Internal Medicine最新文献

{"title":"Cryptococcal Choroid Plexitis and Ependymitis in Progressive Dementia.","authors":"Narumi Okajima, Ryo Ogawa, Juichi Fujimori, Ichiro Nakashima","doi":"10.2169/internalmedicine.4547-24","DOIUrl":"10.2169/internalmedicine.4547-24","url":null,"abstract":"","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"1775-1776"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Fever with Thrombocytopenia Syndrome and Acute Gastric Mucosal Lesions Confirmed Using Esophagogastroduodenoscopy.","authors":"Koki Kitagawa, Mitsuhiro Kitani, Tetsuro Saito, Naoto Yoshitake, Shogo Shirota","doi":"10.2169/internalmedicine.4416-24","DOIUrl":"10.2169/internalmedicine.4416-24","url":null,"abstract":"<p><p>Severe fever with thrombocytopenia syndrome (SFTS) is known to cause gastrointestinal hemorrhaging; however, few reports have so far specified the site of the hemorrhaging or lesion characteristics. A 79-year-old man was admitted to the hospital with fever, anorexia, and diarrhea which was suspected to be due to gastroenteritis. On day 2, the patient developed hematemesis. Esophagogastroduodenoscopy revealed an acute gastric mucosal lesion. Further physical examination revealed an eschar, and the blood test was positive for SFTS virus nucleic acid. This case suggests that SFTS-associated gastrointestinal hemorrhage may be caused by acute gastritis. SFTS should therefore be considered in cases with fever, gastrointestinal symptoms, and thrombocytopenia.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"1673-1676"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enlargement of Gastric Hyperplastic Polyps Arising from Helicobacter heilmannii sensu stricto-infected Mucosa after the Successful Eradication of Helicobacter pylori and the Long-Term Use of a Proton Pump Inhibitor.","authors":"Masayuki Kurimoto, Hajime Honjo, Saki Yoshida, Natsuki Okai, Yasuo Otsuka, Yasuhiro Masuta, Sho Masaki, Ken Kamata, Kosuke Minaga, Osamu Maenishi, Masatoshi Kudo, Tomohiro Watanabe","doi":"10.2169/internalmedicine.4230-24","DOIUrl":"10.2169/internalmedicine.4230-24","url":null,"abstract":"<p><p>Helicobacter pylori eradication is effective for the regression of gastric hyperplastic polyps (GHPs). We report a case which demonstrated an enlargement of GHPs after H. pylori eradication. The patient, who received long-term proton-pump inhibitor (PPI) therapy, lived with a dog, a natural host of Helicobacter heilmanii sensu stricto. Gastric colonization with Helicobacter heilmannii s.s. was observed after H. pylori eradication, thus suggesting the involvement of non-H. pylori Helicobacter species (NHPHs) infection for the enlargement of GHPs, in addition to the proliferative effects of PPI use on the gastric epithelium. Screening for NHPHs may be necessary in dog lovers to avoid paradoxical responses to H. pylori eradication.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"1677-1683"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Factors of Unexpected Hospitalization within Six Months of Undergoing Percutaneous Coronary Intervention in Patients with Chronic Coronary Disease.","authors":"Tetsuo Furukawa, Isamu Mizote, Tatsuya Shiraki, Daisuke Nakamura, Mayu Nishio, Naoki Fukushima, Takashi Kitao, Kensuke Yokoi, Masahiro Kumada, Motoaki Kitagawa, Kunihiko Nagai, Kiyoshi Kume, Keiji Hirooka, Tsutomu Nakagawa, Tohru Ohama, Mitsuyoshi Takahara, Shungo Hikoso, Yasushi Sakata","doi":"10.2169/internalmedicine.3929-24","DOIUrl":"10.2169/internalmedicine.3929-24","url":null,"abstract":"<p><p>Objective Recent guidelines recommend dual antiplatelet therapy (DAPT) for six months following percutaneous coronary intervention (PCI) in patients with chronic coronary disease, as unexpected hospitalization can trigger DAPT discontinuation. This study evaluated the predictive factors for unexpected hospitalization within six months after PCI in patients with chronic coronary disease. Methods This prospective multicenter study included 412 patients who underwent PCI for chronic coronary disease. Unexpected hospitalization was defined as a prolonged hospital stay, unscheduled readmission, and all-cause mortality. The predictive factors for unexpected hospitalization within six months post-PCI were evaluated using the Cox regression model. Results The rate of unexpected hospitalization 6 months after PCI was 10.8%±1.5%. Unexpected hospitalizations due to bleeding events accounted for 12.1% (n=5/41), whereas non-bleeding readmissions accounted for 87.9% (n=36/41). A multivariable analysis revealed that the number of Academic Research Consortium for High Bleeding Risk (ARC-HBR) major criteria met [adjusted hazard ratio (HR), 1.55; 95% confidence interval (CI), 1.05-2.29; p=0.026], body weight (adjusted HR, 2.44; 95% CI 1.33-4.49; p=0.004), and presence of diabetes mellitus (adjusted HR, 1.94; 95% CI 1.09-3.47; p=0.025) were independent risk factors for unexpected hospitalization. Among the major ARC-HBR criteria, oral anticoagulant use (adjusted HR, 2.39; 95% CI, 1.14-5.02, p=0.021) and active malignancy (adjusted HR, 3.85; 95% CI, 1.47-10.05; p=0.006) were significantly associated with unexpected hospitalization after adjusting for a low body weight and diabetes mellitus. Conclusions The majority of unexpected hospitalizations after PCI in patients with chronic coronary disease are attributed to non-bleeding causes. The assessment using major ARC-HBR criteria in these patients not only addresses bleeding risks but also underscores its predictive value in conjunction with a low body weight and diabetes mellitus for the prediction of unexpected hospitalization.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"1640-1647"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creutzfeldt-Jakob Disease Presenting with Alien Hand.","authors":"Sae Ueda, Noriko Arai, Yuji Kato, Satoshi Suda","doi":"10.2169/internalmedicine.4315-24","DOIUrl":"10.2169/internalmedicine.4315-24","url":null,"abstract":"","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"1773-1774"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bortezomib Led to Remission of Immune Thrombocytopenic Purpura in a Patient with Smoldering Multiple Myeloma.","authors":"Akane Yamano, Takayuki Ozawa, Takaya Endo, Midori Koike, Hisashi Kato, Tomoya Takahashi, Ayano Esaki, Hiroaki Masaie, Seiji Tadokoro, Satoru Kosugi, Toru Kida","doi":"10.2169/internalmedicine.4449-24","DOIUrl":"10.2169/internalmedicine.4449-24","url":null,"abstract":"<p><p>A 79-year-old man with smoldering multiple myeloma (MM) developed sudden severe thrombocytopenia and active bleeding. Since anti-GPIIb/IIIa autoantibodies were detected on the platelet surface, thrombocytopenia due to an autoimmune etiology was diagnosed. Although neither steroids nor intravenous immunoglobulins provided improvement, bortezomib provided rapid normalization of the platelet counts with disappearance of the anti-GPIIb/IIIb autoantibodies. MM is rarely associated with immune thrombocytopenic purpura (ITP). Although the underlying pathogenesis of MM and ITP remains elusive, anti-myeloma drugs might be beneficial.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"1733-1736"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double Common Bile Duct with Pancreaticobiliary Maljunction.","authors":"Atsushi Ikehata, Shunsuke Honta, Sadahide Ono","doi":"10.2169/internalmedicine.4562-24","DOIUrl":"10.2169/internalmedicine.4562-24","url":null,"abstract":"","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"1767-1768"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiation Nephropathy Complicated by Tubulointerstitial Nephritis with Predominantly Lymphocyte and Plasma Cell Infiltration.","authors":"Tatsuaki Kosaka, Koji Takaori, Azusa Izumiya, Daisuke Hirai, Mitsuteru Koizumi, Shinya Yamamoto, Akiko Mii, Akira Shimizu, Kiyonao Nakamura, Norio Araki, Koichi Seta","doi":"10.2169/internalmedicine.4265-24","DOIUrl":"10.2169/internalmedicine.4265-24","url":null,"abstract":"<p><p>A 64-year-old Japanese woman presented with gross hematuria and was diagnosed with stage IVB cervical cancer. Renal dysfunction was observed following chemoradiation therapy, and a renal biopsy revealed renal thrombotic microangiopathy (TMA) and tubulointerstitial nephritis (TIN), which are atypical features of radiation nephropathy. Contrast-enhanced computed tomography revealed wedge-shaped areas of high contrast, consistent with areas of high radiation dose in the kidneys, thus leading to the diagnosis of radiation nephropathy. This case underscores the importance of integrating clinical, pathological, and radiological findings for the diagnosis of radiation nephropathy, atypical renal biopsy findings, and a combination of TIN and renal TMA.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"1696-1705"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duodenal Adenocarcinoma with a Gastric Phenotype Demonstrating a Rapidly Progressive Course.","authors":"Sho Matsuyama, Akihisa Fukuda, Nobukazu Agatsuma, Masahito Hoki, Takahiro Utsumi, Hiroshi Seno","doi":"10.2169/internalmedicine.4004-24","DOIUrl":"10.2169/internalmedicine.4004-24","url":null,"abstract":"<p><p>We herein report a rare case of duodenal adenocarcinoma with a rapidly progressive course. Esophagogastroduodenoscopy revealed Brunner's gland hyperplasia in the bulbs of the duodenum three years prior to this presentation. Two years earlier, gastric foveolar metaplasia had been observed in the bulbs. One year earlier, the lesion had increased slightly in size. At this time, the lesion had markedly increased in size, and the duodenum was circumferentially stenotic due to the mass. Pathologically, he was diagnosed with duodenal adenocarcinoma with a gastric-dominant immunophenotype and he died two months later. Although extremely rare, we should keep in mind that duodenal tumors with a gastric phenotype may sometimes progress rapidly within a short period of time.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"1684-1690"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacteremia and Meningitis Caused by Penicillin-resistant Streptococcus pneumoniae Serotype 35B Successfully Treated with Ceftriaxone Combined with Vancomycin Followed by Linezolid.","authors":"Mifumi Tomioka, Kiwamu Nakamura, Shaoqing Duan, Kazuaki Matsumoto, Takahiro Shindo, Keisuke Hoshi, Mika Nagao, Fuminari Oshima, Yasuka Hara, Yoshiyuki Namai","doi":"10.2169/internalmedicine.3904-24","DOIUrl":"10.2169/internalmedicine.3904-24","url":null,"abstract":"<p><p>We herein report a case of bacterial meningitis and bacteremia in a 3-month-old boy caused by Streptococcus pneumoniae serotype 35B multidrug resistance. Intravenous ampicillin was administered on admission. However, when pneumococcal meningitis was suspected, the antibiotic treatment was changed to ceftriaxone (CTRX) and vancomycin (VCM). However, owing to difficulties in achieving sufficient serum trough levels of VCM, this treatment was again switched to linezolid (LZD). The patient recovered without complications after 16 days of CTRX and LZD treatment. This case suggests that LZD is a viable treatment option for bacterial meningitis.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"1761-1766"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}