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Thyrotoxicosis and Excess Iodine Due to Habitual Use of Polyvinylpyrrolidone Iodine While Gargling in an Iodine-sufficient Area. 足碘地区含碘时习惯性使用聚乙烯吡咯烷酮碘致甲状腺毒症和碘过量1例。
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-09-15 Epub Date: 2025-03-22 DOI: 10.2169/internalmedicine.4868-24
Kanako Sato, Hiroaki Asai, Saori Yoshioka, Keisuke Murakawa, Hiroyuki Sho, Ryoko Inui, Motohiro Kosugi, Yoji Hazama, Tetsuyuki Yasuda
{"title":"Thyrotoxicosis and Excess Iodine Due to Habitual Use of Polyvinylpyrrolidone Iodine While Gargling in an Iodine-sufficient Area.","authors":"Kanako Sato, Hiroaki Asai, Saori Yoshioka, Keisuke Murakawa, Hiroyuki Sho, Ryoko Inui, Motohiro Kosugi, Yoji Hazama, Tetsuyuki Yasuda","doi":"10.2169/internalmedicine.4868-24","DOIUrl":"10.2169/internalmedicine.4868-24","url":null,"abstract":"<p><p>Excess iodine can influence the pathophysiology of the thyroid gland and results of various thyroid-related examinations. We herein report a 60-year-old Japanese man with thyrotoxicosis and excess iodine due to habitual use of polyvinylpyrrolidone iodine (PVP-I) to gargle for 20 years. Initial laboratory and imaging findings were suggestive of painless thyroiditis. However, after cessation of PVP-I use for gargling, these results changed to findings suggestive of Graves' disease, with worsening thyrotoxicosis. A detailed questionnaire regarding excess iodine is important for the accurate diagnosis of thyrotoxicosis, even in patients living in iodine-sufficient areas where iodine-induced thyrotoxicosis is rare.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2733-2739"},"PeriodicalIF":1.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700395","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
Randomized Prospective Controlled Open-labeled Trial of Cyclosporine with/without Low-dose Oral Corticosteroids in Idiopathic Membranous Nephropathy in Adults with Nephrotic Syndrome. 环孢素联合/不联合低剂量口服皮质类固醇治疗成人肾病综合征特发性膜性肾病的随机前瞻性对照开放标记试验
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-09-01 Epub Date: 2025-02-22 DOI: 10.2169/internalmedicine.4803-24
Joichi Usui, Kouichi Hirayama, Masaki Kobayashi, Satoshi Suzuki, Itaru Ebihara, Kenta Nishiki, Kaori Mase, Aki Hirayama, Chie Saito, Michihiro Goto, Akio Koyama, Kunihiro Yamagata
{"title":"Randomized Prospective Controlled Open-labeled Trial of Cyclosporine with/without Low-dose Oral Corticosteroids in Idiopathic Membranous Nephropathy in Adults with Nephrotic Syndrome.","authors":"Joichi Usui, Kouichi Hirayama, Masaki Kobayashi, Satoshi Suzuki, Itaru Ebihara, Kenta Nishiki, Kaori Mase, Aki Hirayama, Chie Saito, Michihiro Goto, Akio Koyama, Kunihiro Yamagata","doi":"10.2169/internalmedicine.4803-24","DOIUrl":"10.2169/internalmedicine.4803-24","url":null,"abstract":"<p><p>Objective We conducted a prospective, randomized controlled, open-label study to investigate the efficacy of a combination of cyclosporine and low-dose prednisolone in patients with idiopathic membranous nephropathy (IMN). Methods We recruited biopsy-proven IMN patients with nephrotic syndrome who had never been treated with immunosuppressants. The patients were randomized into 2 groups treated after randomization with cyclosporine (3 mg/kg/day) alone or with an oral low-dose corticosteroid (prednisolone 15 mg/day) for 24 months. Results We recruited 30 patients with IMN and nephrotic-range proteinuria, 28 of whom were included in this study. Fourteen patients were randomized for treatment with only cyclosporine (Group A), and 14 were randomized for treatment with cyclosporine plus low-dose corticosteroids (Group B). Cyclosporine monotherapy induced remission in 12 of the 14 patients in Group A, including partial remission in 7 patients (50.0%) and complete remission in 5 patients (36.7%). In Group B, 12 of 14 patients achieved proteinuria remission, including 11 (78.6%) with complete remission and 1 (7.1%) with partial remission. Although there was no marked difference in the overall remission rate, the complete remission rate was significantly higher in Group B than in Group A (p=0.02). Furthermore, there was a statistically significant difference between the groups in the time from the start of the study to complete remission (10.2±7.8 months in Group A; 9.5±6.1 months in Group B, p=0.03). Conclusion The combination of cyclosporine and low-dose corticosteroid treatment is an effective and important option in the management of patients with IMN with nephrotic-range proteinuria, either as an initial therapy or as a long-term treatment.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2541-2548"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491941","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}
引用次数: 0
Detection of Four Cases of Familial Hypercholesterolemia during a Workers' Compensation Insurance Secondary Health Examination. 工伤保险二次体检中家族性高胆固醇血症4例的检测。
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-09-01 Epub Date: 2025-05-21 DOI: 10.2169/internalmedicine.4790-24
Takayuki Yamaji, Aya Mizobuchi, Yukihito Higashi
{"title":"Detection of Four Cases of Familial Hypercholesterolemia during a Workers' Compensation Insurance Secondary Health Examination.","authors":"Takayuki Yamaji, Aya Mizobuchi, Yukihito Higashi","doi":"10.2169/internalmedicine.4790-24","DOIUrl":"10.2169/internalmedicine.4790-24","url":null,"abstract":"<p><p>Familial hypercholesterolemia (FH), a genetic disorder characterized by the early onset of coronary artery disease, is found in one of 300 people. In the 2022 Japanese FH guidelines, a cut-off value for Achilles tendon thickness measured using ultrasound has been added, enabling the diagnosis of FH during a Workers' Compensation Insurance Secondary Health Examination. In individuals for whom the possibility of FH could not be ruled out based on low-density lipoprotein cholesterol levels, we measured the Achilles tendon thickness by ultrasound and found four cases of FH. The detection of FH in asymptomatic workers is crucial for long-term cardiovascular risk management.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2610-2614"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457926","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}
引用次数: 0
Diffuse Alveolar Hemorrhage Associated with Herbal Medicine: A Case Series and Literature Review. 弥漫性肺泡出血与草药相关：一个病例系列和文献综述。
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-09-01 Epub 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":"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":"2637-2640"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463424/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Successful Resolution of Suspected Red Yeast Rice-induced Nephropathy. 成功解决疑似红曲米肾病。
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-09-01 Epub Date: 2025-03-15 DOI: 10.2169/internalmedicine.4908-24
Haruka Maruyama, Ken-Ei Sada, Machiko Oka, Mitsuru Yanai, Sumi Hidaka, Shuzo Kobayashi
{"title":"Successful Resolution of Suspected Red Yeast Rice-induced Nephropathy.","authors":"Haruka Maruyama, Ken-Ei Sada, Machiko Oka, Mitsuru Yanai, Sumi Hidaka, Shuzo Kobayashi","doi":"10.2169/internalmedicine.4908-24","DOIUrl":"10.2169/internalmedicine.4908-24","url":null,"abstract":"<p><p>Recently, several Japanese patients have developed interstitial nephritis or acute tubular injury/necrosis, both accompanied by Fanconi syndrome, after consuming a specific red yeast rice supplement. In most cases, the renal function did not fully recover even after discontinuation of supplements and glucocorticoid treatment. A 52-year-old woman developed interstitial nephritis and Fanconi syndrome after receiving supplements. A renal biopsy revealed mild lymphocytic infiltration. Her renal function recovered after discontinuing the supplement without glucocorticoids. The supplement was contaminated with puberulic acid, a known cause of tubular necrosis; however, the cause of interstitial nephritis remains uncertain. Biopsy findings guided the decision to avoid glucocorticoids.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2626-2630"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639712","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}
引用次数: 0
Primary Cutaneous CD8-positive Aggressive Epidermotropic Cytotoxic T-cell Lymphoma Complicated by Paraneoplastic Encephalitis. 原发性皮肤cd8阳性侵袭性表皮细胞毒性t细胞淋巴瘤并发副肿瘤脑炎。
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-09-01 Epub Date: 2025-02-01 DOI: 10.2169/internalmedicine.4988-24
Yu Inoue, Taku Tsukamoto, Kentaro Mizuhara, Chika Maekura, Takahisa Nakamura, Haruya Okamoto, Takahiro Fujino, Shinsuke Mizutani, Yuji Shimura, Ayano Maruyama, Mari Nakanishi, Eijirou Tanaka, Yuki Nishida, Kenta Ishii, Yuta Sonobe, Aya Miyagawa-Hayashino, Junya Kuroda
{"title":"Primary Cutaneous CD8-positive Aggressive Epidermotropic Cytotoxic T-cell Lymphoma Complicated by Paraneoplastic Encephalitis.","authors":"Yu Inoue, Taku Tsukamoto, Kentaro Mizuhara, Chika Maekura, Takahisa Nakamura, Haruya Okamoto, Takahiro Fujino, Shinsuke Mizutani, Yuji Shimura, Ayano Maruyama, Mari Nakanishi, Eijirou Tanaka, Yuki Nishida, Kenta Ishii, Yuta Sonobe, Aya Miyagawa-Hayashino, Junya Kuroda","doi":"10.2169/internalmedicine.4988-24","DOIUrl":"10.2169/internalmedicine.4988-24","url":null,"abstract":"<p><p>Primary cutaneous CD8-positive aggressive epidermotropic cytotoxic T-cell lymphoma (PCAE-CTL) is a rare subtype of cutaneous T-cell lymphoma with a poor prognosis. We herein report a case of PCAE-CTL accompanied by anti-Ma2 antibody-positive paraneoplastic encephalitis. A 33-year-old woman with erythema and disturbance of consciousness was diagnosed with PCAE-CTL by a skin biopsy. Head magnetic resonance imaging revealed bilateral medial temporal lobe hyperintensity, and anti-Ma2 antibody in the cerebrospinal fluid was positive. She was diagnosed with concurrent anti-Ma2 antibody-positive paraneoplastic encephalitis. In cases of lymphoma with brain lesions, invasion of the central nervous system by lymphoma and paraneoplastic encephalitis should be considered.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2641-2645"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079760","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}
引用次数: 0
Recurrent Positional Vomiting due to Cerebellar Infarction and Obstructive Hydrocephalus. 小脑梗塞和阻塞性脑积水导致的复发性体位性呕吐：病例报告。
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-09-01 Epub Date: 2025-03-01 DOI: 10.2169/internalmedicine.5080-24
Gohei Yamada
{"title":"Recurrent Positional Vomiting due to Cerebellar Infarction and Obstructive Hydrocephalus.","authors":"Gohei Yamada","doi":"10.2169/internalmedicine.5080-24","DOIUrl":"10.2169/internalmedicine.5080-24","url":null,"abstract":"<p><p>An 80-year-old woman presented with the sudden onset of vertigo and vomiting and was diagnosed with acute cerebellar infarction. Twelve days after the onset, she experienced positional vomiting, predominantly in the lying-down position, triggered by postural changes with immediate or delayed onset. Over 1 month, 23 episodes of vomiting occurred. Brain computed tomography revealed edema in the infarcted area, fourth ventricular outlet compression, and lateral ventricular enlargement. These findings suggest that fluctuations in intracranial pressure are associated with intermittent obstructive hydrocephalus exacerbated by the patient's posture. This case highlights the importance of considering postural triggers in patients with recurrent vomiting associated with cerebellar infarctions.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2652-2656"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537051","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}
引用次数: 0
Bacteremia and Septic Thrombophlebitis Caused by an Infusion Set Contaminated with Bacillus cereus. 蜡样芽孢杆菌污染输液器致菌血症及脓毒性血栓性静脉炎1例。
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-09-01 Epub 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":"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":"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":"2667-2670"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463432/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Subacute Finger Gangrene with Severe Raynaud's Phenomenon. 伴有严重雷诺氏现象的亚急性手指坏疽。
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-09-01 Epub Date: 2025-03-15 DOI: 10.2169/internalmedicine.4689-24
Kazuro Kamada, Michihito Kono, Tatsuya Atsumi
{"title":"Subacute Finger Gangrene with Severe Raynaud's Phenomenon.","authors":"Kazuro Kamada, Michihito Kono, Tatsuya Atsumi","doi":"10.2169/internalmedicine.4689-24","DOIUrl":"10.2169/internalmedicine.4689-24","url":null,"abstract":"","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2680"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639711","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}
引用次数: 0
Immune-related Adverse Event Laryngitis in Durvalumab-treated Hilar Cholangiocarcinoma. 杜伐单抗治疗肝门胆管癌的免疫相关不良事件喉炎。
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-09-01 Epub 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":"10.2169/internalmedicine.4870-24","url":null,"abstract":"","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2678-2679"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463417/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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