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Dyspnea with Hemidiaphragm Elevation in a Patient with Giant Cell Arteritis: A Case Report. 巨细胞动脉炎患者呼吸困难伴膈膜抬高1例。
IF 1 4区 医学
Internal Medicine Pub Date : 2025-01-15 DOI: 10.2169/internalmedicine.4055-24
Yosuke Asano, Yoshinori Matsumoto, Natsuki Kubota, Yuya Terajima, Kazuya Matsumoto, Kenta Shidahara, Kei Hirose, Takato Nakadoi, Shoichi Nawachi, Yu Katayama, Yoshia Miyawaki, Eri Katsuyama, Takayuki Katsuyama, Mariko Takano-Narazaki, Ken-Ei Sada, Jun Wada
{"title":"Dyspnea with Hemidiaphragm Elevation in a Patient with Giant Cell Arteritis: A Case Report.","authors":"Yosuke Asano, Yoshinori Matsumoto, Natsuki Kubota, Yuya Terajima, Kazuya Matsumoto, Kenta Shidahara, Kei Hirose, Takato Nakadoi, Shoichi Nawachi, Yu Katayama, Yoshia Miyawaki, Eri Katsuyama, Takayuki Katsuyama, Mariko Takano-Narazaki, Ken-Ei Sada, Jun Wada","doi":"10.2169/internalmedicine.4055-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4055-24","url":null,"abstract":"<p><p>We herein report the first case of dyspnea with hemidiaphragm elevation in a 68-year-old woman with active giant cell arteritis (GCA), including successful treatment. Contrast-enhanced computed tomography showed a reduced density of the left ophthalmic artery and the left superficial temporal artery with increased soft tissue compared to the other side, indicating that the GCA had flared up and suggesting that the hemidiaphragm elevation might be caused by vasculitis-associated ischemia of the right phrenic nerve. Hemidiaphragm paralysis due to vasculitis-associated ischemia in patients with GCA needs to be distinguished from local infection, tumors, and hepatomegaly, which are the major causes of hemidiaphragm elevation.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004801","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
Simultaneous Occurrence of Hyponatremia and Hypokalemia in a Patient with Herpes Zoster: A Case Report with a Review of the Literature. 带状疱疹患者同时出现低钠血症和低钾血症：病例报告与文献综述。
IF 1 4区 医学
Internal Medicine Pub Date : 2025-01-15 Epub Date: 2024-05-30 DOI: 10.2169/internalmedicine.3795-24
Satoshi Yamagata, Kazunori Kageyama, Miyuki Yanagimachi, Hiroshi Murakami, Makoto Daimon
{"title":"Simultaneous Occurrence of Hyponatremia and Hypokalemia in a Patient with Herpes Zoster: A Case Report with a Review of the Literature.","authors":"Satoshi Yamagata, Kazunori Kageyama, Miyuki Yanagimachi, Hiroshi Murakami, Makoto Daimon","doi":"10.2169/internalmedicine.3795-24","DOIUrl":"10.2169/internalmedicine.3795-24","url":null,"abstract":"<p><p>We herein report a patient with herpes zoster (HZ), severe hyponatremia, and hypokalemia. Syndrome of inappropriate antidiuresis (SIAD) leads to euvolemic hyponatremia and hypoosmotic plasma due to inadequate diuresis. Hyponatremia in the current patient was caused by SIAD and associated with HZ of the trigeminal facial nerve (V1). The patient also had hypokalemia, with excessive urinary potassium excretion and elevated cortisol levels. Hypokalemia is caused by hypercortisolemia, which is stimulated by HZ pain. Adequate treatment for HZ and comprehensive pain control play pivotal roles in improving SIAD, cortisol hypersecretion, and the subsequent electrolyte abnormalities.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"261-266"},"PeriodicalIF":1.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175667","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
Concurrent Amyotrophic Lateral Sclerosis and Huntington's Disease. 并发肌萎缩侧索硬化症和亨廷顿氏病：病例报告
IF 1 4区 医学
Internal Medicine Pub Date : 2025-01-15 Epub Date: 2024-06-20 DOI: 10.2169/internalmedicine.3232-23
Ryoma Takahashi, Minori Furuta, Kazuaki Nagashima, Yoshio Ikeda
{"title":"Concurrent Amyotrophic Lateral Sclerosis and Huntington's Disease.","authors":"Ryoma Takahashi, Minori Furuta, Kazuaki Nagashima, Yoshio Ikeda","doi":"10.2169/internalmedicine.3232-23","DOIUrl":"10.2169/internalmedicine.3232-23","url":null,"abstract":"<p><p>Huntington's disease (HD) is a dominantly inherited neurological disorder characterized by chorea, psychiatric symptoms, and cognitive decline but typically lacks muscular atrophy and weakness. We herein report a case of genetically confirmed HD showing progressive systemic weakness with findings of upper and lower motor neuron involvement due to amyotrophic lateral sclerosis (ALS). The current patient and the previously reported cases with complications of HD and ALS indicate that cytosine-adenine-guanine (CAG) repeat expansion in the huntingtin gene might have a pathogenic role in causing the two neurological disorders.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"297-300"},"PeriodicalIF":1.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426786","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
Hemorrhagic Eight-and-a-half Syndrome. 出血性八点半综合征
IF 1 4区 医学
Internal Medicine Pub Date : 2025-01-15 Epub Date: 2024-06-06 DOI: 10.2169/internalmedicine.3812-24
Marie Tsunogae, Masayuki Ueda
{"title":"Hemorrhagic Eight-and-a-half Syndrome.","authors":"Marie Tsunogae, Masayuki Ueda","doi":"10.2169/internalmedicine.3812-24","DOIUrl":"10.2169/internalmedicine.3812-24","url":null,"abstract":"","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"317-318"},"PeriodicalIF":1.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141260286","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
Ectopic Adrenocorticotropic Hormone Syndrome due to Pancreatic Neuroendocrine Carcinoma. 胰腺神经内分泌癌导致的异位促肾上腺皮质激素综合征：病例报告。
IF 1 4区 医学
Internal Medicine Pub Date : 2025-01-15 Epub Date: 2024-05-30 DOI: 10.2169/internalmedicine.3672-24
Aya Kawanishi, Ryuzo Deguchi, Ayano Ito, Takashi Ueda, Kota Tsuruya, Yoshitaka Arase, Yoshihiro Shirataki, Toshiki Kodama, Masashi Morimachi, Tatehiro Kagawa
{"title":"Ectopic Adrenocorticotropic Hormone Syndrome due to Pancreatic Neuroendocrine Carcinoma.","authors":"Aya Kawanishi, Ryuzo Deguchi, Ayano Ito, Takashi Ueda, Kota Tsuruya, Yoshitaka Arase, Yoshihiro Shirataki, Toshiki Kodama, Masashi Morimachi, Tatehiro Kagawa","doi":"10.2169/internalmedicine.3672-24","DOIUrl":"10.2169/internalmedicine.3672-24","url":null,"abstract":"<p><p>A 55-year-old woman presented to her primary care physician with facial and lower leg edema. After being referred to our hospital because of hypothyroidism and hypokalemia on blood tests, she also had elevated adrenocorticotropic hormone (ACTH) and cortisol levels, but a dexamethasone suppression test showed no cortisol suppression. Ectopic ACTH syndrome due to pancreatic neuroendocrine carcinoma (PNEC) was suspected. endoscopic ultrasound-guided fine-needle aspiration was performed, and a histopathological examination of the obtained specimen revealed multiple liver metastases of the PNEC. Imaging after etoposide and cisplatin therapy showed cystic changes in the primary lesions and shrinkage of the liver metastases, and the ACTH levels were within the normal range.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"237-242"},"PeriodicalIF":1.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175620","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
Immunoglobulin G4-related Autoimmune Pancreatitis and Hypopituitarism Following Immune Checkpoint Inhibitor Therapy. 免疫检查点抑制剂治疗后与免疫球蛋白 G4 相关的自身免疫性胰腺炎和垂体功能减退症：病例报告。
IF 1 4区 医学
Internal Medicine Pub Date : 2025-01-15 Epub Date: 2024-05-30 DOI: 10.2169/internalmedicine.3591-24
Saori Inoue, Yukiko Tsunoda, Kana Yamamoto, Hideki Okamoto
{"title":"Immunoglobulin G4-related Autoimmune Pancreatitis and Hypopituitarism Following Immune Checkpoint Inhibitor Therapy.","authors":"Saori Inoue, Yukiko Tsunoda, Kana Yamamoto, Hideki Okamoto","doi":"10.2169/internalmedicine.3591-24","DOIUrl":"10.2169/internalmedicine.3591-24","url":null,"abstract":"<p><p>A 70-year-old man underwent nephrectomy for renal cell carcinoma followed by 3 cycles of pembrolizumab as adjuvant chemotherapy. Three months later, he complained of appetite loss. He was diagnosed with secondary adrenal insufficiency and pancreatic tumor. Amylase and immunoglobulin G (IgG) 4 levels were normal. The differential diagnosis poses challenges in distinguishing pancreatic cancer, renal cell carcinoma metastasis, and autoimmune pancreatitis, necessitating tumor resection surgery. A histological examination revealed IgG4-related sclerosing pancreatitis. Postoperatively, there was no recurrence of pancreatitis. It is essential to consider the potential development of IgG4-related diseases after the administration of immune checkpoint inhibitors.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"209-215"},"PeriodicalIF":1.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175624","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
Primary Adrenal Insufficiency Triggered by Cytomegalovirus Infection after Obinutuzumab Plus Bendamustine Therapy for Follicular Lymphoma. 卵泡淋巴瘤奥比妥珠单抗加苯达莫司汀治疗后巨细胞病毒感染引发的原发性肾上腺功能不全病例。
IF 1 4区 医学
Internal Medicine Pub Date : 2025-01-15 Epub Date: 2024-05-30 DOI: 10.2169/internalmedicine.3334-23
Takashi Nakamura, Hideki Uryu, Ryutaro Kawashima, Mizuki Ishiguro, Mika Tanizawa, Yasushi Kanazawa, Hiroyuki Yamazaki, Yuichi Yahagi
{"title":"Primary Adrenal Insufficiency Triggered by Cytomegalovirus Infection after Obinutuzumab Plus Bendamustine Therapy for Follicular Lymphoma.","authors":"Takashi Nakamura, Hideki Uryu, Ryutaro Kawashima, Mizuki Ishiguro, Mika Tanizawa, Yasushi Kanazawa, Hiroyuki Yamazaki, Yuichi Yahagi","doi":"10.2169/internalmedicine.3334-23","DOIUrl":"10.2169/internalmedicine.3334-23","url":null,"abstract":"<p><p>A 69-year-old man was diagnosed with follicular lymphoma (grade 3A). Obinutuzumab combined with bendamustine (OB) therapy was initiated as salvage chemotherapy. Nausea, abdominal pain, and hyponatremia appeared after six courses of OB therapy; cytomegalovirus (CMV) enteritis with primary adrenal insufficiency (PAI) was a complication. Ganciclovir and hydrocortisone were administered, and the clinical findings improved. PAI caused by CMV infection has mainly been reported in patients with acquired immunodeficiency syndrome. In the present case, the PAI triggered by CMV infection led to immunodeficiency after chemotherapy.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"273-279"},"PeriodicalIF":1.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175610","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
IgG4-related Hypertrophic Pachymeningitis with Serum ANCA Positivity. 血清 ANCA 阳性的 IgG4 相关肥厚性脑下垂炎
IF 1 4区 医学
Internal Medicine Pub Date : 2025-01-15 Epub Date: 2024-06-06 DOI: 10.2169/internalmedicine.3511-24
Tsuyoshi Suda, Shingo Inagaki, Masako Kobayashi, Eiki Matsushita
{"title":"IgG4-related Hypertrophic Pachymeningitis with Serum ANCA Positivity.","authors":"Tsuyoshi Suda, Shingo Inagaki, Masako Kobayashi, Eiki Matsushita","doi":"10.2169/internalmedicine.3511-24","DOIUrl":"10.2169/internalmedicine.3511-24","url":null,"abstract":"","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"319-320"},"PeriodicalIF":1.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141260287","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
Correlation between Efficacy and Cardiovascular Adverse Events in Patients with Advanced Solid Cancer Who Received VEGF Pathway Inhibitors: Hypertension within the First Eight Weeks Is Associated with Favorable Outcomes of Patients Treated with VEGF Pathway Inhibitors. 接受血管内皮生长因子通路抑制剂治疗的晚期实体瘤患者的疗效与心血管不良事件之间的相关性：前八周内的高血压与血管内皮生长因子通路抑制剂治疗患者的良好预后有关。
IF 1 4区 医学
Internal Medicine Pub Date : 2025-01-15 Epub Date: 2024-06-13 DOI: 10.2169/internalmedicine.3373-23
Yuya Yoshida, Masanobu Takahashi, Keigo Komine, Sakura Taniguchi, Hideharu Yamada, Keiju Sasaki, Sho Umegaki, Yoshifumi Kawamura, Yuki Kasahara, Kota Ouchi, Hiroo Imai, Ken Saijo, Hidekazu Shirota, Noriko Takenaga, Chikashi Ishioka
{"title":"Correlation between Efficacy and Cardiovascular Adverse Events in Patients with Advanced Solid Cancer Who Received VEGF Pathway Inhibitors: Hypertension within the First Eight Weeks Is Associated with Favorable Outcomes of Patients Treated with VEGF Pathway Inhibitors.","authors":"Yuya Yoshida, Masanobu Takahashi, Keigo Komine, Sakura Taniguchi, Hideharu Yamada, Keiju Sasaki, Sho Umegaki, Yoshifumi Kawamura, Yuki Kasahara, Kota Ouchi, Hiroo Imai, Ken Saijo, Hidekazu Shirota, Noriko Takenaga, Chikashi Ishioka","doi":"10.2169/internalmedicine.3373-23","DOIUrl":"10.2169/internalmedicine.3373-23","url":null,"abstract":"<p><p>Objective Many vascular endothelial growth factor (VEGF) pathway inhibitors are used in the treatment of patients with various advanced cancers; however, treatments induce cardiovascular adverse events (CVAEs), such as hypertension, heart failure, arrhythmia, arterial or venous embolism, and hemorrhage. Some studies have suggested a correlation between efficacy and CVAEs; however, further evidence is required. This study evaluated real-world data concerning the frequency and degree of CVAEs and possible associations between CVAEs and efficacy in such patients. Methods We analyzed CVAEs observed in 294 patients with advanced cancer who were treated with ramucirumab, regorafenib, pazopanib, sunitinib, or sorafenib. Results CVAEs of any grade and proteinuria within 8 weeks after the initiation of VEGF pathway inhibitors (early) or during the treatment period (total period) were observed in 72-85% and 77-92% of the patients, respectively. The progression-free survival (PFS) of patients with a CVAE of grade ≥1 in the early period was favorable compared with the PFS of those who had no CVAE (median, 4.9 vs. 3.5 months, p=0.016, log-rank test). Furthermore, the PFS of patients with a CVAE grade ≥3 in the early period was favorable compared to that of those with CVAEs of grades 0-2. Taken together, a higher degree of CVAE was correlated with favorable patient outcomes. Conclusion This study revealed the frequency and degree of CVAEs in patients with solid cancers who received VEGF pathway inhibitors in a real-world setting and added evidence regarding the correlation between CVAEs and efficacy of VEGF pathway inhibitors.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"177-185"},"PeriodicalIF":1.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310664","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
Late-onset Rupture of the Intrahepatic Pseudoaneurysm Developed by Endoscopic Ultrasonography-guided Hepaticogastrostomy: A Case Report and Literature Review. 内镜超声引导肝胃造口术形成的肝内假动脉瘤晚期破裂：病例报告和文献综述。
IF 1 4区 医学
Internal Medicine Pub Date : 2025-01-15 Epub Date: 2024-05-30 DOI: 10.2169/internalmedicine.3717-24
Tesshin Ban, Yoshimasa Kubota, Takuya Takahama, Shun Sasoh, Satoshi Tanida, Makoto Nakamura, Tomoaki Ando, Takashi Joh
{"title":"Late-onset Rupture of the Intrahepatic Pseudoaneurysm Developed by Endoscopic Ultrasonography-guided Hepaticogastrostomy: A Case Report and Literature Review.","authors":"Tesshin Ban, Yoshimasa Kubota, Takuya Takahama, Shun Sasoh, Satoshi Tanida, Makoto Nakamura, Tomoaki Ando, Takashi Joh","doi":"10.2169/internalmedicine.3717-24","DOIUrl":"10.2169/internalmedicine.3717-24","url":null,"abstract":"<p><p>Endoscopic ultrasonography-guided hepaticogastrostomy (EUS-HGS) has emerged as an alternative drainage technique for patients with malignant biliary obstruction. However, few reports have discussed the occurrence of late-onset rupture of hepatic artery pseudoaneurysms following EUS-HGS. A recently available drill dilator equipped with a long screw segment was used in the dilation step of EUS-HGS. We highlight the potential concern that this long screw segment may increase the risk of damage to the hepatic artery, leading to late-onset life-threatening rupture of a pseudoaneurysm.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"217-223"},"PeriodicalIF":1.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175627","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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