118 males, mean age 41.0±11.9 years) underwent serum S-ab level measurement at 3 and 8 months after two inoculations of BNT162b2 vaccine given 3 weeks apart, who had no history of COVID-19 were enrolled in this study. The changes and differences after vaccination due to gender and adverse reactions of S-ab were analyzed. Results Systemic adverse reactions incidence (48%) was significantly higher after the second dose than after the first dose (8%). S-ab levels decreased as the age increased (from the 20s to 60s) in both measurements. S-ab level 8 months after the second inoculation (median 476.3 [interquartile range {IQR} 322.4-750.6] U/mL) was significantly lower than that after 3 months (977.5 [637.2-1409.0] U/mL; P <0.001). The median decrease rate of S-ab levels in 5 months was 50.3 (IQR 40.3-62.6) % and those differences were not observed among all generations. Gender-associated differences in S-ab levels were not observed; however, a significant relationship between higher S-ab levels and the systemic adverse reactions was observed at both measurements. Conclusions The systemic adverse reaction is an independent factor for higher S-ab levels at short and medium terms after BNT162b2 vaccination as demonstrated in our data.