Journal of International Medical Research最新文献

{"title":"5-Methylcytosine methylation predicts cervical cancer prognosis, shaping immune cell infiltration.","authors":"Luyang Su, Ren Xu, Yanan Ren, Shixia Zhao, Liyun Song, Cuiqiao Meng, Weilan Liu, Xuan Zhou, Zeqing Du","doi":"10.1177/03000605251328301","DOIUrl":"https://doi.org/10.1177/03000605251328301","url":null,"abstract":"<p><p>BackgroundEpigenetics, encompassing DNA and RNA modifications, has emerged as a prominent area of research in the post-genomic era. Numerous studies have elucidated the impact of epigenetics on tumor regulation. However, the methylation patterns of 5-methylcytosine in cervical cancer as well as its role in the tumor microenvironment and immunotherapy remain poorly understood.MethodsUtilizing a comprehensive dataset encompassing samples from 306 patients with cervical cancer from The Cancer Genome Atlas and Gene Expression Omnibus repositories, we conducted an in-depth analysis to evaluate the potential association between the modification patterns of 5-methylcytosine and the infiltration of cells within the tumor microenvironment, taking into account 11 regulators of 5-methylcytosine modification. Subsequently, we employed stepwise regression and Least Absolute Shrinkage and Selection Operator Cox regression to quantify 5-methylcytosine modification patterns in patients with cervical squamous cell carcinoma and endocervical adenocarcinoma, yielding the 5-methylcytosine score. Our study explored the link between the 5-methylcytosine score and clinical characteristics as well as prognostic outcomes in patients with cervical squamous cell carcinoma and endocervical adenocarcinoma.ResultsA comprehensive analysis of 306 patients with cervical cancer revealed two distinct 5-methylcytosine modification patterns, henceforth labeled as 5-methylcytosine clusters A and B. These clusters exhibited distinct immunological profiles and biological attributes, with 5-methylcytosine cluster A exhibiting a higher degree of immune cell infiltration. Utilizing univariate Cox regression analysis, we identified 367 genes regulated by 5-methylcytosine that were significantly correlated with patient prognosis. This analysis further stratified the samples into three distinct genomic subtypes. Survival analyses indicated that patients belonging to gene cluster C exhibited more favorable survival outcomes than those belonging to gene clusters A and B. Intriguingly, most 5-methylcytosine regulatory factors had higher expression levels in gene cluster B than in gene cluster A. Gene set enrichment analysis of a single sample revealed elevated immune cell infiltration within gene cluster B, indicating a stronger immune response in this cluster. The 5-methylcytosine score feature was utilized to determine the 5-methylcytosine modification pattern in cervical cancer, revealing that patients with low 5-methylcytosine scores exhibited better survival rates, whereas those with high scores had increased mutation frequencies and better treatment responses.ConclusionsThis research underscores the key role of 5-methylcytosine modification patterns in cervical cancer. Analysis of these patterns will deepen our understanding of the cervical cancer tumor microenvironment, paving the way for the development of more refined and effective immunotherapy strategies.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 4","pages":"3000605251328301"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011186","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":"Rare giant perianal smooth muscle tumor: A case report.","authors":"Yuanchao Guo, Yi Song, Xiaona Li, Houhua Liu, Tao Wei, Maowei Yang, Chaonan Zhang, Xingang Li","doi":"10.1177/03000605251333681","DOIUrl":"https://doi.org/10.1177/03000605251333681","url":null,"abstract":"<p><p>Smooth muscle tumors are benign tumors originating from smooth muscle tissues, mostly occurring in the uterus and digestive tract; however, smooth muscle tumors occurring in the perianal sphincter are very rare. A 48-year-old woman presented with perianal swelling and pain and was misdiagnosed with a perianal abscess after examination at a foreign hospital. Upon further examination, the patient was diagnosed with a perianal smooth muscle tumor, with a size of approximately 6.5 × 5.5 × 4 cm. We succeeded in surgically removing the tumor. The patient was followed up for 2 years after the operation, and her anus functioned well without recurrence. Perianal abscess and perianal smooth muscle tumors are difficult to differentiate in the clinic and need to be identified via imaging. In clinical practice, smooth muscle tumors should be differentiated from perianal abscess and diseases such as rectal mesenchymal tumors and smooth muscle sarcomas.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 4","pages":"3000605251333681"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006801","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":"<i>KMT2C</i> mutation in sporadic cribriform morular thyroid carcinoma: A rare case report and review of literature.","authors":"Yingzheng Gao, Jinwang Ding, Jingjing Xu, Jiahao Chen, Weidong Du","doi":"10.1177/03000605251326789","DOIUrl":"10.1177/03000605251326789","url":null,"abstract":"<p><p>Cribriform morular thyroid carcinoma is a rare thyroid malignancy with uncertain histogenesis. It predominantly affects young women and is strongly associated with familial adenomatous polyposis. This paper reports a rare case of sporadic cribriform morular thyroid carcinoma in a female patient in her early 50s, with somatic genetic testing revealing a <i>KMT2C</i> mutation. She presented with a solitary lesion confined to the right thyroid lobe and had no family history of familial adenomatous polyposis. Colonoscopy and germline genetic testing revealed no abnormalities. This finding suggests a potential link between <i>KMT2C</i> mutations and sporadic cribriform morular thyroid carcinoma. The clinical and imaging manifestations of this malignancy lack specificity, and the final diagnosis depends on routine pathological examination and immunohistochemical analysis. This report indicates the need for the clinical investigation of family history and genetic testing, thus contributing to the clinical realization of standardized follow-up monitoring and management.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 4","pages":"3000605251326789"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772438","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":"Impact of the 13-valent pneumococcal vaccine on <i>Streptococcus pneumoniae</i> serotypes and antibiotic susceptibility in children.","authors":"Zhang Shengxin, Yuan Lin, Chen Lei, Zhang Yan, Liu Huaying, Lou Qing","doi":"10.1177/03000605251336064","DOIUrl":"https://doi.org/10.1177/03000605251336064","url":null,"abstract":"<p><p>ObjectiveTo examine the impact of the 13-valent pneumococcal vaccine on <i>Streptococcus pneumoniae</i> serotypes and antibiotic susceptibility in children to inform the prevention and treatment of <i>S. pneumoniae</i> infections.MethodsWe analyzed and compared <i>S. pneumoniae</i> serotypes and antibiotic susceptibility between children vaccinated with 13-valent pneumococcal vaccine (vaccinated group) and unvaccinated children (control group).ResultsWe collected 167 <i>S. pneumoniae</i> strains that met the study requirements from 60 children (35.92%) in the vaccinated group and 107 (64.08%) children in the control group. The antibiotic susceptibility test revealed no significant difference in susceptibility to oral penicillin (a β-lactam) or penicillin injection between the two groups. Of the third-generation cephalosporins, susceptibility to ceftriaxone and cefotaxime differed significantly among children with meningitis between the two groups (<i>P</i> < 0.05) but not among children without meningitis. In total, 167 strains were susceptible to vancomycin. Neither of the groups were susceptible to erythromycin.ConclusionsThe majority of the <i>S. pneumoniae</i> serotypes isolated from children in Xiamen were covered by the 13-valent pneumococcal vaccine. The isolated <i>S. pneumoniae</i> strains were highly resistant to erythromycin and tetracycline but remained susceptible to vancomycin. Children vaccinated with the 13-valent pneumococcal vaccine may benefit from parenteral third-generation cephalosporins after developing pneumococcal meningitis.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 4","pages":"3000605251336064"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969910","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":"Renal artery rupture with lethal outcome in a patient with neurofibromatosis type 1: Case report and review of literature.","authors":"Jisun Lee, Yook Kim","doi":"10.1177/03000605251335853","DOIUrl":"https://doi.org/10.1177/03000605251335853","url":null,"abstract":"<p><p>Neurofibromatosis type 1 is an autosomal dominant disorder. The vasculopathy of neurofibromatosis type 1 may rarely comprise stenosis, occlusion, aneurysm, pseudoaneurysm, and arteriovenous deformity, and it often presents as rupture of an undiagnosed lesion, which highly increases mortality in young patients with neurofibromatosis type 1. A female patient in her early 30s who had neurofibromatosis type 1 presented to our hospital with extensive and progressive bleeding of a ruptured renal artery pseudoaneurysm caused by trauma. Complete total embolization of the renal artery was performed using several microcoils and a mixture of n-butyl cyanoacrylate and iodized oil. Despite combined endovascular and surgical management tailored to the patient's condition, she died from uncontrolled bleeding. Endovascular treatment is widely regarded as a safe and less invasive option for managing vascular complications in neurofibromatosis type 1. However, it may be insufficient in rapidly progressive cases. Considering the vascular fragility and recurrence of hemorrhagic shock, earlier surgical intervention, including nephrectomy, should have been more strongly considered. This case highlights the limitations of repeated endovascular management alone and suggests that prompt surgical exploration is warranted when pseudoaneurysm rupture is suspected, even in seemingly stable patients. Ultimately, this case underscores the need for heightened clinical vigilance and early surgical decision-making in the treatment of neurofibromatosis type 1 and rapidly evolving vascular injuries.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 4","pages":"3000605251335853"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988587","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":"Identification of hub genes related to DNA damage response in asthma via combinative bioinformatics strategy.","authors":"Li He, Fangmei Lin, Yawen Zhou, Meihua Dong, Mingfang Deng, Jing Li, Nan Jia","doi":"10.1177/03000605251332204","DOIUrl":"https://doi.org/10.1177/03000605251332204","url":null,"abstract":"<p><p>ObjectiveEmerging evidence has indicated the potential role of DNA damage response in asthma pathogenesis, but the underlying mechanisms remain elusive. Therefore, this study aimed to identify key diagnostic DNA damage response-related genes in asthma and explore their regulatory networks.MethodsDifferentially expressed genes between healthy individuals and patients with asthma were identified using the Gene Expression Omnibus database. Hub DNA damage response-related differentially expressed genes were determined via protein-protein interaction network and verified through gene expression analysis. Receiver operating characteristic curve was employed to identify diagnostic genes. Transcription factor-microRNA-target gene interactions were analyzed to uncover the regulatory networks in asthma pathogenesis. In this observational study, reverse transcription quantitative polymerase chain reaction was used to validate gene expression levels in healthy individuals and patients with asthma.ResultsSix of the nine hub genes (<i>ATM</i>, <i>PCNA</i>, <i>CUL4A</i>, <i>PARP2</i>, <i>HLTF</i>, and <i>NBN</i>) were identified as key diagnostic genes. These genes may contribute to asthma progression by regulating inflammatory pathways, such as cyclic GMP-AMP synthase-stimulator of interferon genes, senescence-associated secretory phenotype, autophagy, and apoptosis. Three microRNAs and eleven transcription factors were recognized as potential regulators. Reverse transcription quantitative polymerase chain reaction confirmed the downregulation of DNA damage response genes in asthma and revealed distinct expression patterns across different asthma endotypes.ConclusionSix DNA damage response-related genes may serve as diagnostic biomarkers for asthma, and the transcription factor-microRNA-DNA damage response gene network highlights the role of DNA damage response in asthmatic inflammation.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 4","pages":"3000605251332204"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027091","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":"Impact of preoperative complement-dependent cytotoxicity crossmatch on postoperative outcomes in kidney transplant recipients: A retrospective analysis.","authors":"Chonghe Xu, Siqi Xie, Meiyi Lu, Wei Xu, Mei Zhu","doi":"10.1177/03000605251332762","DOIUrl":"https://doi.org/10.1177/03000605251332762","url":null,"abstract":"<p><p>ObjectivesThe aim of the present study was to compare the differences in clinical outcomes within 6 months postoperatively between a complement-dependent cytotoxicity <10% group of low-risk kidney transplant patients and a complement-dependent cytotoxicity ≥10% group of relatively high-risk patients.MethodsThe clinical data of 330 patients who underwent kidney transplantation were retrospectively analyzed. The patients were divided into three groups according to the results of complement-dependent cytotoxicity crossmatch: (a) group 1 (complement-dependent cytotoxicity ≥10%); (b) group 2a (5% ≤ complement-dependent cytotoxicity < 10%); and (c) group 2b (complement-dependent cytotoxicity <5%). The clinical outcomes were compared between the three groups.ResultsSignificant differences were noted in serum creatinine levels and estimated glomerular filtration rate between groups 2a and 2b on days (D) 1, 2, 3, and 7 (P < 0.005). From postoperative D1 to month (M) 6, a significant difference (P < 0.05) was noted in urea levels between the three groups. On D3, blood glucose levels were significantly lower in group 2b than in group 2a (P < 0.001); at M6, group 2b exhibited lower blood glucose levels than group 1 (P = 0.043). On D2, group 2b had a lower neutrophil percentage than group 1 (P < 0.05), which was significantly different from those of groups 1 and 2a on D3 (P < 0.05). The percentage and absolute number of lymphocytes in group 2b were significantly higher than those in group 1 (P < 0.01) on D1 and D2. The percentage and absolute number of lymphocytes were significantly higher in group 2b than in groups 1 and 2a on D3 and D7 (P < 0.05).ConclusionsComplement-dependent cytotoxicity <10%, particularly complement-dependent cytotoxicity <5%, was associated with superior attributes compared with complement-dependent cytotoxicity ≥10% in terms of most aspects of postoperative recovery and low incidence of adverse events. However, delayed graft function rate was highest in the complement-dependent cytotoxicity of 5%-10% group. The source of donor kidneys was the most important factor influencing delayed graft function, and a larger cohort with a longer follow-up period may be needed to verify the tendency.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 4","pages":"3000605251332762"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025144","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":"Isolated neurological symptoms of Wilson's disease manifesting as focal epileptic seizures without hepatic involvement: Insights from a case report.","authors":"Ayham Qatza, Ahmad Almohamed, Rima Alassaad, Saja Karaja, Ghina Hamsho, Ghiath Alassad","doi":"10.1177/03000605251328574","DOIUrl":"https://doi.org/10.1177/03000605251328574","url":null,"abstract":"<p><p>Patients with Wilson's disease, an autosomal recessive disorder caused by <i>ATP7B</i> mutations, present with hepatic and neurological symptoms, including tremors, chorea, personality changes, and rare manifestations such as neuropathy, autonomic dysfunction, headache, and epilepsy. This report describes the case of a 14-year-old man born to consanguineous parents who presented with focal seizures and oromandibular dystonia. A neurological exam revealed left upper limb hypotonia. An electroencephalogram showed right hemisphere epileptiform activity, and magnetic resonance imaging indicated bilateral basal ganglia hyperintensities. An ophthalmological exam revealed an incomplete Kayser-Fleischer ring. Laboratory tests confirmed Wilson's disease with low serum ceruloplasmin (3 mg/dL) and elevated urinary copper excretion (1226 mcg/24 h) levels. Treatment included penicillamine (250 mg/day) and zinc (50 mg bi-daily), along with clonazepam for seizures. Routine follow-ups were recommended. This case highlights the importance of recognizing neurological presentations in patients with Wilson's disease for timely diagnosis and management.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 4","pages":"3000605251328574"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022407","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":"Alpha-fetoprotein and carbohydrate antigen 19-9 as prognostic biomarkers in acute liver failure: A retrospective study.","authors":"Rui Qi, Xin Wang, Zhidan Kuang, Xueyi Shang, Fang Lin, Dan Chang, Jinsong Mu","doi":"10.1177/03000605251332808","DOIUrl":"https://doi.org/10.1177/03000605251332808","url":null,"abstract":"<p><p>ObjectiveTo investigate the clinical significance of alpha-fetoprotein and carbohydrate antigen 19-9 as potential predictors of outcomes in patients with acute liver failure.MethodsWe conducted a retrospective analysis of 208 patients with acute liver failure admitted to the intensive care unit between 2009 and 2023. Serum alpha-fetoprotein and carbohydrate antigen 19-9 levels were measured on Days 1 and 3, and their prognostic value was evaluated using logistic regression and receiver operating characteristic curve analyses. Patients were stratified by etiologies to assess biomarker performance across different causes of acute liver failure.ResultsNonsurvivors had significantly lower alpha-fetoprotein levels and higher carbohydrate antigen 19-9 levels than survivors on Days 1 and 3 (all <i>p </i><<i> </i>0.05). Alpha-fetoprotein levels increased over time in both groups, whereas carbohydrate antigen 19-9 levels increased in nonsurvivors and decreased in survivors. The combination of carbohydrate antigen 19-9 with the Model for End-Stage Liver Disease score significantly improved prognostic accuracy, with an area under the curve value of 0.828, compared with 0.784 for alpha-fetoprotein combined with Model for End-Stage Liver Disease score. Etiology-specific analysis revealed that carbohydrate antigen 19-9 showed the best predictive performance in acetaminophen-induced acute liver failure (area under the curve value = 0.885), whereas alpha-fetoprotein showed better predictive performance in viral hepatitis-associated acute liver failure (area under the curve value = 0.880).ConclusionsAlpha-fetoprotein is a protective prognostic factor, whereas carbohydrate antigen 19-9 enhances outcome prediction, particularly when combined with Model for End-Stage Liver Disease score. Etiology-specific biomarker performance supports tailored prognostic approaches in the management of acute liver failure.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 4","pages":"3000605251332808"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008412","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":"IgA nephropathy, non-cirrhotic portal fibrosis, and POEMS syndrome: A rare combination in the long-term follow-up of Sjögren's syndrome.","authors":"Xiuhong Wang, Lina Zhang, Tong Zhang, Bozhi Lin, Jing Xu, Meixiang Zhang, Zhicheng Liu","doi":"10.1177/03000605251332903","DOIUrl":"https://doi.org/10.1177/03000605251332903","url":null,"abstract":"<p><p>Sjögren's syndrome is a heterogeneous autoimmune disorder that may be associated with systemic manifestations involving multiple organs. We herein reported a rare combination of immunoglobulin A nephropathy; non-cirrhotic portal fibrosis; and polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, and skin changes (POEMS) syndrome in a 15-year follow-up of a female patient initially diagnosed with Sjögren's syndrome. The patient had excessive lymphoproliferation featured by lymphadenopathy and hyperglobulinemia. The diagnoses of immunoglobulin A nephropathy and non-cirrhotic portal fibrosis were confirmed by renal and liver biopsies. She received prolonged corticosteroids and immunosuppressive drugs, which improved immunoglobulin A nephropathy but did not hinder the progression of portal fibrosis, leading to intractable variceal bleeding. The patient died of repeated hematemesis despite endoscopic variceal ligation. Valuable pathological information of multi-organ involvement as well as detailed clinical course were presented to facilitate further understanding of this rare entity. Excessive lymphoproliferation might play an important role in the progression of systemic complications in Sjögren's syndrome, which requires prolonged immunosuppression and organ-specific treatment.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 4","pages":"3000605251332903"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007575","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}