JaLCDOI 10.18926/AMO/54977
FullText URL 71_2_97.pdf
Author Iwamuro, Masaya| Kondo, Eisei| Tanaka, Takehiro| Hagiya, Hideharu| Kawano, Seiji| Kawahara, Yoshiro| Otsuka, Fumio| Okada, Hiroyuki|
Abstract We retrospectively analyzed the cases of 14 patients (9 women, 5 men, mean age: 51.6 years) with cytomegalovirus (CMV) involvement in the esophagus, stomach, and/or duodenum diagnosed at a single center, to determine their endoscopic features and clinical backgrounds. Thirteen patients (92.9%) had hematologic disease; the other had rheumatoid arthritis. Of the former, 12 patients underwent allogeneic hematopoietic stem cell transplantation, and 9 of these patients had graft-versus-host disease (GVHD) before undergoing esophagogastroduodenoscopy (EGD). All 14 patients had been taking one or more immunosuppressive agents including cyclosporine (n=10), corticosteroids (n=9), mycophenolic acid (n=6), tacrolimus (n=3), and methotrexate (n=1). Tests for CMV antigenemia were positive in 11 patients (78.6%). EGD examinations revealed esophageal (n=3), gastric (n=9), and duodenal involvement (n=6). Macroscopically, esophageal lesions by CMV infection presented as redness (n=1), erosions (n=1), and ulcers (n=1). Gastric lesions manifested as redness (n=7), erosions (n=3), exfoliated mucosa (n=2), and verrucous erosions (n=1). Mucosal appearances in the duodenum varied: redness (n=2), ulcers (n=2), multiple erosions (n=2), single erosion (n=1), edema (n=1). CMV was detected even in the intact duodenal mucosa (n=1). In conclusion, physicians must recall the relevance of CMV infection when any mucosal alterations exist in the upper gastrointestinal tract of immunosuppressed patients.
Keywords cytomegalovirus duodenum esophagogastroduodenoscopy esophagus stomach
Amo Type Original Article
Published Date 2017-04
Publication Title Acta Medica Okayama
Volume volume71
Issue issue2
Publisher Okayama University Medical School
Start Page 97
End Page 104
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 28420890
JaLCDOI 10.18926/AMO/54504
FullText URL 70_4_279.pdf
Author Nishimura, Yoshito| Iwamuro, Masaya| Ocho, Kazuki| Hasegawa, Kou| Kimura, Kosuke| Hanayama, Yoshihisa| Kondo, Eisei| Tanaka, Takehiro| Otsuka, Fumio|
Abstract A 61-year-old Japanese man with IgG4-related autoimmune pancreatitis was referred to our hospital because of perspiration during food intake. Abdominal computed tomography (CT) with contrast media revealed multiple mesenteric lymphadenopathies. An open surgical abdominal biopsy and subsequent histopathological analysis revealed abnormally large lymphoid cells that were negative for CD3, CD5, and c-myc and positive for CD20 and bcl-2, leading to a diagnosis of diffuse large B-cell lymphoma. Here, we discuss the risk of malignancies, particularly malignant lymphoma in patients with IgG4-related disease. The importance of pathological analysis to reach the appropriate diagnosis in such cases should be emphasized.
Keywords IgG4-related disease autoimmune pancreatitis immunophenotyping diffuse large B-cell lymphoma
Amo Type Case Report
Published Date 2016-08
Publication Title Acta Medica Okayama
Volume volume70
Issue issue4
Publisher Okayama University Medical School
Start Page 279
End Page 283
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27549673
Web of Sience KeyUT 000384748600008
JaLCDOI 10.18926/AMO/54422
FullText URL 70_3_217.pdf
Author Waseda, Koichi| Ocho, Kazuki| Hasegawa, Kou| Kimura, Kosuke| Iwamuro, Masaya| Hanayama, Yoshihisa| Kondo, Eisei| Miyahara, Nobuaki| Otsuka, Fumio|
Abstract KL-6 is a glycoprotein found predominantly on type II pneumocytes and alveolar macrophages, and often shows increased serum levels in patients with interstitial pneumonia. We report a case of mycobacterium avium complex (MAC) infection whose disease activity was correlated with KL-6 levels in serum. During treatment of rheumatoid arthritis (RA)-associated interstitial lung disease (ILD) with prednisolone, chest image findings improved in association with decreased KL-6 levels. Following tapering of prednisolone, chest image findings deteriorated again as levels of KL-6 increased, suggesting recurrence of RA-ILD. Bronchoscopic examination revealed active MAC infection. Treatment of MAC infection not only improved chest image findings but also decreased KL-6 levels in serum, suggesting that KL-6 was increased by active MAC infection by itself, not by recurrence of RA-ILD. To the best of our knowledge, this is the first documentation of KL-6 elevation in serum in association with active MAC infection.
Keywords KL-6 mycobacterium avium complex pulmonary nontuberculous mycobacterium infection rheumatoid arthritis-associated interstitial lung disease bronchial alveolar lavage
Amo Type Case Report
Published Date 2016-06
Publication Title Acta Medica Okayama
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 217
End Page 221
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27339212
Web of Sience KeyUT 000379406100010
JaLCDOI 10.18926/AMO/53342
FullText URL 69_2_123.pdf
Author Waseda, Koichi| Hagiya, Hideharu| Hanayama, Yoshihisa| Terasaka, Tomohiro| Kimura, Kosuke| Tsuzuki, Takao| Hasegawa, Kou| Nada, Takahiro| Nakamura, Eri| Murakami, Kazutoshi| Kondo, Eisei| Otsuka, Fumio|
Abstract An 81-year-old Japanese male with primary Sjögren syndrome (pSS) developed a low-grade fever and productive cough which were refractory to antibiotic therapy. Based on the high level of eosinophils observed in his bronchial alveolar lavage, he was diagnosed with chronic eosinophilic pneumonia (CEP) and successfully treated by oral prednisolone. Interstitial lung diseases associated with pSS (pSS-ILDs) usually present as nonspecific interstitial pneumonia or usual interstitial pneumonia; therefore, the present case is extremely unique in that the patientʼs condition was complicated with CEP. A diagnosis of advanced gallbladder cancer was made in the patientʼs clinical course, suggesting the advisability of a whole-body workup in cases of pSS, especially in elderly patients.
Keywords bronchial alveolar lavage eosinophilic pneumonia eosinophilia interstitial lung diseases Sjögren syndrome
Amo Type Case Report
Published Date 2015-04
Publication Title Acta Medica Okayama
Volume volume69
Issue issue2
Publisher Okayama University Medical School
Start Page 123
End Page 127
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25899635
Web of Sience KeyUT 000353181700008
JaLCDOI 10.18926/AMO/53028
FullText URL 68_6_379.pdf
Author Doi, Shinichiro| Kimura, Shuhei| Morizane, Yuki| Hosogi, Mika| Hosokawa, Mio| Shiode, Yusuke| Kawata, Tetsuhiro| Kondo, Eisei| Shiraga, Fumio|
Abstract We report a case of POEMS syndrome in a 20-year-old patient diagnosed after visiting an eye clinic with a chief complaint of reduced visual acuity. A male university student aged 20 years was referred to our department complaining of blurred vision in both eyes that had persisted for 1 month. He also noted headache, nausea, and paresthesia in the lower extremities around the same time. The visual acuity of his right and left eye was 20/40 and 20/20, respectively. Optic disc edema and serous retinal detachment were present. Brain magnetic resonance imaging showed no intracranial abnormalities, while elevated cerebrospinal fluid pressure, reduced nerve conduction velocity in both lower extremities, hepatosplenomegaly, M proteinemia, high blood VEGF levels, osteoblastic and osteolytic changes in the spine, and atypical plasma cells in bone lesions were noted. From the above findings, the patient was diagnosed with POEMS syndrome. He received high-dose dexamethasone, thalidomide, and radiotherapy on the sacral mass, followed by high-dose melphalan with autologous stem-cell support, and showed subsequent systemic and ophthalmologic improvement. Here, we report the youngest case ever of POEMS syndrome with ocular manifestation. If patients have optic disc edema in both eyes with no intracranial space-occupying lesion, POEMS syndrome should be considered in differential diagnosis, regardless of age.
Keywords POEMS syndrome serous retinal detachment VEGF
Amo Type Case Report
Published Date 2014-12
Publication Title Acta Medica Okayama
Volume volume68
Issue issue6
Publisher Okayama University Medical School
Start Page 379
End Page 383
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25519033
Web of Sience KeyUT 000346882200009
JaLCDOI 10.18926/AMO/53025
FullText URL 68_6_363.pdf
Author Ota, Seisuke| Hiramatsu, Yasushi| Kondo, Eisei| Kasahara, Akinori| Takada, Saimon| Umena, Sachio| Noguchi, Toshio| Tanimoto, Mitsune| Matsumura, Tadashi|
Abstract Leukocytosis is occasionally seen in patients with presumptive but undiagnosed myeloproliferative disorders (MPD). A 74-year-old woman was admitted to our hospital for tarry stools, anemia, and marked peripheral leukocytosis of 1.4×10<sup>5</sup>/μL. Gastroenteroscopy revealed an acute gastric and duodenal mucosal lesion that was treated successfully via endoscopic hemoclipping. Bone marrow aspiration revealed marked megakaryocyte proliferation with atypia of naked nuclei and marrow hypercellularity (90% cellularity). A fluorescence in situ hybridization test could not detect the BCR-ABL fusion gene. Bone marrow aspiration later revealed further abnormalities of megakaryocytes. The patient died from cerebral bleeding. The present case fulfilled 2 of the 3 major criteria of primary myelofibrosis according to the World Health Organization 2008 classification:namely, megakaryocytic hyperplasia with hypercellular marrow and granulocytic hyperplasia. However, the megakaryocytic abnormality was not strictly compatible with the criteria. Instead, we considered prefibrotic primary myelofibrosis as a possibility, although myelodysplastic syndrome/myeloproliferative neoplasm, unclassifiable (MDS/MPN-U) was technically the correct diagnosis. The present case shows that MPN diagnosis remains difficult and suggests that other cases of peripheral leukocytosis with diagnosed MDS/MPN-U might include similar findings.
Keywords prefibrotic primary myelofibrosis leukocytosis anemia acute gastric mucosal lesion multiple cerebral hemorrhages
Amo Type Case Report
Published Date 2014-12
Publication Title Acta Medica Okayama
Volume volume68
Issue issue6
Publisher Okayama University Medical School
Start Page 363
End Page 368
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25519030
Web of Sience KeyUT 000346882200006
Author Sugiyama, Haruko| Maeda, Yoshinobu| Nishimori, Hisakazu| Yamasuji, Yoshiko| Matsuoka, Ken-ichi| Fujii, Nobuharu| Kondo, Eisei| Shinagawa, Katsuji| Tanaka, Takehiro| Takeuchi, Kengo| Teshima, Takanori| Tanimoto, Mitsune|
Published Date 2014-02
Publication Title Biology of Blood and Marrow Transplantation
Volume volume20
Issue issue2
Content Type Journal Article
Author Kondo, Eisei|
Published Date 2003-06-30
Publication Title
Content Type Thesis or Dissertation