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Complete Remission of Acute-onset Autoimmune Hepatitis Following Transcatheter Splenic Arterial Embolization and Splenectomy for Spontaneous Splenic Rupture. 自发性脾破裂经导管脾动脉栓塞和脾切除术后急性自身免疫性肝炎完全缓解。
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.5735-25
Ikue Sekai, Masahiro Takita, Shigenobu Yasuhara, Naoya Omaru, Takuya Matsubara, Masahiro Morita, Hirokazu Chishina, Kosuke Minaga, Satoru Hagiwara, Hiroshi Ida, Misa Kojima, Osamu Maenishi, Tomohiro Watanabe, Masatoshi Kudo
{"title":"Complete Remission of Acute-onset Autoimmune Hepatitis Following Transcatheter Splenic Arterial Embolization and Splenectomy for Spontaneous Splenic Rupture.","authors":"Ikue Sekai, Masahiro Takita, Shigenobu Yasuhara, Naoya Omaru, Takuya Matsubara, Masahiro Morita, Hirokazu Chishina, Kosuke Minaga, Satoru Hagiwara, Hiroshi Ida, Misa Kojima, Osamu Maenishi, Tomohiro Watanabe, Masatoshi Kudo","doi":"10.2169/internalmedicine.5735-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5735-25","url":null,"abstract":"<p><p>A 62-year-old woman presented with jaundice and fatigue. A blood examination revealed markedly elevated serum transaminase and bilirubin levels and negative hepatitis virus markers. A radiographic examination revealed no bile duct abnormalities. Serum transaminase levels decreased and normalized without immunosuppression after transcatheter arterial embolization and splenectomy for spontaneous splenic rupture, respectively. The pathological findings of the liver biopsy specimens were consistent with those of acute-onset autoimmune hepatitis (AIH), despite normal serum IgG levels. The clinical course of the present case suggests that pathogenic immune responses associated with acute-onset AIH may arise in the spleen, but not in the liver.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Urinary β2-microglobulin as a Potential Biomarker for Early Treatment Selection: A Patient with Severe IgG4-related Tubulointerstitial Nephritis. 尿β2微球蛋白作为早期治疗选择的潜在生物标志物：严重igg4相关性肾小管间质肾炎患者
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.5407-25
Nozomi Taniguchi, Masato Sakai, Takahiro Masuda, Chihiro Otsuki, Maki Asakura-Kinoshita, Kyohei Misawa, Kazuho Oe, Kazutoshi Ono, Natsuko Wakabayashi, Kentaro Oka, Erika Hishida, Yuko Ono, Tetsu Akimoto, Daisuke Nagata
{"title":"Urinary β2-microglobulin as a Potential Biomarker for Early Treatment Selection: A Patient with Severe IgG4-related Tubulointerstitial Nephritis.","authors":"Nozomi Taniguchi, Masato Sakai, Takahiro Masuda, Chihiro Otsuki, Maki Asakura-Kinoshita, Kyohei Misawa, Kazuho Oe, Kazutoshi Ono, Natsuko Wakabayashi, Kentaro Oka, Erika Hishida, Yuko Ono, Tetsu Akimoto, Daisuke Nagata","doi":"10.2169/internalmedicine.5407-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5407-25","url":null,"abstract":"<p><p>This case report describes an 80-year-old man with severe immunoglobulin G4-related tubulointerstitial nephritis (IgG4-TIN), characterized by storiform fibrosis with diffuse lymphocytic and plasma cell infiltration observed on a renal biopsy. Steroid pulse therapy administered immediately after confirming a remarkable increase in urinary β2-microglobulin (100,948 μg/L) along with no evidence of malignancy significantly improved the renal function and reduced the urinary β2-microglobulin levels. This study highlights the potential utility of urinary β2-microglobulin as a biomarker for early treatment selection in severe IgG4-TIN and emphasizes the need for timely intervention to prevent irreversible kidney damage.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spontaneous Regression in Pancreatic Neuroendocrine Tumor. 胰腺神经内分泌肿瘤的自发消退。
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.5837-25
Mami Bamba, Yuki Yamauchi, Takeshi Matsumura
{"title":"Spontaneous Regression in Pancreatic Neuroendocrine Tumor.","authors":"Mami Bamba, Yuki Yamauchi, Takeshi Matsumura","doi":"10.2169/internalmedicine.5837-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5837-25","url":null,"abstract":"<p><p>Spontaneous regression (SR) of pancreatic neuroendocrine tumors (pNETs) is extremely rare. We herein report a 64-year-old man with a nonfunctioning pNET that was incidentally detected during an evaluation for back pain. Imaging showed a 30-mm mass in the pancreatic tail, but surgery was delayed because of an old myocardial infarction. Four months later, follow-up imaging revealed tumor shrinkage of 20 mm without treatment. Laparoscopic distal pancreatectomy confirmed a grade 3 pNET. While ischemia was considered, factors such as mild immune response or metabolic stress may have contributed. This case suggests that ischemia and other factors may also play a role. Further research is needed to elucidate the mechanisms underlying SR in NETs.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Case of Urinary Retention Triggered by Urethritis in Olanzapine-induced Diabetic Ketoacidosis. 奥氮平所致糖尿病酮症酸中毒并发尿道炎尿潴留1例。
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.5880-25
Hideyuki Murakami, Kazuaki Norita, Akihiro Ikeda
{"title":"A Case of Urinary Retention Triggered by Urethritis in Olanzapine-induced Diabetic Ketoacidosis.","authors":"Hideyuki Murakami, Kazuaki Norita, Akihiro Ikeda","doi":"10.2169/internalmedicine.5880-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5880-25","url":null,"abstract":"<p><p>A 58-year-old woman with schizophrenia was transported to our hospital by ambulance due to impaired consciousness. At the time of the examination, the patient had significant abdominal distension and diabetic ketoacidosis associated with urinary retention. Although the symptoms improved with the insertion of a urinary catheter and glycemic control, the involvement of the antipsychotic olanzapine was considered the background to the pathophysiology of this case. We herein report the relationship between antipsychotic drugs, diabetic ketoacidosis, and urinary retention along with a literature review.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hepatic Ectopic Adrenal Gland in a Patient with Hepatitis C Virus Who Achieved a Sustained Virological Response: A Case Report. 实现持续病毒学应答的丙型肝炎患者肝肾上腺异位：一例报告。
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.5655-25
Mariya Kawanishi, Akitoshi Douhara, Koji Ishida, Masato Nakatsuji, Noriyuki Hamato, Daisuke Hokuto, Masahiro Tsutsumi, Toshiya Nakatani
{"title":"Hepatic Ectopic Adrenal Gland in a Patient with Hepatitis C Virus Who Achieved a Sustained Virological Response: A Case Report.","authors":"Mariya Kawanishi, Akitoshi Douhara, Koji Ishida, Masato Nakatsuji, Noriyuki Hamato, Daisuke Hokuto, Masahiro Tsutsumi, Toshiya Nakatani","doi":"10.2169/internalmedicine.5655-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5655-25","url":null,"abstract":"<p><p>Hepatic ectopic adrenal glands are rare and can mimic hepatocellular carcinoma (HCC). We herein report a 60-year-old woman with a history of chronic hepatitis C who achieved a sustained virological response. A 23-mm hepatic lesion was detected and initially diagnosed as HCC. However, laparoscopic resection and histopathology confirmed the presence of an ectopic adrenal gland. Given the location of the posterior liver, a biopsy is challenging. Adrenal scintigraphy may aid in the diagnosis and reduce the need for invasive procedures. As more cases are reported, improved imaging-based diagnoses may facilitate noninvasive identification of hepatic ectopic adrenal glands, avoiding unnecessary surgical intervention.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Subclinical Myocardial Involvement Evaluated by Cardiac Magnetic Resonance Imaging in a Patient with Anti-Ro52/SS-A Antibody-positive Sjögren's Disease Complicated with Polymyositis. 抗ro52 /SS-A抗体阳性Sjögren病患者合并多发性肌炎的心脏磁共振成像评估亚临床心肌损害
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.5500-25
Kiichi Sugito, Masashi Uchikawa, Shinya Asatani, Masahiro Nishihara, Yosuke Nagasawa, Hirotake Inomata, Masako Tsukamoto, Hitomi Kobayashi, Noboru Kitamura, Hideki Nakamura, Yasuo Okumura
{"title":"Subclinical Myocardial Involvement Evaluated by Cardiac Magnetic Resonance Imaging in a Patient with Anti-Ro52/SS-A Antibody-positive Sjögren's Disease Complicated with Polymyositis.","authors":"Kiichi Sugito, Masashi Uchikawa, Shinya Asatani, Masahiro Nishihara, Yosuke Nagasawa, Hirotake Inomata, Masako Tsukamoto, Hitomi Kobayashi, Noboru Kitamura, Hideki Nakamura, Yasuo Okumura","doi":"10.2169/internalmedicine.5500-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5500-25","url":null,"abstract":"<p><p>A 52-year-old woman with myalgia, anti-aminoacyl tRNA synthetase, anti-SS-A/Ro52 antibody positivity, and elevated creatine kinase levels was admitted to our hospital. She was diagnosed with Sjögren's disease (SjD) complicated by polymyositis (PM). No chest symptoms were observed. Although her electrocardiogram and echocardiogram findings were normal, cardiac magnetic resonance imaging (CMRI) revealed myocardial edema and fibrosis with late gadolinium enhancement, elevated extracellular volume, and elevated T2 values. After treatment with prednisolone, the myalgia and CMRI abnormalities improved. This case suggests that CMRI may be useful for the detection and treatment of subclinical myocardial damage in patients with SjD complicated by PM.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Acute Kidney Injury Secondary to Aortic Dissection Following Transcatheter Aortic Valve Implantation: Perspectives from Nephrologists. 经导管主动脉瓣植入术后继发于主动脉夹层的急性肾损伤：肾内科医生的观点。
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.5904-25
Ryo Tajima, Ryo Koyama, Mikihiro Suzuki, Suguru Takayama, Toshiya Yoshida, Takahiko Kai, Masashi Koga, Masahiko Yazawa
{"title":"Acute Kidney Injury Secondary to Aortic Dissection Following Transcatheter Aortic Valve Implantation: Perspectives from Nephrologists.","authors":"Ryo Tajima, Ryo Koyama, Mikihiro Suzuki, Suguru Takayama, Toshiya Yoshida, Takahiko Kai, Masashi Koga, Masahiko Yazawa","doi":"10.2169/internalmedicine.5904-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5904-25","url":null,"abstract":"<p><p>Aortic dissection (AD) is a rare but serious complication of transcatheter aortic valve implantation (TAVI) and should be considered in the differential diagnosis of acute kidney injury (AKI). We herein report an older man who developed AKI secondary to Stanford type B AD after transfemoral TAVI. Non-contrast computed tomography (CT) revealed inward displacement of the calcified intima, which is a key early finding. Contrast-enhanced CT confirmed AD extending to the renal artery. As endovascular intervention was not feasible, conservative management was selected. Nephrologists should recognize AD as an important cause of AKI following TAVI and carefully assess CT images for early subtle signs.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Japanese Encephalitis: Characteristic Imaging in Substantia Nigra, Thalamus, and Basal Ganglia. 日本脑炎：黑质、丘脑和基底神经节的特征性影像。
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.5832-25
Kazumasa Sekiguchi, Jun Sawada, Yuhei Anan, Shigeru Fujimoto
{"title":"Japanese Encephalitis: Characteristic Imaging in Substantia Nigra, Thalamus, and Basal Ganglia.","authors":"Kazumasa Sekiguchi, Jun Sawada, Yuhei Anan, Shigeru Fujimoto","doi":"10.2169/internalmedicine.5832-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5832-25","url":null,"abstract":"","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Solitary Fused Pelvic Kidney with Limb Agenesis. 孤立融合盆腔肾伴肢体发育不全。
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.6002-25
Mana Kashiwagi, Hiroki Kobayashi, Yoshihiro Nakamura, Masanori Abe
{"title":"Solitary Fused Pelvic Kidney with Limb Agenesis.","authors":"Mana Kashiwagi, Hiroki Kobayashi, Yoshihiro Nakamura, Masanori Abe","doi":"10.2169/internalmedicine.6002-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.6002-25","url":null,"abstract":"","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spinal Dural Arteriovenous Fistula Revealed by Heavily T2-weighted Sequences. 重t2加权序列显示的硬脊膜动静脉瘘。
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.5719-25
Takahiro Makino, Kazuki Machino, Kyosuke Takasaka, Ikuo Kamitsukasa
{"title":"Spinal Dural Arteriovenous Fistula Revealed by Heavily T2-weighted Sequences.","authors":"Takahiro Makino, Kazuki Machino, Kyosuke Takasaka, Ikuo Kamitsukasa","doi":"10.2169/internalmedicine.5719-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5719-25","url":null,"abstract":"","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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