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Delayed Methotrexate Elimination Following High-dose Methotrexate Prophylaxis in High-risk Diffuse Large B-cell Lymphoma.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-15 DOI: 10.2169/internalmedicine.4999-24
Masahiro Akimoto, Takuya Miyazaki, Hiroyuki Takahashi, Takaaki Takeda, Yuto Hibino, Mayumi Tokunaga, Takuma Ohashi, Ayako Matsumura, Haruka Teshigawara, Taisei Suzuki, Hiroshi Teranaka, Yuki Nakajima, Kenji Matsumoto, Chizuko Hashimoto, Katsumichi Fujimaki, Hiroyuki Fujita, Rika Sakai, Shin Fujisawa, Hideaki Nakajima
{"title":"Delayed Methotrexate Elimination Following High-dose Methotrexate Prophylaxis in High-risk Diffuse Large B-cell Lymphoma.","authors":"Masahiro Akimoto, Takuya Miyazaki, Hiroyuki Takahashi, Takaaki Takeda, Yuto Hibino, Mayumi Tokunaga, Takuma Ohashi, Ayako Matsumura, Haruka Teshigawara, Taisei Suzuki, Hiroshi Teranaka, Yuki Nakajima, Kenji Matsumoto, Chizuko Hashimoto, Katsumichi Fujimaki, Hiroyuki Fujita, Rika Sakai, Shin Fujisawa, Hideaki Nakajima","doi":"10.2169/internalmedicine.4999-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4999-24","url":null,"abstract":"<p><p>Objective High-dose methotrexate (HD-MTX) is widely used as central nervous system (CNS) prophylaxis in patients with diffuse large B-cell lymphoma (DLBCL) who are at a high risk of CNS relapse. Ensuring safe prophylactic administration with minimal adverse events is a key concern; however, few studies have detailed the safety profile of HD-MTX prophylaxis in patients with high-risk DLBCL. We analyzed the adverse events associated with HD-MTX in this population, focusing on delayed MTX elimination. Methods This multicenter retrospective study included 98 patients with DLBCL at high risk of CNS relapse who received HD-MTX as part of frontline therapy between 2014 and 2020. CNS prophylaxis involved 2 cycles of HD-MTX (3.0 g/m<sup>2</sup>) at 2-week intervals. Results The median age at the diagnosis was 63 (34-84) years old, and 34 patients received a reduced methotrexate (MTX) dose. The overall incidence of delayed MTX elimination was 18.4%. No cases of delayed MTX elimination were observed in the group that received a 3-h MTX infusion (n=50). Toxicities were more frequent in patients with delayed MTX elimination than in those without (77.8% vs. 26.2%, p≤0.05), including higher incidences of grade ≥3 adverse events and grade ≤2 renal dysfunction. Conclusion Delayed MTX elimination is associated with increased complications. Shorter MTX infusion rates, particularly at 3 h, may reduce the risk of delayed MTX elimination.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diffuse Alveolar Hemorrhage Associated with Herbal Medicine: A Case Series and Literature Review.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-08 DOI: 10.2169/internalmedicine.4960-24
Kazuo Tsuchiya, Ryota Miyamoto, Tomo Tsunoda, Taisuke Ito, Takuro Akashi, Yoshiyuki Oyama, Masaki Ikeda
{"title":"Diffuse Alveolar Hemorrhage Associated with Herbal Medicine: A Case Series and Literature Review.","authors":"Kazuo Tsuchiya, Ryota Miyamoto, Tomo Tsunoda, Taisuke Ito, Takuro Akashi, Yoshiyuki Oyama, Masaki Ikeda","doi":"10.2169/internalmedicine.4960-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4960-24","url":null,"abstract":"<p><p>Although there have been several reports of drug-induced pneumonitis caused by herbal medicines in recent years, herbal medicine-induced diffuse alveolar hemorrhage (DAH) is rare. We herein report two cases of DAH associated with herbal medicines. Patient 1 developed dyspnea and hemoptysis after receiving jidabokuippo. Patient 2 developed a fever and dyspnea after taking otsuji-to. Both patients exhibited severe respiratory failure, and bronchoalveolar lavage revealed bloody fluid that confirmed the diagnosis of DAH. In both patients, discontinuation of herbal medicines and corticosteroid therapy resulted in significant improvement. These cases highlight the potential risks of DAH associated with herbal medicines.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How to Prevent Left Atrial thrombus Formation Following TEER in Patients With Prior Left Atrial Appendage Occlusion.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-08 DOI: 10.2169/internalmedicine.5125-24
Nobuyuki Fukuda, Teruhiko Imamura
{"title":"How to Prevent Left Atrial thrombus Formation Following TEER in Patients With Prior Left Atrial Appendage Occlusion.","authors":"Nobuyuki Fukuda, Teruhiko Imamura","doi":"10.2169/internalmedicine.5125-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.5125-24","url":null,"abstract":"","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Venous Thromboembolism with Double Left Common Iliac Veins.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-08 DOI: 10.2169/internalmedicine.5252-25
Takao Konishi, Sakae Takenaka, Toshiyuki Nagai, Toshihisa Anzai
{"title":"Venous Thromboembolism with Double Left Common Iliac Veins.","authors":"Takao Konishi, Sakae Takenaka, Toshiyuki Nagai, Toshihisa Anzai","doi":"10.2169/internalmedicine.5252-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5252-25","url":null,"abstract":"","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Budd-Chiari Syndrome after Living Liver Donor Hepatectomy.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-08 DOI: 10.2169/internalmedicine.4995-24
Takahiko Omameuda, Yasuharu Onishi, Yasunaru Sakuma
{"title":"Budd-Chiari Syndrome after Living Liver Donor Hepatectomy.","authors":"Takahiko Omameuda, Yasuharu Onishi, Yasunaru Sakuma","doi":"10.2169/internalmedicine.4995-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4995-24","url":null,"abstract":"","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Case of Bacteremia and Septic Thrombophlebitis Caused by an Infusion Set Contaminated with Bacillus cereus.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-08 DOI: 10.2169/internalmedicine.4918-24
Yusuke Watanabe, Shunsuke Ohba, Tamaki Nakamura, Shogo Yamada, Akira Kato, Daisuke Kawahata, Kaoru Yamazaki, Hidehiro Watanabe
{"title":"A Case of Bacteremia and Septic Thrombophlebitis Caused by an Infusion Set Contaminated with Bacillus cereus.","authors":"Yusuke Watanabe, Shunsuke Ohba, Tamaki Nakamura, Shogo Yamada, Akira Kato, Daisuke Kawahata, Kaoru Yamazaki, Hidehiro Watanabe","doi":"10.2169/internalmedicine.4918-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4918-24","url":null,"abstract":"<p><p>A 48-year-old man with Fisher syndrome was admitted to our hospital for amino acid-containing peripheral parenteral nutrition. On day 19 of his hospital stay, he became febrile and Bacillus cereus was isolated from blood cultures. Vancomycin was administered, and the entire infusion set was replaced. The cultures were prepared from the infusion set. B. cereus was detected in several connectors and hubs, although catheter tip culture was negative. Echocardiography revealed cephalic venous thrombophlebitis. In cases with no improvement despite effective antibiotic use, clinicians should consider the possibility that the infusion set might have become contaminated.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Immune-related Adverse Event Laryngitis in Durvalumab-treated Hilar Cholangiocarcinoma.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-08 DOI: 10.2169/internalmedicine.4870-24
Shinichi Morita, Daisuke Kumaki, Takeshi Sakai, Kazuhiro Funakoshi
{"title":"Immune-related Adverse Event Laryngitis in Durvalumab-treated Hilar Cholangiocarcinoma.","authors":"Shinichi Morita, Daisuke Kumaki, Takeshi Sakai, Kazuhiro Funakoshi","doi":"10.2169/internalmedicine.4870-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4870-24","url":null,"abstract":"","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Case of Successful Transvaginal Endoscopic Ultrasound-guided Pelvic Abscess Drainage.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-08 DOI: 10.2169/internalmedicine.4448-24
Yoshitaka Ando, Makoto Motegi, Toshiyuki Sakurai, Masayuki Saruta
{"title":"A Case of Successful Transvaginal Endoscopic Ultrasound-guided Pelvic Abscess Drainage.","authors":"Yoshitaka Ando, Makoto Motegi, Toshiyuki Sakurai, Masayuki Saruta","doi":"10.2169/internalmedicine.4448-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4448-24","url":null,"abstract":"<p><p>Endoscopic ultrasound-guided pelvic abscess drainage (EUS-PAD) has emerged as a viable alternative to percutaneous drainage (PCD). However, reports of this method are limited to procedures associated with transrectal access. We herein present the first case of successful transvaginal EUS-PAD in a 22-year-old female who developed a pelvic abscess after undergoing a cesarean section. An ultrasound endoscope was inserted transvaginally to visualize the abscess. Puncture and dilation were performed and a 7 Fr endoscopic nasobiliary drainage (ENBD) tube was put in place. The patient showed a rapid improvement after the procedure and was discharged without any complications. This case report highlights the efficacy and safety of transvaginal EUS-PAD as a viable option for performing pelvic abscess drainage.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development of Adult T-Cell Leukemia/Lymphoma During Treatment with PD-L1 Inhibitor for Lung Cancer.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-08 DOI: 10.2169/internalmedicine.5114-24
Hikari Fujioka, Kentaro Kikuchi, Takumi Nakahara, Satoshi Yoshioka, Rina Kawai, Maki Kajitani, Mana Ishizuka, Masaya Akiyama, Yutaro Tanaka, Ayako Kobayashi, Ken Sato, Kennosuke Karube, Goh Tanaka, Tadashi Kohyama
{"title":"Development of Adult T-Cell Leukemia/Lymphoma During Treatment with PD-L1 Inhibitor for Lung Cancer.","authors":"Hikari Fujioka, Kentaro Kikuchi, Takumi Nakahara, Satoshi Yoshioka, Rina Kawai, Maki Kajitani, Mana Ishizuka, Masaya Akiyama, Yutaro Tanaka, Ayako Kobayashi, Ken Sato, Kennosuke Karube, Goh Tanaka, Tadashi Kohyama","doi":"10.2169/internalmedicine.5114-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.5114-24","url":null,"abstract":"<p><p>Advancements in immunotherapy, the phenomenon of hyperprogression in cancer patients, have garnered increasing attention. We herein report a case of acute adult T-cell leukemia/lymphoma (ATL) that developed after administration of the PD-L1 inhibitor durvalumab in a patient with lung cancer. Although the patient was a carrier of human T-cell leukemia virus type 1 (HTLV-1), this was unknown prior to durvalumab treatment. HTLV-1 bZIP factor was detected in formalin-fixed lymph node tissue, confirming the diagnosis of ATL. Our findings suggest a potential association between immune checkpoint inhibition and ATL development in HTLV-1 carriers.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reply: How to Prevent Left Atrial Thrombus Formation Following TEER in Patients with Prior Left Atrial Appendage Occlusion.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-08 DOI: 10.2169/internalmedicine.5322-25
Kyoko Unno, Atsushi Sakamoto, Keisuke Iguchi, Makoto Sano, Kenichiro Suwa, Hayato Ohtani, Yuichiro Maekawa
{"title":"Reply: How to Prevent Left Atrial Thrombus Formation Following TEER in Patients with Prior Left Atrial Appendage Occlusion.","authors":"Kyoko Unno, Atsushi Sakamoto, Keisuke Iguchi, Makoto Sano, Kenichiro Suwa, Hayato Ohtani, Yuichiro Maekawa","doi":"10.2169/internalmedicine.5322-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5322-25","url":null,"abstract":"","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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