{"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}
{"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}
{"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}
Internal MedicinePub Date : 2025-09-01Epub Date: 2025-03-01DOI: 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}
{"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}
{"title":"Differences in Lung Cancer-related Clinical Practice and Basic Research Background between Japan and China: A Narrative Review.","authors":"Lan Wang, Yiyan Miao, Yihang Gu, Tomoya Kawaguchi, Megumi Mizutani, Toshiyuki Nakai, Tetsuya Watanabe, Kazuhisa Asai, Hui Zhang, Wenwen Cai, Yoko Tani, Hiroyasu Kaneda","doi":"10.2169/internalmedicine.4808-24","DOIUrl":"10.2169/internalmedicine.4808-24","url":null,"abstract":"<p><p>With its increasing incidence, lung cancer has become one of the leading causes of cancer-related deaths worldwide, posing a great threat to the health and lives of patients. Due to varying economic and cultural backgrounds, there are significant differences in clinical treatment practices and related basic research on lung cancer between Japan and China. These differences are mainly reflected in many aspects, such as cancer prevention, cancer treatment, provision of medical insurance, patient compliance, medical education system, and sources of research funding. By understanding these differences, Japan and China can learn from each other, make progress together, and strengthen further exchanges and cooperation, which will help improve the long-term efficacy of lung cancer treatment and improve patients' clinical outcomes.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2524-2533"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537021","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 : 2025-09-01Epub Date: 2025-02-22DOI: 10.2169/internalmedicine.4489-24
Marko Atanasković, Bojan Mihajlović, Maja Stefanović, Marija Bjelobrk, Branislav Crnomarković, Mila Kovačević
{"title":"Sigmoid Septum: A Bystander or Contributor to a Left Ventricular Outflow Tract Obstruction in Takotsubo Syndrome - A Case Report with a Literature Review.","authors":"Marko Atanasković, Bojan Mihajlović, Maja Stefanović, Marija Bjelobrk, Branislav Crnomarković, Mila Kovačević","doi":"10.2169/internalmedicine.4489-24","DOIUrl":"10.2169/internalmedicine.4489-24","url":null,"abstract":"<p><p>Approximately 20% of patients with Takotsubo syndrome (TTS) develop complications such as left ventricular outflow tract obstruction (LVOTO). The published data suggest that a significant proportion of these patients have predisposing septal hypertrophy or sigmoid septum. However, the pathophysiology regarding this connection has not yet been fully elucidated. We herein present the case of a 75-year-old female patient with TTS complicated by LVOTO, which was successfully managed. During the follow-up, mild basal septal hypertrophy was observed. Subsequent exercise and dobutamine stress echocardiography were performed to reveal the mechanism of LVOTO in TTS.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2557-2573"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491951","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":"Dapagliflozin for the Treatment of Collagenofibrotic Glomerulopathy.","authors":"Enyu Imai, Atsuhiro Imai, Masaaki Izumi, Jun Nakazawa, Hideki Fujii, Shinichi Nishi","doi":"10.2169/internalmedicine.4952-24","DOIUrl":"10.2169/internalmedicine.4952-24","url":null,"abstract":"<p><p>Collagenofibrotic glomerulopathy is a rare, incurable kidney disease characterized by severe proteinuria and extensive type III collagen deposition in mesangial and subendothelial spaces. To date, no effective treatment has yet been reported. A 45-year-old Japanese woman was treated daily with 10 mg dapagliflozin. Her eGFR slope improved from -3.61 mL/min/1.73 m<sup>2</sup>/year over 4 years before treatment to 0.11 mL/min/1.73 m<sup>2</sup>/year after 3 years of treatment. Additionally, her nephrotic-range proteinuria, initially exceeding 4 g/gCr, decreased to <2 g/gCr after dapagliflozin treatment. To our knowledge, this is the first documented case of effective treatment for collagenofibrotic glomerulopathy.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2615-2618"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457923","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}