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

被引用文献数

3

---

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

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

被引用文献数

3

---

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

2

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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.

著者

Kenji Sekiguchi Naoko Yasui Hisatomo Kowa Fumio Kanda Tatsushi Toda

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.3181-3184, 2016-11-01 (Released:2016-11-01)

参考文献数

20

被引用文献数

9 11

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We herein present two cases of acute disseminated encephalomyelitis (ADEM) following vaccination against human papilloma virus (HPV). Case 1 experienced diplopia and developed an unstable gait 14 days after a second vaccination of Cervarix. Brain magnetic resonance imaging (MRI) showed an isolated small, demyelinating lesion in the pontine tegmentum. Case 2 experienced a fever and limb dysesthesia 16 days after a second vaccination of Gardasil. Brain MRI revealed hyperintense lesion in the pons with slight edema on a T2-weighted image. Both cases resolved completely. It is important to accumulate further data on confirmed cases of ADEM temporally associated with HPV vaccination.

著者

Satoe Okabayashi Masashi Goto Takashi Kawamura Hidetsuna Watanabe Akira Kimura Reiko Uruma Yuko Takahashi Setsuko Taneichi Manabu Musashi Koichi Miyaki

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.53, no.9, pp.949-956, 2014 (Released:2014-05-01)

参考文献数

23

被引用文献数

6 6

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Objective Kakkonto, a Japanese herbal medicine, is frequently used to treat the common cold not only with a physician's prescription, but also in self-medication situations. This study aimed to examine whether Kakkonto prevents the aggravation of cold symptoms if taken at an early stage of illness compared with a well-selected Western-style multiple cold medicine. Methods This study was a multicenter, active drug-controlled, randomized trial. Adults 18 to 65 years of age who felt a touch of cold symptoms and visited 15 outpatient healthcare facilities within 48 hours of symptoms onset were enrolled. The participants were randomly assigned to two groups: one treated with Kakkonto (Kakkonto Extract-A, 6 g/day) (n=209) and one treated with a Western-style multiple cold medicine (Pabron Gold-A, 3.6 g/day) (n=198) for at most four days. The primary outcome of this study was the aggravation of cold, nasal, throat or bronchial symptoms, scored as moderate or severe and lasting for at least two days within five days after entry into the study. Results Among the 410 enrollees, 340 (168 in the Kakkonto group and 172 in the Pabron group) were included in the analyses. The proportion of participants whose colds were aggravated was 22.6% in the Kakkonto group and 25.0% in the Pabron group (p=0.66). The overall severity of the cold symptoms was not significantly different between the groups. No harmful adverse events occurred in either group. Conclusion Kakkonto did not significantly prevent the progression of cold symptoms, even when prescribed at an early stage of the disease.

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

pp.2551-23, (Released:2023-10-13)

参考文献数

50

被引用文献数

3

---

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 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

Shogo Hanai Mitsunaga Iwata Teruhiko Terasawa

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.2339-18, (Released:2019-06-27)

参考文献数

9

被引用文献数

4

---

Pivoxil-containing cephalosporins can result in symptomatic hypocarnitinemia in children. We herein report a case of an 85-year-old man at risk of carnitine deficiency who developed relapsing symptomatic hypoglycemia after treatment with cefcapene pivoxil for urinary tract infection. On admission, laboratory tests showed low blood carnitine concentrations with low normal blood ketone levels. The patient was successfully treated by the oral administration of levocarnitine and dietary modification, including aggressive consumption of meat and dairy products, and remained symptom-free for nine months after the correction of carnitine concentrations. Healthcare providers should be cautious when prescribing pivoxil-containing antimicrobials to patients at high risk of hypocarnitinemia.

著者

Yoshifumi Yamada Junichi Uchida Hisa Izumi Yoko Tsukamoto Gaku Inoue Yuichi Watanabe Junichiro Irie Satoru Yamada

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.53, no.1, pp.13-19, 2014 (Released:2014-01-01)

参考文献数

26

被引用文献数

7 92

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Objective Although caloric restriction is a widely used intervention to reduce body weight and insulin resistance, many patients are unable to comply with such dietary therapy for long periods. The clinical effectiveness of low-carbohydrate diets was recently described in a position statement of Diabetes UK and a scientific review conducted by the American Diabetes Association. However, randomised trials of dietary interventions in Japanese patients with type 2 diabetes are scarce. Therefore, the aim of this study was to examine the effects of a non-calorie-restricted, low-carbohydrate diet in Japanese patients unable to adhere to a calorie-restricted diet. Methods The enrolled patients were randomly allocated to receive a conventional calorie-restricted diet or low-carbohydrate diet. The patients received consultations every two months from a registered dietician for six months. We compared the effects of the two dietary interventions on glycaemic control and metabolic profiles. Results The HbA1c levels decreased significantly from baseline to six months in the low-carbohydrate diet group (baseline 7.6±0.4%, six months 7.0±0.7%, p=0.03) but not in the calorie-restricted group (baseline 7.7±0.6%, six months 7.5±1.0%, n.s.), (between-group comparison, p=0.03). The patients in the former group also experienced improvements in their triglyceride levels, without experiencing any major adverse effects or a decline in the quality of life. Conclusion Our findings suggest that a low-carbohydrate diet is effective in lowering the HbA1c and triglyceride levels in patients with type 2 diabetes who are unable to adhere to a calorie-restricted diet.

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

pp.9004-21, (Released:2022-02-08)

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 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

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

vol.62, no.10, pp.1547-1551, 2023-05-15 (Released:2023-05-15)

参考文献数

22

被引用文献数

1 9

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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

Madoka Sano Kitae Kim Yutaka Furukawa

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.8826-21, (Released:2021-12-28)

参考文献数

3

著者

Seiji Kobayashi Kazunori Fugo Ryo Hatano Kazuto Yamazaki Chikao Morimoto Hiroyuki Terawaki

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.1027-22, (Released:2023-02-01)

参考文献数

20

被引用文献数

1

---

As coronavirus disease 2019 (COVID-19) vaccine booster campaigns progress worldwide, new reports of complications following COVID-19 vaccination have emerged. We herein report a case of new-onset anti-glomerular basement membrane (GBM) disease concomitant with myeloperoxidase-antineutrophil cytoplasmic antibody positivity concurrent with high levels of interleukin (IL)-26 following the second dose of the Pfizer-BioNTech COVID-19 vaccine. The temporal association with vaccination in this case suggests that an enhanced neutrophilic immune response through IL-26 may have triggered necrotizing glomerulonephritis and a T-cell-mediated immune response to GBMs, leading to the development of anti-GBM antibodies, with an enhanced B-cell response after the vaccination triggering anti-GBM IgG and the onset of anti-GBM disease.

著者

Tsuyoshi Doman Hiroaki Saito Yukari Tanaka Dai Hirasawa Mareyuki Endo Daichi Togo Tomoki Matsuda

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0518-22, (Released:2022-12-28)

参考文献数

39

被引用文献数

3

---

A 61-year-old man presented with a 7-day history of watery diarrhea and loss of appetite after receiving the second dose of the Pfizer-BioNTech Covid-19 vaccine. Laboratory studies showed significant eosinophilia and an elevated IgE level (white cell count, 18.4×109/L; eosinophil count, 9.5×109/L; and IgE level, 540 IU/L). Symptoms resolved 10 days after vaccination without any steroids or antiallergic medications, and the eosinophil count had also returned to within normal limits 2 months later. Several cases of eosinophilic disorders following receipt of any type of injectable COVID-19 vaccine have been reported, so the etiology should be examined.

著者

Takahiro Kanda Kei Tawarahara Naoki Nakamura Yuki Tokonami Hiroyuki Aoshima Gaku Matsukura Masayoshi Matsunari Rumi Takabayashi Mariko Ozeki Hiroshi Ukigai Ryosuke Takeuchi Kazuhiko Takeuchi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.60, no.19, pp.3121-3124, 2021-10-01 (Released:2021-10-01)

参考文献数

14

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Acute type A aortic dissection is a potentially fatal disease, and emergency surgery should be considered when it is diagnosed. We herein report two cases of retrograde type A aortic dissection with intramural hematoma, followed by re-dissection, rupture, and cardiac tamponade. The diagnoses in these cases had to be made carefully, as the false lumen of the ascending aorta was sometimes unclear on contrast-enhanced computed tomography.

著者

Tamaki Koda Bunki Natsumoto Hirofumi Shoda Keishi Fujio

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.1788-23, (Released:2023-07-19)

参考文献数

31

被引用文献数

2

---

Angioedema with eosinophilia (AE) is a rare disease of unknown etiology characterized by episodic (EAE) or nonepisodic AE (NEAE). SARS-CoV-2 mRNA-based vaccines function as immunogens and intrinsic adjuvants and have been shown to be safe in large-scale trials. However, the long-term adverse reactions, especially those related to eosinophilic complications, have not been fully clarified. We herein report a case of self-limited but severe NEAE that developed in a young woman one week after receiving the second BNT162b2 mRNA vaccine. The symptoms that impaired her activities of daily living, such as edema, gradually resolved with supportive care over 10 weeks without corticosteroid treatment.

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

pp.6082-20, (Released:2021-04-26)

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

Satoshi Hamada Naoya Tanabe Toyohiro Hirai

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.5888-20, (Released:2020-12-15)

参考文献数

2

被引用文献数

3

著者

Ryuichiro Hayashi Shigeki Yamaguchi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.2339-23, (Released:2023-08-02)

参考文献数

19

被引用文献数

1

---

A 33-year-old woman developed paresthesia in her right thumb approximately 30 minutes after receiving the BNT162b2 (Pfizer-BioNTech) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. The paresthesia gradually spread to her right-side limbs and trunk, and cervical magnetic resonance imaging (MRI) revealed a localized lesion in the right dorsal column. After glucocorticoid therapy, her symptoms and MRI findings improved. Although disease developing less than 24 h after vaccination is considered an unlikely cause of immuno-associated adverse events following vaccination, we discuss the possible mechanisms involved in early-onset central nervous system inflammation after vaccination in view of preexisting immunopathological susceptibility.

著者

Kikuaki Yoshida Ayaka Sakaki Yoriko Matsuyama Toshiki Mushino Masanori Matsumoto Takashi Sonoki Shinobu Tamura

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.3, pp.407-412, 2022-02-01 (Released:2022-02-01)

参考文献数

28

被引用文献数

1 20

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A 57-year-old man without underlying diseases presented with fatigue, loss of appetite, and jaundice 1 week after receiving the first dose of the BNT162b2 mRNA coronavirus disease 2019 (COVID-19) vaccine and showed hemolytic anemia with fragmented erythrocytes and severe thrombocytopenia 2 weeks after receiving the vaccine. An a disintegrin-like and metalloproteinase with thrombospondin type 1 motifs 13 (ADAMTS13) activity level of <10% and ADAMTS13 inhibitor positivity confirmed the diagnosis of acquired thrombotic thrombocytopenic purpura (TTP). Combination therapy with plasma exchange, corticosteroid, and rituximab improved the clinical outcome. We herein report the first Japanese case of TTP possibly associated with vaccination. Physicians should be alert for this rare but life-threatening hematological complication following COVID-19 vaccination.

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.