著者

Kenta Hayashino Yusuke Meguri Aya Komura Chisato Matsubara Yutarou Shiraishi Chikamasa Yoshida Kazuhiko Yamamoto Kenji Imajo

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.8122-21, (Released:2021-11-13)

参考文献数

14

---

Scurvy is a rare disease caused by a vitamin C deficiency. Vitamin C is a water-soluble vitamin found in vegetables and fruits, but it is lost after boiling. A 59-year-old man presented with gingival pain after having a tooth extracted five years previously. Following the procedure, his diet comprised boiled vegetables to prevent pain. He then experienced bilateral lower leg pain, and computed tomography revealed intramuscular bleeding. His serum vitamin C level was below the detectable limit. His symptoms immediately improved with vitamin C administration. This case emphasized that consuming only boiled vegetables can lead to the onset of scurvy.

著者

Arisa Hamahata Seiya Mitsusada Tomoyuki Iwata Ken Nakajima Yuki Ogawa Akira Miyazaki Marina Kobayashi Yushi Fujiwara Yu Asano Kazuhisa Mabuchi Miki Yoshida Ayako Misawa

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.60, no.21, pp.3435-3440, 2021-11-01 (Released:2021-11-01)

参考文献数

22

被引用文献数

1

---

A 79-year-old man with underlying alcoholic liver cirrhosis presented with complaints of a fever, abdominal pain, and difficulty walking. A diagnostic work-up revealed liver atrophy and chylous ascites, and spontaneous bacterial peritonitis (SBP) was diagnosed based on the cell and neutrophil counts. The Burkholderia cepacia complex (Bcc) was detected on blood and ascitic fluid cultures. Although broad-spectrum antibiotic therapy was initiated, the infection was difficult to control, and the patient died of multiple organ failure. Bcc is often multidrug-resistant and difficult to treat. SBP caused by Bcc has been rarely reported and may have a serious course, thus necessitating caution.

著者

Akihiro Kotani Yasuhiro Oda Yosuke Hirakawa Motonobu Nakamura Yoshifumi Hamasaki Masaomi Nangaku

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.60, no.21, pp.3447-3452, 2021-11-01 (Released:2021-11-01)

参考文献数

16

被引用文献数

1

---

A 77-year-old man developed peritoneal dialysis-related peritonitis caused by Streptococcus oralis, a rare pathogen causing the disease. The infection, which was not controlled by one-week intraperitoneal administration of cefazolin and ceftazidime, was cured only after switching to two-week intravenous administration of cefazolin and ceftazidime. The patient had no major dental disease or recent history of dental intervention. This case suggests that S. oralis might cause peritoneal dialysis-related peritonitis with persistent systemic inflammation via an extra-oral infection route. The clinical course is discussed along with a review of the literature.

著者

Hayato Yamana Sachiko Ono Nobuaki Michihata Taisuke Jo Hideo Yasunaga

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.60, no.21, pp.3401-3408, 2021-11-01 (Released:2021-11-01)

参考文献数

29

被引用文献数

4

---

Objective Maoto is a traditional Japanese Kampo formula used to treat influenza. However, clinical evidence for maoto has been limited to small-scale studies of its effect in alleviating symptoms. The present study evaluated whether or not the addition of maoto to a neuraminidase inhibitor was associated with a reduction in hospitalization following influenza. Methods Using the JMDC Claims Database, we identified outpatients <60 years old who were diagnosed with influenza by an antigen test from September 2013 to August 2018. One-to-five propensity score matching was conducted between patients who received maoto in addition to a neuraminidase inhibitor and those who received a neuraminidase inhibitor alone. Hospitalization within seven days of the influenza diagnosis was compared in the matched groups using the Mantel-Haenszel test. Results We identified 1.79 million cases of influenza from the database in the 5-year study period. Maoto was prescribed for 3.9% of the 1.67 million cases receiving a neuraminidase inhibitor. In the 64,613 propensity score-matched groups of patients, the 7-day hospitalization rate was 0.116% (n=75) for patients with maoto and 0.122% (n=394) for patients without maoto. The difference between these treatment groups was nonsignificant (common odds ratio, 0.95; 95% confidence interval, 0.74 to 1.22; p=0.695). Conclusion The addition of maoto to a neuraminidase inhibitor was not associated with a decrease in hospitalization among nonelderly patients with influenza. Further research is necessary to clarify the indication and efficacy of maoto.

著者

Tomonori Nakazato Kazuhito Suzuki Ai Mihara Yukinari Sanada Tsunayuki Kakimoto

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.48, no.24, pp.2157-2158, 2009 (Released:2009-12-15)

参考文献数

2

被引用文献数

1

著者

Chie Watanabe Yoshifumi Kimizuka Yuji Fujikura Takaaki Hamamoto Akira Watanabe Takashi Yaguchi Tomoya Sano Ryohei Suematsu Yoshiki Kato Jun Miyata Susumu Matsukuma Akihiko Kawana

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.7639-21, (Released:2021-10-26)

参考文献数

29

被引用文献数

3

---

A 69-year-old woman who had undergone renal transplantation and was receiving sulfamethoxazole/trimethoprim (ST) developed pulmonary nocardiosis. To our knowledge, this is the first report of the identification of Nocardia elegans using nanopore sequencing, supported by 16S rDNA capillary sequencing findings. Chest computed tomography performed after ST initiation revealed significant improvement of the pulmonary shadows compared to previous findings. We herein report the value of nanopore sequencing for rapid identification of rare pathogens, such as Nocardia elegans. Furthermore, our findings suggest that Nocardia may infect even patients receiving ST, which is currently the most effective prophylactic drug.

著者

Nobukazu Ishizaka

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.59, no.19, pp.2453, 2020-10-01 (Released:2020-10-01)

参考文献数

5

著者

Kiyozumi Suzuki Hiromasa Otsuka

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.7771-21, (Released:2021-10-12)

参考文献数

2

被引用文献数

2

著者

Satoshi Kurahashi Naohiro Toda Masaaki Fujita Katsuya Tanigaki Jun Takeoka Hisako Hirashima Eri Muso Katsuhiro Io Takaki Sakurai Toshiyuki Komiya

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.8046-21, (Released:2021-09-18)

参考文献数

20

被引用文献数

1

---

Rosai-Dorfman-Destombes disease (RDD) is a non-Langerhans cell histiocytosis characterized by the accumulation of histiocytes inside the lymph nodes or extranodally. The association between RDD and IgG4-related disease (IgG4-RD) is discussed. We herein report a case of RDD manifesting as acute tubulointerstitial nephritis mimicking IgG4-RD. The first renal biopsy showed severe tubulointerstitial nephritis with infiltration of S100-positive histiocytes and IgG4-positive plasma cells; storiform fibrosis and obliterative phlebitis were not confirmed. After prednisolone therapy, IgG4-positive cells and S100-positive histiocytes were decreased, but the IgG4/IgG ratio increased despite clinical improvement. These findings indicated extranodal RDD in the kidney presenting as tubulointerstitial nephritis.

著者

Kanji IGA Kenjiro HORI

出版者

The Japanese Society of Internal Medicine

雑誌

Japanese Journal of Medicine (ISSN:00215120)

巻号頁・発行日

vol.29, no.3, pp.305-308, 1990 (Released:2006-03-27)

参考文献数

6

被引用文献数

3 4

---

A case of tetanus accompanied by severe reversible left ventricular motion impairment is reported. Emergent coronary angiography showed no abnormalities and large akinesis was present on left ventriculography. The plasma catecholamine level was not too high in the acute phase, therefore it is thought that the cause of this depressed left ventricular wall motion abnormality was due to some metabolite derived from tetanus.

著者

Motoyasu Kusano Fumitaka Moki Hiroko Hosaka Yasuyuki Shimoyama Osamu Kawamura Atsuto Nagoshi Masaki Maeda Shikou Kuribayashi Hiroaki Zai Masafumi Mizuide Tsutomu Horikoshi Masatomo Mori Masako Akuzawa

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.50, no.7, pp.667-671, 2011 (Released:2011-04-01)

参考文献数

20

被引用文献数

7 8

---

Objective Gastroptosis is recognized by its characteristic appearance on barium studies. The present prospective study assessed the relationship between gastroptosis and dyspeptic symptoms. Methods Japanese subjects underwent health screening, and gastroptosis was diagnosed by barium studies. Consecutive subjects (500 women and 167 men) with gastroptosis were identified and the same number of age-matched subjects without gastroptosis were selected as controls. Dyspepsia was classified as reflux-like (heartburn and belching), dysmotility-like (bloating and fullness), or ulcer-like dyspepsia (epigastralgia) based on the Rome II criteria. Results Body mass index was significantly lower in women with gastroptosis than in controls [19.7±1.83 (SD) vs. 23.4±3.70, p<0.0001], and also in men (19.7±2.00 vs. 23.9±2.89, p<0.0001). The incidence of dyspepsia was significantly lower in women with gastroptosis than in controls (56/500 vs. 87/500, p<0.01) and also in men (10/167 vs. 25/167, p<0.05), especially in women with ulcer-like dyspepsia (15/500 vs. 32/500, p<0.05) and in men with reflux-like dyspepsia (2/167 vs. 12/167, p<0.05). By logistic regression analysis, gastroptosis was associated with a lower risk of dyspepsia (odds ratio: 0.62, 95% CI: 0.405-0.941, p=0.025) and ulcer-like dyspepsia (odds ratio: 0.36, 95% CI: 0.177-0.726, p=0.004) in women. Conclusion Dyspeptic symptoms were significantly less common in subjects with gastroptosis. Accordingly, gastroptosis may protect against dyspeptic symptoms, rather than causing functional dyspepsia.

著者

Hideto Kajitani Hiroki Nishiwaki Toshiharu Ueno Fumihiko Koiwa Shigeki Iwasaki Satoshi Hirade

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.7823-21, (Released:2021-09-25)

参考文献数

13

---

A 64-year-old Japanese man who worked at a butcher shop was hospitalized for a fever, headache, and deafness. We diagnosed him with sepsis and meningitis caused by Streptococcus suis infection. The patient's renal function declined rapidly, and hemodialysis was performed temporarily. A renal biopsy was performed, and the renal function tended to improve with antimicrobial therapy. This case seemed rather similar to one of staphylococcal-associated nephritis in that it showed mesangial proliferative nephritis with IgA deposition, even though the nephritis was caused by streptococci. Similarly, intramembranous electron-dense deposits were characteristic findings. We present new findings of an in vivo renal biopsy in a case of S. suis-associated glomerulonephritis.

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

Kengo Furuichi Miho Shimizu Akinori Hara Tadashi Toyama Takashi Wada

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.57, no.23, pp.3345-3350, 2018-12-01 (Released:2018-12-01)

参考文献数

23

被引用文献数

3 22

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Diabetic kidney disease is the main cause of end-stage kidney disease. However, the clinical manifestations of diabetic kidney disease are diverse. Therefore, the clinical classification of diabetic kidney disease is clinically important and valuable. In Japan, two clinical staging systems divided by the estimated glomerular filtration rate (eGFR) and albuminuria can be used for diabetic kidney disease: the chronic kidney disease (CKD) risk classification and the Japanese classification of diabetic nephropathy. The Japanese classification of diabetic nephropathy and the CKD risk classification are similar; however, these two classification systems show different frequencies of outcomes. For example, the frequency of the kidney outcomes in stage 4 of the Japanese classification of diabetic nephropathy was found to be higher than that in the red stage of the CKD risk classification (composite kidney events: stage 4=32.0/100 person-years, red =14.5/100 person-years). However, there were no marked differences in the speed or rate of decline in the kidney function (speed: stage 4=6.8 mL/min/1.73 m2/year, red =5.8 mL/min/1.73 m2/year; rate: stage 4=38.8%/year, red =34.3%/year) or in the pathological changes between the two classifications. These data indicate that each stage of these clinical classification systems has characteristic clinical and pathological features. Therefore, it is important to understand each characteristic feature and use each classification system appropriately.

著者

Emi Tanaka Naohiro Oda Sayo Kobayashi Tsuneyoshi Ogawa Reo Mitani Toru Nawa Ichiro Takata Toru Ueki Hiroyuki Okada

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.8214-21, (Released:2021-09-11)

参考文献数

13

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An 80-year-old man underwent follow-up examinations after endoscopic submucosal dissection (ESD) for esophageal cancer. Computed tomography (CT) showed enlarged lymph nodes of the right recurrent nerve. The patient had esophageal stenosis due to repeated ESD for multiple esophageal tumors. The stenosis made the passage of an endoscopic ultrasound (EUS) scope through the esophagus difficult. Thus, an endobronchial ultrasound bronchoscope, which had a thinner diameter than that of the EUS scope, was used for transesophageal endoscopic ultrasound with bronchoscope-guided fine-needle aspiration. This technique led to the diagnosis of mediastinal lymph node metastasis of esophageal cancer.

著者

Masayuki KIKAWADA Daisuke WATANABE Akihiro KIMURA Haruo HANYU Hiromi SERIZAWA Toshihiko IWAMOTO

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.44, no.12, pp.1312-1315, 2005 (Released:2006-01-17)

参考文献数

23

被引用文献数

4 6

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Primary Sjögren’s syndrome is an autoimmune disease characterized by lymphocytic infiltration of the salivary glands and lacrimal glands. The histological features of chronic inflammation in primary Sjögren’s syndrome may be associated with B cell hyper-reactivity. This syndrome also has various manifestations associated with other exocrine glands and nonglandular tissues. The hematological abnormalities usually seen in Sjögren’s syndrome are lymphopenia, leucopenia, and thrombocytopenia. Although the direct Coomb’s test is often positive, the occurrence of autoimmune hemolytic anemia (AIHA) is rare. Here, we report an elderly patient with primary Sjögren’s syndrome who developed AIHA during the clinical course.

著者

Naoto Ishimaru Yohei Kanzawa Hiroyuki Seto Saori Kinami

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.58, no.15, pp.2251-2255, 2019-08-01 (Released:2019-08-01)

参考文献数

17

被引用文献数

2 3

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We herein report a patient with syphilitic cervicitis and cervical cancer presenting as oropharyngeal syphilis. A 31-year-old Japanese woman with a history of unprotected vaginal and oral sex visited our hospital with right submandibular adenomas and erythema in the extremities. The fornix uteri was red, with a nodule noted. The rapid plasma reagin ratio was 1:3. She was diagnosed with syphilitic cervicitis and treated with amoxicillin for four weeks. Initial cervical cytology showed cells with mild nuclear enlargement, which was thought to be metaplasia associated with syphilis. Repeated cytology a month later showed a high-grade squamous intraepithelial lesion. A punch biopsy of the lesion led to the pathological diagnosis of cervical carcinoma in situ. We performed cervical conization, and no recurrence occurred. Human papillomavirus (HPV) immunostaining was positive in the lesion. Mucosal lesions are an infrequently reported symptom of syphilis. When oropharyngeal lesions are found, the sexual history should be ascertained, and the patient should be screened for sexually transmitted diseases. HPV is especially significant because of its association with cervical cancer. Coinfection of HPV with cervical cancer must be ruled out during follow-up for women when oropharyngeal syphilis involves genital lesions.

著者

Katsuhisa Kuwano Yuki Ota Kiyokazu Tsuji Kenta Torigoe Ayuko Yamashita Kumiko Muta Mineaki Kitamura Hiroshi Yamashita Tadashi Uramatsu Masato Tashiro Hiroko Hayashi Koichi Izumikawa Hiroshi Mukae Tomoya Nishino

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.7332-21, (Released:2021-08-13)

参考文献数

18

被引用文献数

3

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A 68-year-old woman developed systemic blisters while receiving treatment for nephrotic syndrome. As she also developed marked liver dysfunction and disseminated intravascular coagulation, she was admitted to our hospital. She was diagnosed with varicella zoster virus (VZV) infection. Treatment was administered in the intensive-care unit, but the patient died on day 24 post-admission after severe VZV infection. A post-mortem examination showed micro-abscesses and necrosis caused by varicella zoster infection in multiple organs, including the liver, kidneys, and gastrointestinal tract. Because VZV infection can become severe in immunocompromised patients, careful consideration is needed for the prevention and treatment of the viral infection.

著者

Takeshi Mochizuki Koichiro Yano Katsunori Ikari Ken Okazaki

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.2585-2591, 2021-08-15 (Released:2021-08-15)

参考文献数

29

被引用文献数

3

---

Objectives We aimed to investigate the safety of zoledronic acid (ZOL) combined with acetaminophen (APAP) regarding both the adverse events and the efficacy of ZOL combined with an eldecalcitol (ELD) in a randomized clinical trial conducted in patients with primary osteoporosis. Methods A total of 109 patients were administered ZOL 5 mg and then were randomly assigned to the following groups (3:2:1): those treated with ZOL, those treated with ZOL combined with APAP and ELD, and those treated with ZOL combined with ELD. For the analyses, the groups were classified into four treatment groups: patients treated with APAP (APAP group) and without APAP (non-APAP group), and those treated with ELD (ELD group) and without ELD (non-ELD group). The incidence rates of symptomatic adverse events were compared between the APAP and non-APAP groups, and the efficacy was compared between the ELD and non-ELD groups. Results In the APAP and non-APAP groups, the incidence rates of symptomatic adverse events were 20.6% and 44.6% (p=0.009), respectively. Age and APAP use were found to be significant factors associated with adverse events. The percent changes in the bone mineral density values from baseline (ΔBMD) in the ELD and non-ELD groups at 12 months were 8.2% and 6.2% for the lumbar spine, 4.2% and 4.0% for the total hip, and 3.9% and 2.2% for the femoral neck, respectively. The ΔBMD of all sites did not differ significantly between the ELD and non-ELD groups. Conclusion In ZOL treatment, the co-administration of APAP should thus be considered as a therapeutic option to reduce the occurrence of symptomatic adverse events stemming from ZOL treatment in Japanese patients with primary osteoporosis, particularly in younger patients.

著者

Yasutaka Tsujimoto Tomoaki Nakamura Jun Onishi Naoto Ishimaru Naoko Iwata Haruki Fujisawa Atsushi Suzuki Yoshihisa Sugimura Kazuo Chihara

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.7663-21, (Released:2021-08-06)

参考文献数

26

被引用文献数

2

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A 21-year-old Japanese man without known diabetes mellitus had abdominal pain. The diagnosis was ketoacidosis and hypertriglyceridemia-induced acute pancreatitis. He had polydipsia and polyuria and had habitually drunk several soft drinks every day for two years. After hospitalization, despite adequate liquid intake, dehydration remained with hypotonic polyuria. Further examinations revealed the coexistence of central diabetes insipidus (CDI), possibly caused by lymphocytic infundibulo-neurohypophysitis, based on anti-rabphilin-3A antibody positivity. Although CDI had been undiagnosed for two years, over-consumption of sugar-rich soft drinks to ease thirst caused ketoacidosis, hypertriglyceridemia, and acute pancreatitis. There are no previous reports of this three-part combination of symptoms caused by CDI.