Internal MedicinePub Date : 2025-10-01Epub Date: 2025-04-12DOI: 10.2169/internalmedicine.4613-24
Yui Yoshida, Yasuhiro Hagiwara, Mari Ito, Hiroshi Nishi, Yutaka Matsuyama
{"title":"Association of Obesity, Visceral Fat Accumulation, and Dyslipidemia with the Risk of Chronic Kidney Disease.","authors":"Yui Yoshida, Yasuhiro Hagiwara, Mari Ito, Hiroshi Nishi, Yutaka Matsuyama","doi":"10.2169/internalmedicine.4613-24","DOIUrl":"10.2169/internalmedicine.4613-24","url":null,"abstract":"<p><p>Objective Although chronic kidney disease (CKD) is independently associated with hypertension or hyperglycemia, there is no consensus on the thresholds of obesity, dyslipidemia, or visceral fat accumulation to predict CKD onset and progression. Methods We performed a multivariable logistic regression analysis for the association of the subsequent rate of estimated glomerular filtration rate (eGFR) decline with body mass index (BMI), blood high-density lipoprotein (HDL) cholesterol and triglycerides (TG) levels on 308,174 subjects who underwent health examinations conducted by the Public Health Research Center Foundation from 2015 to 2022. In addition, a Poisson regression analysis was used to evaluate the association between the appearance of urinary protein in participants without baseline urinary protein levels and eGFR decline. Results The median age of the subjects was 46 years old, and the median observation period was approximately 3 years. An eGFR decline rate of ≥5%/year was significantly associated with low HDL-cholesterol levels (<40 mg/dL), independent of the BMI and TG levels. A high baseline BMI (≥25 kg/m<sup>2</sup>) or waist circumference (≥85 cm for men and ≥90 cm for women), high TG levels (≥150 mg/dL), and low HDL-cholesterol levels were significantly associated with new-onset proteinuria. Furthermore, the higher the baseline BMI, the higher the incidence rate ratio of new-onset proteinuria. Conclusion Independent of hyperglycemia and hypertension, dyslipidemia according to the Japanese metabolic syndrome criteria and an elevated BMI were associated with a high risk of new-onset proteinuria, and a low HDL-cholesterol level was significantly associated with a rapid eGFR decline.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2823-2828"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997644","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}
Internal MedicinePub Date : 2025-10-01Epub Date: 2025-03-22DOI: 10.2169/internalmedicine.5113-24
Hengwei Liu
{"title":"A Rare Case of Hereditary Factor XI Deficiency Accompanied by Lupus Anticoagulant in an Adult Patient with Monoclonal Gammopathy of Undetermined Significance.","authors":"Hengwei Liu","doi":"10.2169/internalmedicine.5113-24","DOIUrl":"10.2169/internalmedicine.5113-24","url":null,"abstract":"<p><p>Acquired coagulopathy, particularly bleeding due to factor X deficiency, is a rare but not unusual phenomenon in patients with plasma cell dyscrasias such as amyloidosis. We herein report a rare case of a Han Chinese man with recurrent scattered skin ecchymosis on the forearms due to factor XI (FXI) deficiency and lupus anticoagulant who was diagnosed with monoclonal gammopathy of undetermined significance (MGUS) and confirmed to have a heterozygous mutation p.L190P (c.T569C) in the FXI gene. To our knowledge, this is the first case report of MGUS concurrent with a FXI missense mutation and lupus anticoagulant.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2892-2896"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700397","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}
Internal MedicinePub Date : 2025-10-01Epub Date: 2025-04-12DOI: 10.2169/internalmedicine.4811-24
Kengo Maeda
{"title":"Copy Number Variations in a Case with Intractable Epilepsy, Intellectual Disability, and Hereditary Neuropathy with Liability to Pressure Palsies Having a 17p12 Deletion.","authors":"Kengo Maeda","doi":"10.2169/internalmedicine.4811-24","DOIUrl":"10.2169/internalmedicine.4811-24","url":null,"abstract":"<p><p>Some copy number variations (CNVs) in DNA are associated with the development of pathological phenotypes. Regarding the diagnosis of recurrent radial nerve palsies, a 73-year-old female patient with intractable epilepsy and intellectual disability was diagnosed with duplicated 15q11.1-11.2, in addition to a deletion of 17p12, causing hereditary neuropathy with liability to pressure palsies. CNVs in 15q11.1-11.2 have been reported in patients with schizophrenia and autism. Although CNVs are also sometimes seen in healthy individuals, duplicated 15q11.1-11.2 could be associated with CNS symptoms in this patient.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2897-2900"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995199","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}
Internal MedicinePub Date : 2025-10-01Epub Date: 2025-03-29DOI: 10.2169/internalmedicine.5255-25
Shu Yoshihara, Taku Yaegashi, Masaki Matsunaga
{"title":"Serial Change of Perivascular Fat Attenuation Index in a Case of Spontaneous Coronary Artery Dissection Involving the Proximal Left Coronary Artery.","authors":"Shu Yoshihara, Taku Yaegashi, Masaki Matsunaga","doi":"10.2169/internalmedicine.5255-25","DOIUrl":"10.2169/internalmedicine.5255-25","url":null,"abstract":"<p><p>The perivascular fat attenuation index (FAI) has been recognized as a cardiac computed tomography-based (CCT)-based biomarker of coronary inflammation. We report the case of a 47-year-old woman with acute spontaneous coronary artery dissection (SCAD) involving the proximal left coronary artery (LCA), who underwent FAI three times. The initial CCT scan revealed higher perivascular FAI values in the dissected LCA. The second CCT scan, performed 8 days later, showed persistence of a higher perivascular FAI value only in the left circumflex coronary artery, in which progression of stenotic severity and myocardial infarction formation were found. The persistence of a higher perivascular FAI may indicate disease deterioration in patients with SCAD.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2863-2869"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752599","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":"Coronary Artery Spasm as a Contributor to Heart Failure: Lessons from Three Cases.","authors":"Ayami Naito, Takumi Toya, Akane Kawai, Kota Mizutani, Kazuhiko Kuinose, Yuji Nagatomo, Takeshi Adachi","doi":"10.2169/internalmedicine.5057-24","DOIUrl":"10.2169/internalmedicine.5057-24","url":null,"abstract":"<p><p>Coronary artery spasm (CAS) is an underrecognized cause of heart failure, even in the absence of obstructive coronary artery disease. We report three cases of heart failure in which CAS was identified as the critical etiology. All patients exhibited symptoms of heart failure with nonobstructive coronary arteries, and CAS provocation testing confirmed epicardial spasm. In two cases, cardiac magnetic resonance imaging revealed ischemic patterns consistent with CAS-related injuries. Calcium channel blockers effectively stabilize the signs and symptoms related to heart failure. This series highlights CAS as a contributor to heart failure progression and emphasizes the importance of provocation testing and early tailored therapy for improving outcomes.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2881-2886"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752591","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":"Effect of Biologics against Interleukin-5 Administered to Patients with Eosinophilic Gastroenteritis.","authors":"Kazuya Miyaguchi, Hisashi Matsumoto, Rie Shiomi, Hiroshi Yamaguchi, Yoshikazu Tsuzuki, Hiroyuki Imaeda","doi":"10.2169/internalmedicine.5029-24","DOIUrl":"10.2169/internalmedicine.5029-24","url":null,"abstract":"<p><p>Biologics against interleukin-5 were administered to five patients with eosinophilic gastroenteritis (EGE) and bronchial asthma (BA). BA and abdominal symptoms as well as changes in steroid dose and the blood eosinophil count were examined. The man-to-woman ratio was 1:4. The average age of onset was 63 years old. The duration of the disease was three to nine years. Four patients showed improved BA symptoms with mepolizumab or benralizumab, and three successfully discontinued steroids. Regarding abdominal symptoms, mepolizumab was effective in one of three cases, while benralizumab improved symptoms in three of four cases. Biologics targeting interleukin-5 are effective in some patients with EGE accompanied by BA.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2846-2851"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639602","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":"A Serial Assessment of T1 and T2 Mapping Cardiac Magnetic Resonance before and after Heart Failure Onset in a Case of Cardiomyopathy in Anti-mitochondrial Antibody-positive Myositis.","authors":"Mitsuru Ishizuka, Hideaki Suzuki, Satoshi Higuchi, Hidenobu Takagi, Naoki Suzuki, Rumiko Izumi, Hirofumi Watanabe, Haruka Sato, Taijyu Satoh, Saori Miyamichi-Yamamoto, Nobuhiro Yaoita, Kouki Takeuchi, Marina Arai, Hideka Hayashi, Kotaro Nochioka, Hiroyuki Takahama, Shunsuke Tatebe, Hiroshi Fujii, Masashi Aoki, Satoshi Yasuda","doi":"10.2169/internalmedicine.5007-24","DOIUrl":"10.2169/internalmedicine.5007-24","url":null,"abstract":"<p><p>A 69-year-old woman presented with heart failure and progressive muscle weakness and was diagnosed as anti-mitochondrial antibody (AMA) myositis with cardiac involvement. Immunosuppressive therapy with prednisolone and intravenous cyclophosphamide significantly improved the symptoms, hemodynamics, and cardiac function. Cardiac magnetic resonance (CMR) T1 and T2 mapping showed elevated native T1, T2, and extracellular volume fractions during heart failure exacerbation (day 37) compared to pre-hospitalization values (10 months before admission) and follow-up conducted 6 and 12 months after admission. This case underscores the importance of comprehensive evaluation, such as serial CMR imaging and immunosuppressive therapy, in managing myocardial involvement in AMA-positive myositis.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2870-2875"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700398","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":"Disseminated Fusariosis Successfully Treated with Empirical Liposomal Amphotericin B and Voriconazole Combination Followed by Ocular Therapy in an Allogenic Hematopoietic Stem Cell Transplant Recipient.","authors":"Yuya Kishida, Masahiro Sakaguchi, Tomoyuki Kunishige, Atsushi Takeyoshi, Taichiro Tokura, Kazuki Inai, Ryosuke Kinoshita, Toshio Ibaraki, Satoshi Yamanaka, Toshio Asayama, Shunsuke Yui, Satoshi Wakita, Hiroki Yamaguchi","doi":"10.2169/internalmedicine.4657-24","DOIUrl":"10.2169/internalmedicine.4657-24","url":null,"abstract":"<p><p>We report the case of a 61-year-old man with chronic myelomonocytic leukemia, who underwent unrelated peripheral blood stem cell transplantation. Fusariosis was suspected prior to identification of the fungal species, and voriconazole and liposomal amphotericin B combination therapy were administered. The patient developed fusarium-related endophthalmitis, accompanied by eye pain. Despite vitrectomy, the endophthalmitis was poorly controlled, and the left eye was enucleated. No recurrence of fusariosis was observed until death following multiple-organ failure due to steroid-resistant graft-versus-host disease.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2907-2912"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015047","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}