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Internal Medicine

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https://www.readbyqxmd.com/read/28626196/acute-calcific-prevertebral-tendinitis
#1
Tsuneaki Kenzaka, Ayako Kumabe
No abstract text is available yet for this article.
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626195/pyomyositis-in-a-patient-with-aids
#2
Takashi Shinha
No abstract text is available yet for this article.
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626194/spontaneous-improvement-of-interstitial-pneumonia-with-autoimmune-features
#3
Keishi Oda, Takako Kawaguchi, Minoru Satoh, Kazuhiro Yatera
No abstract text is available yet for this article.
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626193/uremic-tumoral-calcinosis-resolved-by-improvements-in-hyperphosphatemia
#4
Hirofumi Watanabe, Ryo Koda, Noriaki Iino, Ichiei Narita
No abstract text is available yet for this article.
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626192/increased-18-f-fdg-uptake-in-igg4-related-coronary-periarterial-pseudotumor
#5
Yumiko Kanzaki, Hideaki Morita, Nobukazu Ishizaka
No abstract text is available yet for this article.
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626191/hemophagocytic-lymphohistiocytosis-in-a-fatal-case-of-severe-fever-with-thrombocytopenia-syndrome
#6
Ayako Nakano, Hirohisa Ogawa, Yoshinori Nakanishi, Hiromi Fujita, Fumihiko Mahara, Kazuya Shiogama, Yutaka Tsutsumi, Toshiaki Takeichi
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging disease caused by a novel Bunyavirus with a high mortality rate. We herein report a fatal case of an 86-year-old woman with SFTS complaining of a fever, fatigue, and bicytopenia. Her condition deteriorated with rapid progression of bleeding tendency, disturbance of consciousness, and multiple organ failure leading to death on Day 6 of her illness. The histopathological findings in the autopsy revealed marked infiltration of macrophages with hemophagocytosis in the bone marrow, liver, and spleen leading to a diagnosis of hemophagocytic lymphohistiocytosis (HLH)...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626190/miliary-tuberculosis-in-a-young-woman-with-hemophagocytic-syndrome-a-case-report-and-literature-review
#7
Mina Asaji, Kazunori Tobino, Koujin Murakami, Yuki Goto, Takuto Sueyasu, Saori Nishizawa, Kohei Yoshimine, Miyuki Munechika, Yuki Ko, Yuki Yoshimatsu, Kosuke Tsuruno, Hiromi Ide, Hiroyuki Miyajima, Noriyuki Ebi
We herein report a rare case of miliary tuberculosis-associated hemophagocytic syndrome (HPS) complicated with respiratory failure. A 19-year-old Japanese woman with a fever, general malaise, and chest radiograph abnormalities was referred to our hospital. After admission, she developed respiratory failure with pancytopenia. A histological examination of lung and bone marrow biopsy samples revealed noncaseating granulomas without evidence of acid-fast bacilli or lymphoma. In addition, a bone marrow biopsy showed marked histiocyte hyperplasia with hemophagocytosis, and a bronchoalveolar lavage fluid culture grew Mycobacterium tuberculosis...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626189/successful-switch-to-golimumab-for-eosinophilia-and-skin-symptoms-related-to-multiple-biologics-in-a-patient-with-rheumatoid-arthritis
#8
Naoto Azuma, Kiyoshi Matsui, Naoaki Hashimoto, Takahiro Yoshikawa, Hajime Sano
Biologics used in the treatment of rheumatoid arthritis (RA) rarely cause eosinophilia. We herein report a patient with RA being treated with infliximab, adalimumab, and tocilizumab who developed eosinophilia with skin symptoms. Interestingly, the marked eosinophilia and skin symptoms did not reappear after the patient's medication was switched to golimumab. In this case, the presence of biologics-specific antibodies suggested that immunogenicity caused the eosinophilia. Therefore, switching to a biologic with a lower immunogenicity was effective...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626188/discoid-lupus-erythematosus-complicated-with-pregnancy-induced-hemophagocytic-syndrome
#9
Hideto Takada, Naoki Kimura, Yoko Yoshihashi-Nakazato, Kimito Kawahata, Hitoshi Kohsaka
A 35-year-old woman with discoid lupus erythematosus (DLE) was admitted at 11 weeks' gestation with a persistent fever. Laboratory studies revealed pancytopenia, elevated liver enzymes, and hyperferritinemia. Bone marrow aspiration confirmed the diagnosis of hemophagocytic syndrome (HPS). She had no findings of infection or active systemic lupus erythematosus. The administration of high-dose corticosteroids resolved the clinical and laboratory findings. She delivered a healthy baby at 35 weeks' gestation. This case suggests that DLE can be a predisposing factor for pregnancy-induced HPS...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626187/efficacy-of-intravenous-cyclophosphamide-pulse-therapy-for-p-glycoprotein-expressing-b-cell-associated-active-true-renal-lupus-vasculitis-in-lupus-nephritis
#10
Akio Kawabe, Shizuyo Tsujimura, Kazuyoshi Saito, Yoshiya Tanaka
True renal lupus vasculitis (TRLV), a vascular lesion usually associated with proliferative lupus nephritis (LN), is resistant to conventional treatments. The expression of P-glycoprotein (P-gp) on activated lymphocytes causes drug resistance. We herein report a patient with TRLV, minimal change LN, overexpression of P-gp on peripheral B cells, and accumulation of P-gp(+) B cells at the site of TRLV. High-dose corticosteroids combined with intravenous cyclophosphamide pulse therapy resulted in clinical remission and the long-term normal renal function...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626186/reversible-cerebral-vasoconstriction-syndrome-presenting-with-transient-global-amnesia
#11
Kenji Isahaya, Kensuke Shinohara, Masashi Akamatu, Takahiro Shimizu, Kenzo Sakurai, Makoto Shiraishi, Hisanao Akiyama, Yasuhiro Hasegawa
A 65-year-old man who had been diagnosed with transient global amnesia (TGA) 15 years previously was admitted to hospital with complaints of amnesia and headache. His symptoms improved on day-2. The initial brain MRI and electroencephalography findings were normal. He was diagnosed with a recurrence of TGA and discharged. However, he returned with right leg weakness and complained of a thunderclap headache. MRI demonstrated subarachnoid hemorrhage and multifocal segmental narrowing of the left posterior cerebral artery (PCA) and large intracranial arteries, and he was diagnosed with reversible cerebral vasoconstriction syndrome (RCVS)...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626185/miliary-tuberculosis-that-developed-after-intravesical-bacillus-calmette-guerin-therapy
#12
Kyohei Kaburaki, Keishi Sugino, Muneyuki Sekiya, Yujiro Takai, Kazutoshi Shibuya, Sakae Homma
As a treatment for superficial transitional cell carcinoma, Bacillus Calmette-Guerin (BCG) intravesical instillation can rarely cause unpredictable systemic side effects. We describe a patient admitted due to continuous pyrexia and general fatigue. He was previously treated with intravesical BCG. Laboratory data indicated a hepatic disorder, and chest computed tomography revealed extensive bilateral miliary nodules. Transbronchial lung biopsy specimens showed several small noncaseating granulomas. The diagnosis was unsolved on the basis of acid fast staining, polymerase chain reaction and microbiological cultures, so we considered the possibility of BCG side effect-induced granuloma...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626184/a-16-year-follow-up-case-of-interstitial-pneumonia-with-systemic-sclerosis-rheumatoid-arthritis-overlap-syndrome
#13
Hideaki Yamakawa, Eri Hagiwara, Yumie Yamanaka, Satoshi Ikeda, Akimasa Sekine, Hideya Kitamura, Tomohisa Baba, Koji Okudela, Tae Iwasawa, Tamiko Takemura, Takashi Ogura
Interstitial pneumonia is a common and major comorbidity affecting the prognosis of patients with systemic sclerosis (SSc). However, there are few reported cases of SSc-rheumatoid arthritis (RA) overlap-associated interstitial pneumonia. We herein report a case in which the clinical behavior and histopathology of interstitial pneumonia with SSc-RA overlap syndrome was followed over a long clinical course. When clinicians are deciding on the treatment strategy for patients with SSc-RA overlap syndrome-associated interstitial pneumonia, a pathological examination of a surgical lung biopsy may be useful...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626183/desquamative-interstitial-pneumonia-complicated-with-igg4-related-lung-disease
#14
Hideaki Yamakawa, Yoshihiro Suido, Shinko Sadoyama, Yumie Yamanaka, Satoshi Ikeda, Hideya Kitamura, Tomohisa Baba, Koji Okudela, Tamiko Takemura, Takashi Ogura
As an idiopathic interstitial pneumonia, desquamative interstitial pneumonia (DIP) is an uncommon form of interstitial lung disease and is considered to be a smoking- or dust inhalation-related interstitial pneumonia in the majority of cases. However, the details regarding immunoglobulin G4 (IgG4)-related lung disease remain unclear and controversial. We herein report the first case of DIP complicated with IgG4-related lung disease. Even if a patient has a smoking history, we emphasize the importance of exploring the association between DIP and IgG4-related lung disease to clarify the pathogenesis of these two disorders...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626182/small-cell-lung-cancer-in-a-20-year-old-non-smoking-man-with-systemic-sclerosis
#15
Go Saito, Torahiko Jinta, Hiroshi Nakaoka, Atsushi Kitamura, Kenichi Yamaguchi, Naoki Nishimura
Small cell lung cancer (SCLC) is a neuroendocrine tumor, and the median age of onset is about 70 years old. A 20-year-old non-smoking man with known systemic sclerosis presented with discomfort in his left chest. Chest X-ray showed a mass shadow in the left upper zone. A transbronchial lung biopsy revealed small cell carcinoma, and imaging studies reached the diagnosis of extensive disease small cell lung cancer. He had concurrent interstitial lung disease with a non-specific interstitial pneumonia pattern and anti-Scl-70 antibodies...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626181/long-term-low-density-lipoprotein-apheresis-in-a-patient-with-refractory-idiopathic-membranous-glomerulonephritis
#16
Junko Yabuuchi, Tatsuya Suwabe, Hiroki Mizuno, Toshiharu Ueno, Junichi Hoshino, Akinari Sekine, Masahiro Kawada, Masayuki Yamanouchi, Noriko Hayami, Rikako Hiramatsu, Eiko Hasegawa, Naoki Sawa, Kenmei Takaichi, Takeshi Fujii, Kenichi Ohashi, Yoshifumi Ubara
A 61-year-old Japanese man developed nephrotic syndrome (NS) due to idiopathic membranous glomerulonephritis (MGN). He received immunosuppressive therapy for two years, including prednisolone, cyclophosphamide, and cyclosporine A, but the NS persisted. Low-density lipoprotein apheresis (LDL-A) was initiated at a frequency of twice a month and continued for 9 years (203 sessions in total). His proteinuria reduced to less than 1 g daily after 9 years. LDL-A was stopped, and the NS has not relapsed for five years...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626180/pregnancy-is-a-risk-factor-for-secondary-focal-segmental-glomerulosclerosis-in-women-with-a-history-of-very-low-birth-weight
#17
Mari Tanaka, Sachio Iwanari, Yasushi Tsujimoto, Keisuke Taniguchi, Koichiro Hagihara, Daiki Fumihara, Syo Miki, Saeko Shimoda, Masaki Ikeda, Hiroya Takeoka
Low birth weight (LBW) has been known to increase the susceptibility to renal injury in adulthood. A 26-year-old woman developed proteinuria in early pregnancy; she had been born with very LBW. The clinical course was progressive, and an emergency Caesarean section was performed at 36 weeks due to acute kidney injury. A renal biopsy provided a diagnosis of post-adaptive focal segmental glomerulosclerosis. Increased demand for glomerular filtration during early pregnancy appeared to have initiated the renal injury...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626179/two-patients-with-familial-hypercholesterolemia-who-were-successfully-weaned-from-low-density-lipoprotein-apheresis-after-treatment-with-evolocumab
#18
Akihito Tanaka, Daijo Inaguma, Yu Watanabe, Eri Ito, Naoki Kamegai, Hiroya Shimogushi, Hibiki Shinjo, Kiyomi Koike, Yasuhiro Otsuka, Asami Takeda
Two elderly patients (a 76-year-old man and a 75-year-old woman), who had been previously diagnosed with familial hypercholesterolemia (at 58 and 48 years of age, respectively) underwent long-term treatment with oral therapy and low-density lipoprotein (LDL) apheresis. As their LDL cholesterol levels remained high (>150 mg/dL and >120 mg/dL, respectively) and their familial hypercholesterolemia was complicated with angina pectoris, we added evolocumab to their prescription. Thereafter, their LDL cholesterol levels decreased rapidly, and the patients were successfully weaned from LDL apheresis...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626178/hypoglycemic-coma-induced-by-the-use-of-succinic-acid-cibenzoline-in-frail-late-stage-elderly-subjects
#19
Yurie Hirata, Shinji Kamei, Fuminori Tatsumi, Masashi Shimoda, Akihito Tanabe, Junpei Sanada, Yoshiro Fushimi, Shintaro Irie, Tomoatsu Mune, Kohei Kaku, Hideaki Kaneto
Succinic acid cibenzoline (CZ) is an antiarrhythmic agent often used for the treatment of tachyarrhythmia. However, hypoglycemia should be avoided in the treatment of diabetes. We herein report two late-stage elderly subjects who experienced a severe and prolonged hypoglycemic coma after the usage of CZ. These cases suggest that, when CZ is administered to elderly subjects with renal dysfunction and/or frailty, we should be aware of the possibility that this medicine may induce hypoglycemia and should adjust the dose as appropriate and monitor the concentration of CZ to avoid severe hypoglycemia...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626177/recurrence-30-years-after-surgical-resection-of-a-localized-rectal-neuroendocrine-tumor
#20
Yasuyuki Shigematsu, Hiroaki Kanda, Tsuyoshi Konishi, Yutaka Takazawa, Yosuke Inoue, Tetsuichiro Muto, Yuichi Ishikawa, Shunji Takahashi
Localized small rectal neuroendocrine tumors (NETs) without any vascular involvement rarely metastasize, and their resection alone is considered curative. We herein report a case of localized rectal NET (10×8 mm) without vascular involvement. Although resected initially, it recurred as liver metastasis 30 years later. For rectal NETs smaller than 10 to 20 mm, surveillance for 12 months is considered sufficient. However, this case suggests that such tumors can recur even 30 years after curative resection. The interval of recurrence is the longest among reported cases...
2017: Internal Medicine
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