{"title":"Bucillamine-induced Yellow Nail Syndrome with Chylothorax.","authors":"Yukari Hisamoto, Yoriyuki Murata, Kazuki Matsuda, Koji Narikiyo, Taiga Kobayashi, Kosei Yonezawa, Keita Murakawa, Kazuki Hamada, Syuichiro Ohata, Toshiaki Utsunomiya, Yoshikazu Yamaji, Keiji Oishi, Maki Asami-Noyama, Nobutaka Edakuni, Tomoyuki Kakugawa, Tsunahiko Hirano, Kazuto Matsunaga","doi":"10.2169/internalmedicine.4935-24","DOIUrl":"10.2169/internalmedicine.4935-24","url":null,"abstract":"<p><p>Yellow nail syndrome (YNS), a rare condition characterized by thickened yellow nails, lymphedema, and respiratory manifestations, is rarely caused by bucillamine, an anti-rheumatic agent. Respiratory manifestations of YNS include chylothorax in 18.8-22% of patients with pleural effusion. We herein report the first case of bucillamine-induced YNS with chylothorax. Lymphangiography revealed narrowing of the lymphatic vessels and stagnation of the lymphatic fluid, suggesting impaired lymphatic drainage. The chylothorax persisted despite the discontinuation of bucillamine. The present case illustrates that bucillamine can cause irreversible lymphatic impairment and chylothorax.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2755-2759"},"PeriodicalIF":1.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752580","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":"An Atypical Cystic Renal Mass in a Patient with IgG4-Related Kidney Disease.","authors":"Chisato Minezaki, Hiroki Uchida, Kouhei Todaka, Nobuchika Koumatsu, Jun Okita, Akiko Kudo, Takeshi Nakata, Akihiro Fukuda, Naoya Fukunaga, Noriko Uesugi, Hirotaka Shibata","doi":"10.2169/internalmedicine.4691-24","DOIUrl":"10.2169/internalmedicine.4691-24","url":null,"abstract":"<p><p>We herein report a case of IgG4-related kidney disease (IgG4-RKD) with an atypical cystic renal mass in a 73-year-old man. Computed tomography revealed diffuse renal enlargement and a cystic mass in the left kidney. Blood tests revealed elevated IgG and IgG4 levels. A renal biopsy led to the IgG4-RKD diagnosis. The cystic mass was deemed to be benign based on the clinical, imaging, and ultrasonography findings. No malignancy or abscess formation was noted. Both the renal function and IgG4 levels improved after steroid treatment; moreover, the mass shrunk, suggesting an IgG4-RKD etiology. Cystic renal masses with capsule formation should be considered in patients presenting with IgG4-RKD.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2740-2746"},"PeriodicalIF":1.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752574","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":"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":"10.2169/internalmedicine.5322-25","url":null,"abstract":"","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2816"},"PeriodicalIF":1.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508609/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Recurrent Vomiting due to Severe Hyponatremic-Hypertensive Syndrome in an Elderly Patient.","authors":"Koki Morishita, Kaito Nakamura, Takafumi Kubota, Yusuke Ota, Mirei Nabuchi, Keita Hibako, Yoshimoto Serizawa, Tetsuya Hoshi","doi":"10.2169/internalmedicine.4725-24","DOIUrl":"10.2169/internalmedicine.4725-24","url":null,"abstract":"<p><p>Hyponatremic-hypertensive syndrome (HHS) is a rare disorder, particularly in adults. A 76-year-old woman presented with vomiting and severe hyponatremia. The patient had been hospitalized four times over the past four years due to hyponatremia and recurrent vomiting. On admission, magnetic resonance angiography revealed left renal artery stenosis, which led to a diagnosis of HHS. Treatment with enalapril followed by tolvaptan improved the patient's condition, without the need for renal artery angioplasty. HHS should therefore be considered in patients with hyponatremia, hypertension, or recurrent vomiting. In addition to angiotensin-converting enzyme inhibitors and renal artery angioplasty, tolvaptan may also be a new effective treatment option for HHS.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2804-2808"},"PeriodicalIF":1.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639609","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":"Scoping Review of the Health Benefits of Stretching Exercises in Patients with Type 2 Diabetes Mellitus.","authors":"Tomoko Takamiya, Rokuro Ito, Junko Sasaki, Toshihiro Amagawa, Sawako Wakui, Yuko Odagiri, Ryo Suzuki","doi":"10.2169/internalmedicine.4928-24","DOIUrl":"10.2169/internalmedicine.4928-24","url":null,"abstract":"<p><p>This study aimed to clarify the current state of research on the effects of stretching exercises on the health of patients with type 2 diabetes mellitus (T2DM). A scoping review of the literature was conducted in December 2024, using four databases. Experimental and clinical studies were included if they compared stretching exercises with non-stretching exercises for T2DM-related health outcomes. The primary search terms used were \"diabetes mellitus, type 2,\" \"muscle stretching exercises,\" and \"range of motion, articular.\" Eleven studies met our inclusion criteria. Eight studies focused on blood glucose levels, one of which assessed the functional capacity. The remaining studies investigated plantar pressure, shoulder joint mobility/pain/disability, and fatigue, with one study addressing each outcome. This review indicates that stretching exercises may affect a variety of health parameters, including blood glucose regulation, in patients with T2DM but emphasizes the need for further high-quality research to determine their effectiveness.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2681-2691"},"PeriodicalIF":1.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752595","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 : 2025-09-15Epub Date: 2025-03-22DOI: 10.2169/internalmedicine.4597-24
Shigenori Nakamura
{"title":"Development of Graves' Disease after Resection of an Autonomously Functioning Thyroid Nodule.","authors":"Shigenori Nakamura","doi":"10.2169/internalmedicine.4597-24","DOIUrl":"10.2169/internalmedicine.4597-24","url":null,"abstract":"<p><p>We herein report a 46-year-old woman with autonomously functioning thyroid nodules (AFTNs) who developed Graves' disease (GD) approximately one year after AFTN resection. Before surgery, the patient was positive for anti-thyroglobulin antibodies (TgAb) and anti-thyroid peroxidase antibodies (TPOAb), and negative for TSH-receptor antibodies (TRAb). An AFTN is a follicular adenoma surrounded by chronic thyroiditis. At the onset of GD, her TgAb and TPOAb titers increased, and TRAb became positive. This case suggests that surgery releases a large amount of thyroid tissue that contains thyroid-stimulating hormone receptors, leading to GD in susceptible individuals. Preoperative chronic thyroiditis can predict the postoperative development of GD.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2728-2732"},"PeriodicalIF":1.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700401","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 Systemic Lupus Erythematosus with Anti-centromere Antibody.","authors":"Wataru Fujii, Takahiro Seno, Masataka Kohno, Ikoi Omatsu, Eiichi Konishi, Yu Mihara, Yutaka Kawahito","doi":"10.2169/internalmedicine.4951-24","DOIUrl":"10.2169/internalmedicine.4951-24","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is a systemic disease that affects several organs. The diagnosis was performed using the international classification criteria updated in 2019. The significance of anti-nuclear antibodies (ANAs) with a centromere pattern has not been clearly documented in these criteria. We herein report a patient with ANAs with a centromere pattern and anti-centromere antibodies, without anti-Sm antibodies or anti-dsDNA antibodies, who developed severe lupus nephritis, neuropsychiatric SLE, and lupus pleuritis. The patient was successfully treated with prednisolone, hydroxychloroquine, mycophenolate mofetil, cyclophosphamide, and belimumab, despite several relapses. Anti-centromere antibodies are not regarded as characteristics of SLE but can be detected in SLE patients with severe organ involvement.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2790-2793"},"PeriodicalIF":1.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491933","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":"Multiple Myeloma in a Patient with Birt-Hogg-Dubé Syndrome.","authors":"Fumiaki Matsumura, Tatsuhiro Sakamoto, Hirayasu Kai, Toshiaki Usui, Kunio Kawanishi, Ryota Matsuoka, Kantaro Ishitsuka, Kenichi Makishima, Sakurako Suma, Yumiko Maruyama, Takayasu Kato, Naoki Kurita, Keiichiro Hattori, Yasuhito Suehara, Hidekazu Nishikii, Naoshi Obara, Joichi Usui, Daisuke Matsubara, Kunihiro Yamagata, Mamiko Sakata-Yanagimoto","doi":"10.2169/internalmedicine.4985-24","DOIUrl":"10.2169/internalmedicine.4985-24","url":null,"abstract":"<p><p>Birt-Hogg-Dubé syndrome (BHDS) is an autosomal dominant disease caused by germline folliculin (FLCN) mutations and it is characterized by skin folliculomas, pulmonary cysts, and renal cell carcinomas (RCC). We herein report the first case of a female patient with BHDS who was diagnosed with multiple myeloma. Daratumumab-based treatment was effective, and the patient remained responsive for over three years. Whole-exome sequencing confirmed an FLCN germline mutation and nine somatic mutations, including an MPDZ mutation, which is a component of the tumor-suppressive Hippo-YAP pathway. Considering the reported association between the Hippo-YAP pathway and RCC with BHDS, an MPDZ mutation may contribute to carcinogenesis in patients with BHDS.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2764-2768"},"PeriodicalIF":1.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639633","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":"Sarcoid Neuropathy Presenting with Two Novel Ultrasound Findings of Increased Intraneural Blood Flow and Small Saphenous Vein Wall Thickening.","authors":"Hiroki Yamazaki, Ryota Sato, Tomoyasu Matsubara, Naoko Takamatsu, Yusuke Osaki, Takashi Kanda, Yuishin Izumi","doi":"10.2169/internalmedicine.4964-24","DOIUrl":"10.2169/internalmedicine.4964-24","url":null,"abstract":"<p><p>Diagnosing sarcoid neuropathy (SN) can be difficult because of its nonspecific symptoms and requirement for histological confirmation. We herein report a 71-year-old woman who presented with distal muscle weakness and paresthesia. Nerve conduction studies support the existence of polyneuropathy. Nerve ultrasonography revealed enlargement of the sural nerve and loss of the normal \"honeycomb\" appearance. In addition, increased intraneural blood flow within the nerve and small saphenous vein wall thickening were observed. These ultrasound findings led to a successful nerve biopsy confirming SN. Steroid therapy has resulted in clinical and ultrasonographic improvements. These results suggest the potential utility of ultrasound for diagnosing and monitoring SN.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2779-2783"},"PeriodicalIF":1.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585627","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}