Innere Medizin (Heidelberg, Germany)最新文献_第2页

Fortbildungen des BDI. BDI培训。

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-05-01 DOI: 10.1007/s00108-026-02115-3

引用次数: 0

Primärversorgungssystem. Primärversorgungssystem .

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-05-01 DOI: 10.1007/s00108-026-02114-4

引用次数: 0

[An unusual cause for kidney transplantation]. [肾脏移植的一个不寻常的原因]。

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-05-01 Epub Date: 2025-11-18 DOI: 10.1007/s00108-025-02019-8

Phillip Kremer, Thorsten Wiech, Ina Kötter, Malte Kluger, Tobias Huber, Martin Krusche, Tingting Xiong

{"title":"[An unusual cause for kidney transplantation].","authors":"Phillip Kremer, Thorsten Wiech, Ina Kötter, Malte Kluger, Tobias Huber, Martin Krusche, Tingting Xiong","doi":"10.1007/s00108-025-02019-8","DOIUrl":"10.1007/s00108-025-02019-8","url":null,"abstract":"Background: Systemic amyloidoses are a heterogeneous group of rare diseases characterized by deposition of misfolded proteins. Amyloid A (AA) amyloidosis results from chronic inflammatory processes, with autoinflammatory diseases-particularly familial Mediterranean fever (FMF)-representing one of the most common causes. Genetic autoinflammatory diseases should be considered in the differential diagnosis, especially in patients from high-prevalence regions with unexplained renal insufficiency.Case report: The case of a 50-year-old female patient of Armenian origin who underwent kidney transplantation in 2022 for end-stage renal failure of unknown etiology is reported. Despite adequate immunosuppression, she developed progressive graft dysfunction with increasing proteinuria. In addition, persistently elevated serological inflammatory markers were observed, but without accompanying clinical symptoms. Repeat transplant biopsy ultimately revealed glomerular amyloid deposits on Congo red staining, and immunohistochemistry confirmed AA amyloidosis. Genetic analysis demonstrated compound heterozygosity in the Met694Val/Val726Ala (MEFV) gene. A diagnosis of familial Mediterranean fever type II with systemic amyloidosis was established, and anti-inflammatory therapy with colchicine was initiated. Type II FMF typically follows a primarily subclinical course and first manifests through the development of systemic, most commonly renal, AA amyloidosis.Conclusion: This case highlights the need for a thorough differential diagnostic work-up in progressive renal failure of unknown etiology combined with persistent serological inflammation. In end-stage renal failure of unknown cause and systemic inflammatory signs, rare conditions such as AA amyloidosis should also be considered. Genetic testing for FMF may be useful, particularly in the presence of familial or ethnic predisposition.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"574-581"},"PeriodicalIF":0.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Update on hypertrophic cardiomyopathy]. [肥厚性心肌病最新进展]。

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-05-01 Epub Date: 2026-03-02 DOI: 10.1007/s00108-026-02064-x

Andreas J Rieth, Tim Seidler

引用次数: 0

[Vasculitides and anti-GBM disease]. [血管闭塞和抗gbm疾病]。

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-05-01 Epub Date: 2026-04-02 DOI: 10.1007/s00108-026-02105-5

Adrian Schreiber, Jonas Reimers

{"title":"[Vasculitides and anti-GBM disease].","authors":"Adrian Schreiber, Jonas Reimers","doi":"10.1007/s00108-026-02105-5","DOIUrl":"10.1007/s00108-026-02105-5","url":null,"abstract":"Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV)-granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), eosinophilic granulomatosis with polyangiitis (EGPA)-as well as anti-glomerular basement membrane disease (anti-GBM disease) are systemic small-vessel vasculitides with high mortality. Diagnosis relies on serology/laboratory testing, organ screening, and exclusion of differential diagnoses. Biopsy must not delay therapy initiation in fulminant cases. In GPA and MPA, loss of T‑ and B‑cell tolerance and ANCA-mediated activation of neutrophils are pivotal. Diagnostic hallmarks include myeloperoxidase (MPO)- or proteinase 3 (PR3)-ANCA. Kidney biopsy reveals pauci-immune necrotizing and extracapillary proliferative glomerulonephritis. Remission induction consists of glucocorticoids (GC) combined with rituximab (RTX) or cyclophosphamide (CYC). Maintenance therapy is preferably performed with RTX. EGPA is defined by eosinophilic tissue infiltration, often accompanied by asthma and nasal polyposis; ANCAs are present in 30-40%. Diagnostic evaluation includes blood count, inflammatory markers, immunoglobuline E (IgE), ANCA, and ENT, pulmonary, and cardiac evaluation. Nonorgan-threatening disease is treated with GC, whereas relapsing disease is managed with interleukin (IL)-5 pathway inhibitors. Organ- or life-threatening manifestations require GC plus CYC or RTX, followed by IL‑5 pathway inhibitors for maintenance therapy. Anti-GBM is driven by autoantibodies against type IV collagen and presents with a nephritic syndrome and/or alveolar hemorrhage. Within 24 h, diagnostic evaluation should include testing for anti-GBM antibodies and ANCA, thoracic imaging, exclusion of infection, and a kidney biopsy demonstrating linear IgG deposits. Treatment consists of plasmapheresis combined with GC and CYC, with RTX as an alternative. Maintenance therapy is not required unless concomitant ANCA positivity is present.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"515-523"},"PeriodicalIF":0.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610915","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

[Histology and more-modern nephropathology]. [组织学和更现代的肾脏病理学]。

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-05-01 Epub Date: 2026-04-13 DOI: 10.1007/s00108-026-02106-4

Kerstin Amann

引用次数: 0

[Immune complex- and complement-mediated glomerulonephritides]. [免疫复合物和补体介导的肾小球肾肽]。

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-05-01 Epub Date: 2026-04-21 DOI: 10.1007/s00108-026-02108-2

Vega Gödecke

{"title":"[Immune complex- and complement-mediated glomerulonephritides].","authors":"Vega Gödecke","doi":"10.1007/s00108-026-02108-2","DOIUrl":"https://doi.org/10.1007/s00108-026-02108-2","url":null,"abstract":"Glomerulonephritis represents a heterogeneous group of kidney diseases characterized by inflammation of the glomeruli and capable of leading to acute or chronic kidney failure. In addition to the primary glomerulonephritides described elsewhere in this issue, there is a group of diseases in which immune complex deposition or disturbances in complement regulation play a central pathogenic role. Among the most important and clinically relevant forms of these immune complex- and complement-mediated glomerulonephritides are postinfectious glomerulonephritis (PIGN), lupus nephritis (LN), cryoglobulinemic glomerulonephritis, and C3 glomerulopathy (C3G). While PIGN, LN, and cryoglobulinemic glomerulonephritis are characterized by glomerular immune complex deposits, C3 glomerulopathy is primarily based on a dysregulation of the alternative complement pathway. These diseases require specialized treatment in university outpatient clinics in collaboration with nephrology practices. Renal biopsy is a key diagnostic tool, and histologically, a membranoproliferative pattern is frequently observed. This article provides a systematic overview of immune complex- and complement-mediated glomerulonephritis and compares their pathogenesis, clinical presentation, immunoserological profiles, histology, and available therapies.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":"67 5","pages":"506-514"},"PeriodicalIF":0.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790987","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

[Artificial intelligence-assisted diagnostics in the pathology of internal and oncological diseases]. [人工智能在内科和肿瘤疾病病理学中的辅助诊断]。

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-04-29 DOI: 10.1007/s00108-026-02120-6

Vincenzo Mitchell Barroso, Alexander Quaas, Reinhard Büttner, Yuri Tolkach

{"title":"[Artificial intelligence-assisted diagnostics in the pathology of internal and oncological diseases].","authors":"Vincenzo Mitchell Barroso, Alexander Quaas, Reinhard Büttner, Yuri Tolkach","doi":"10.1007/s00108-026-02120-6","DOIUrl":"https://doi.org/10.1007/s00108-026-02120-6","url":null,"abstract":"Background: Artificial intelligence (AI) is increasingly being implemented in digital pathology to support the tissue classification, cell detection, biomarker quantification, the grading and prediction of clinically relevant molecular alterations.Objective: Current applications of AI in the pathology of internal and oncological diseases are summarized with a focus on the most important algorithm approaches, representative cases of diagnostic applications and current limits of clinical implementation.Material and methods: This narrative overview of the most recent advances describes the essential model forms, including tissue segmentation systems, algorithms for recognition of individual cells, unsupervised learning and foundation models, tools for the evaluation of immunohistochemistry and multimodal or language-based applications. Representative studies on renal, liver, pulmonary, gastrointestinal, hematological and thyroid gland pathologies are discussed.Results: In many situations AI improves the reproducibility, objectiveness and efficiency. Some systems achieve an accuracy that is comparable to that of experts. Most AI tools are still in the validation stage and only a few have been transferred to routine clinical use.Discussion: Artificial intelligence could further optimize the diagnostic and predictive histopathology. Their role remains assistive. A broad implementation is limited due to various hurdles and bottlenecks. The future progress depends on prospective validation and the integration into routine digital workflows.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790975","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

Leserbrief zu „Was ist gesichert in der Vorsorge des kolorektalen Karzinoms?“. “什么是癌症预防？”

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-04-29 DOI: 10.1007/s00108-026-02110-8

Thomas Kühlein

引用次数: 0

[Medicine and artificial intelligence. An ethical and legal perspective]. 医学和人工智能。道德和法律的观点]。

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-04-29 DOI: 10.1007/s00108-026-02123-3

Eric Hilgendorf

引用次数: 0