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Internal Medicine

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https://www.readbyqxmd.com/read/28090064/purpura-fulminans-associated-with-overwhelming-postsplenectomy-infection
#1
Kazuya Sakai, Akira Kuriyama
No abstract text is available yet for this article.
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090063/mycotic-aneurysm-of-a-persistent-sciatic-artery
#2
Mayu Hikone, Kenichi Ariyada, Ken-Ichiro Kobayashi
No abstract text is available yet for this article.
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090062/ankylosis-of-the-finger-in-erosive-osteoarthritis
#3
Naoho Takizawa, Takuya Hamada, Yoshiro Fujita
No abstract text is available yet for this article.
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090061/umbilical-plaque-in-psoriatic-arthritis
#4
Takao Nagashima, Seiji Minota
No abstract text is available yet for this article.
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090060/medullary-nephrocalcinosis-in-a-furosemide-abuser
#5
Nobutaka Hirooka, Mai Tahara, Koichi Takebayashi
No abstract text is available yet for this article.
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090059/isolated-bilateral-coronary-ostial-stenosis-in-beh%C3%A3-et-s-disease
#6
Toshiki Sawai, Tetsushiro Takeuchi, Masaaki Ito
No abstract text is available yet for this article.
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090058/herpes-simplex-encephalitis-complicated-by-cerebral-hemorrhage-during-acyclovir-therapy
#7
Yukinori Harada, Yuuta Hara
Herpes simplex encephalitis (HSE) can be complicated by adverse events in the acute phase. We herein present the case of a 71-year-old woman with HSE complicated by cerebral hemorrhage. She presented with acute deterioration of consciousness and fever and was diagnosed with HSE based on the detection of herpes simplex virus-1 in the cerebrospinal fluid by a polymerase chain reaction. The cerebral hemorrhage developed during acyclovir therapy; however, its diagnosis was delayed for 2 days. After the conservative treatment of the cerebral hemorrhage, the patient made a near-complete recovery...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090057/the-first-case-report-of-acute-cholangitis-and-bacteremia-due-to-neisseria-subflava
#8
Yoshifumi Uwamino, Kayoko Sugita, Eisuke Iwasaki, Hiroshi Fujiwara, Tomoyasu Nishimura, Naoki Hasegawa, Satoshi Iwata
We herein report a case of acute cholangitis and bacteremia caused by a commensal Neisseria species, Neisseria subflava, in an 82-year-old man with cholangiocarcinoma. Emergency endoscopic nasobiliary drainage and cefoperazone/sulbactam therapy were effective. Gram negative coccobacilli were isolated from both blood and bile cultures on 5% sheep blood agar. The isolate was identified as N.subflava biovar perflava by mass spectrometry, a sequence analysis of the 16S rRNA, and biochemical testing. Although biliary infections due to commensal Neisseria are extremely rare, this case demonstrates the possibility of its occurrence in patients undergoing bile duct treatment...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090056/suspected-pulmonary-infection-with-trichoderma-longibrachiatum-after-allogeneic-stem-cell-transplantation
#9
Tomoaki Akagi, Chizuko Kawamura, Norio Terasawa, Kohei Yamaguchi, Kohmei Kubo
Aspergillus and Candida species are the main causative agents of invasive fungal infections in immunocompromised human hosts. However, saprophytic fungi are now increasingly being recognized as serious pathogens. Trichoderma longibrachiatum has recently been described as an emerging pathogen in immunocompromised patients. We herein report a case of isolated suspected invasive pulmonary infection with T. longibrachiatum in a 29-year-old man with severe aplastic anemia who underwent allogeneic stem cell transplantation...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090055/natalizumab-is-effective-for-the-treatment-of-relapsing-remitting-tumefactive-multiple-sclerosis
#10
Masataka Nakamura, Kumi Itani, Kousuke Miyake, Takenobu Kunieda, Satoshi Kaneko, Hirofumi Kusaka
We herein report the case of a 57-year-old woman presenting with a biopsy-proven tumefactive demyelinating lesion as her first clinical event. Subsequently, she displayed a relapsing-remitting course with recurrence of large demyelinating lesions exceeding 2 cm in diameter rather than the small ovoid lesions characteristic of multiple sclerosis. Administration of interferon beta did not suppress the disease activity. Finally, treatment with natalizumab, which is a humanized monoclonal antibody against the cell-adhesion molecule α4-integrin, was initiated, resulting in clinical and radiological stabilization...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090054/hemoglobin-kansas-as-a-rare-cause-of-cyanosis-a-case-report-and-review-of-the-literature
#11
Yoshikuni Nagayama, Minoru Yoshida, Tadashi Kohyama, Katsuyuki Matsui
Hemoglobin (Hb) Kansas is an inherited Hb variant with a low oxygen affinity that is associated with low oxygen saturation on pulse oximetry (SpO2). It leads to asymptomatic cyanosis. Patients with Hb Kansas do not require any specific treatment and the prognosis is good. In patients with unexplained cyanosis, we should thus consider Hb variants, including Hb Kansas and avoid unnecessary investigations and managements. We herein report the case of 65-year-old woman with Hb Kansas and review five other cases (three lineages) that have been reported in Japan...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090053/a-suspected-case-of-an-alveolar-haemorrhage-caused-by-dasatinib
#12
Yoritake Sakoda, Yojiro Arimori, Masakatsu Ueno, Takafumi Matsumoto
A 39-year-old man treated with dasatinib for chronic myelogenous leukaemia presented to our hospital with haemoptysis, coughing, and dyspnoea. Chest radiography and computed tomography revealed ground-glass opacities and a crazy-paving pattern. Bronchoalveolar lavage was not performed due to serious hypoxemia and bleeding. Significant bleeding from the peripheral bronchi led to a diagnosis of an alveolar haemorrhage. Dasatinib-induced alveolar haemorrhaging was suspected based on the clinical findings. His condition improved immediately after dasatinib withdrawal and initiation of steroid therapy...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090052/interstitial-pneumonia-associated-with-the-influenza-vaccine-a-report-of-two-cases
#13
Makoto Hibino, Tetsuri Kondo
Although the influenza vaccine is relatively safe and effective, serious complications can develop in rare cases. We encountered two cases of interstitial pneumonia that developed after vaccination during the 2014-2015 influenza season. Overall, nine cases, including the two presented here, have been recorded in PubMed and the Cochrane library; eight patients were treated with corticosteroids, and all nine survived, suggesting a good prognosis. Interstitial pneumonia is rare; however, we found an increase in its incidence after 2009...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090051/different-effects-of-tolvaptan-in-patients-with-idiopathic-membranous-nephropathy-with-nephrotic-syndrome
#14
Atsushi Tanaka, Tsukasa Nakamura, Eiichi Sato, Yoshihiko Ueda, Koichi Node
This case report discusses the clinical indication for immunosuppressants in patients with idiopathic membranous nephropathy (IMN). Because this disease occasionally shows spontaneous remission, it is necessary to determine the predictive values for a therapeutic effect in order to provide appropriate treatment. Two distinct cases described herein illustrate the different effects of tolvaptan in responders and non-responders, according to the pre-treatment levels of AQP-2 immunostaining in the samples from renal biopsy and urinary levels of AQP-2 and osmolality, suggesting that these values may be useful predictors of response to tolvaptan in patients with nephrotic IMN...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090050/euglycemic-diabetic-ketoacidosis-with-persistent-diuresis-treated-with-canagliflozin
#15
Junichiro Adachi, Yuusuke Inaba, Chisato Maki
Diabetic ketoacidosis is characterized by hyperglycemia, anion-gap acidosis, and increased plasma ketones. After the resolution of hyperglycemia, persistent diuresis is rare. We herein report the case of a 27-year-old Asian woman with type 2 diabetes who was treated with a sodium-glucose cotransporter 2 (SGLT2) inhibitor (canagliflozin) who developed euglycemic diabetic ketoacidosis and persistent diuresis in the absence of hyperglycemia. Physicians should consider euglycemic diabetic ketoacidosis in the differential diagnosis of patients treated with SGLT2 inhibitors...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090049/thyroid-storm-precipitated-by-diabetic-ketoacidosis-and-influenza-a-a-case-report-and-literature-review
#16
Toshiyuki Ikeoka, Hiroaki Otsuka, Naruhiro Fujita, Yukiko Masuda, Shigeto Maeda, Ichiro Horie, Takao Ando, Norio Abiru, Atsushi Kawakami
A 46-year-old woman with a history of Graves' disease presented with the chief complaints of appetite loss, weight loss, fatigue, nausea, and sweating. She was diagnosed with diabetic ketoacidosis (DKA), thyroid storm, and influenza A. She was treated with an intravenous insulin drip, intravenous fluid therapy, intravenous hydrocortisone, oral potassium iodine, and oral methimazole. As methimazole-induced neutropenia was suspected, the patient underwent thyroidectomy. It is important to maintain awareness that thyroid storm and DKA can coexist...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090048/hyponatremia-in-an-elderly-patient-due-to-isolated-hypoaldosteronism-occurring-after-licorice-withdrawal
#17
Yuji Hataya, Akifumi Oba, Takafumi Yamashita, Yasato Komatsu
Hyponatremia is one of the most common electrolyte disorders encountered in the elderly. We present the case of an 81-year-old man who developed hyponatremia due to isolated hypoaldosteronism occurring after licorice withdrawal. He had severe hypokalemia with hypertension and was diagnosed with pseudoaldosteronism. He had been taking a very small dose of licorice as a mouth refresher since his early adulthood. Five months after licorice withdrawal, he developed hypovolemic hyponatremia, which was resolved with administration of fludrocortisone acetate...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090047/platypnea-orthodeoxia-syndrome-in-a-patient-with-an-atrial-septal-defect-the-diagnosis-and-choice-of-treatment
#18
Shuichiro Kazawa, Takashi Enomoto, Naomasa Suzuki, Tomoyasu Koshikawa, Yuka Okubo, Shinpei Yoshii, Masahito Sato, Masaaki Okabe, Akira Yamashina, Yoshifusa Aizawa
A 77-year-old woman developed dyspnea over three years which occurred during sitting, standing or walking. Her physical examination, chest X-ray, ECG and cardiac catheterization results were all normal. A marked fall in arterial oxygen saturation was observed on sitting or standing. Transesophageal echocardiography showed an increase of right to left shunt flow on sitting. The patient was diagnosed with platypnea-orthodeoxia syndrome and underwent the surgical closure of an atrial septal defect of 19 mm in diameter...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090046/an-isolated-case-of-late-onset-amyloidogenic-transthyretin-type-familial-amyloid-polyneuropathy-associated-with-a-mutant-transthyretin-substituting-methionine-for-valine-at-position-30-showing-latent-progressive-cardiac-involvement-confirmed-by-serial-annual
#19
Chikako Sato, Tomofumi Takaya, Shumpei Mori, Kohei Hasegawa, Fumitaka Soga, Hidekazu Tanaka, Yoshiaki Watanabe, Tatsuya Nishii, Atsushi K Kono, Yukiko Morinaga, Hatsue Ishibashi-Ueda, Ken-Ichi Hirata
Late-onset amyloidogenic transthyretin (ATTR) type familial amyloid polyneuropathy (FAP) shows features distinct from those of early-onset hereditary ATTR type FAP. We herein describe an asymptomatic 68-year-old man with late-onset ATTR type FAP whose serial annual electrocardiograms demonstrated progressive left bundle branch block. Latent but severe cardiac involvement seems to be one feature of late-onset ATTR type FAP, similar to senile systemic amyloidosis (SSA). Early differential diagnosis of late-onset ATTR type FAP from SSA is important because, currently, only the former has new therapeutic options available in Japan...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090045/a-pitfall-in-the-diagnosis-of-eosinophilic-myocarditis-in-a-patient-who-received-steroid-therapy
#20
Yusuke Watanabe, Hiroshi Wada, Kenichi Sakakura, Hideo Fujita, Shin-Ichi Momomura
Eosinophilic myocarditis is a rare form of myocardial inflammation that is characterized by the infiltration of eosinophilic cells into the myocardium. The clinical symptoms of eosinophilic myocarditis are similar to those of acute coronary syndrome, and eosinophilic myocarditis sometimes occurs in combination with bronchial asthma. We herein present a case of eosinophilic myocarditis in which additional time was required to make a definitive diagnosis because the patient received steroid therapy. The diagnosis of eosinophilic myocarditis is challenging, especially when a patient has other inflammatory diseases, such as bronchial asthma...
2017: Internal Medicine
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