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UEDA YoUniversity Hospital / Rheumatology and Clinical ImmunologyAssistant Professor
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■ Paper- We present three cases of eosinophilic granulomatosis with polyangiitis (EGPA) where patients experienced relapse of eosinophilic sinusitis without peripheral eosinophilia while on remission maintenance therapy with mepolizumab (MPZ), an anti-interleukin (IL)-5 monoclonal antibody. Despite the initial control of symptoms with high-dose prednisolone (PSL) and MPZ, patients experienced a relapse of nasal obstruction and eosinophilic infiltration in nasal mucosal biopsies. Notably, relapses occurred despite normal peripheral eosinophil counts, indicating the localized nature of eosinophilic inflammation. While IL-5 inhibitors effectively reduce peripheral blood eosinophils, eosinophilic sinusitis may persist due to local factors such as IL-4-mediated inflammation. IL-4 has been implicated in promoting eosinophil migration into nasal tissues, suggesting that IL-5 inhibitors alone may not sufficiently suppress eosinophilic infiltration in such cases. These findings highlight the importance of considering the possibility of eosinophilic sinusitis relapse in EGPA patients treated with IL-5 inhibitors and reduced glucocorticoid doses. Further research is warranted to elucidate the mechanisms underlying local eosinophilic inflammation and optimize treatment strategies for EGPA patients.Sep. 2024, Clinical rheumatology, English, International magazineScientific journal
- We encountered a 64-year-old Japanese woman who developed subarachnoid hemorrhaging (SAH) with multiple cerebral artery stenoses during remission induction therapy for eosinophilic granulomatosis and polyangiitis (EGPA). The treatment involved intensified steroid pulse therapy and continued intravenous cyclophosphamide pulse therapy, which led to beneficial effects. Given the rarity of multiple EGPA-associated cerebral artery stenoses and SAH, it is crucial to differentiate them from other diseases. The mortality rate of EGPA complicated by intracranial hemorrhagic lesions, including SAH, is high. When headache is present at the onset of EGPA, the possibility of SAH must be considered.May 2024, Internal medicine (Tokyo, Japan), English, Domestic magazineScientific journal
- Dec. 2023, Arthritis Research and Therapy, 25(1) (1)Scientific journal
- OBJECTIVE: This multicentre, retrospective study compared the efficacy and safety of tofacitinib, baricitinib, peficitinib and upadacitinib in real-world clinical settings after minimizing selection bias and adjusting the confounding patient characteristics. METHOD: The 622 patients were selected from the ANSWER cohort database and treated with tofacitinib (TOF), baricitinib (BAR), peficitinib (PEF) or upadacitinib (UPA). The patient's background was matched using propensity score-based inverse probability of treatment weighting (IPTW) among four treatment groups. The values of Clinical Disease Activity Index (CDAI), C-reactive protein (CRP), and modified Health Assessment Questionnaire (mHAQ) after drug initiation and the remission or low disease activity (LDA) rates of CDAI at 6 months after drug initiation were compared among the four groups. Further, the predictive factor for TOF and BAR efficacy was analysed. RESULTS: The retention and discontinuation rates until 6 months after drug initiations were not significantly different among the four JAK inhibitors treatment groups. Mean CDAI value, CDAI remission rate, and CDAI-LDA rate at 6 months after drug initiation were not significantly different among treatment groups. Baseline CDAI (TOFA: OR 1.09, P < 0.001; BARI: OR 1.07, P < 0.001), baseline CRP (TOFA: OR 1.32, P = 0.049), baseline glucocorticoid dose (BARI: OR 1.18, 95% CI 1.01-1.38, P = 0.035), a number of previous biological or targeted synthetic disease-modifying antirheumatic drugs (biological/targeted synthetic DMARDs) (BARI: OR 1.36, P = 0.004) were predictive factors for resistance to CDAI-LDA achievement to JAK inhibitor treatment. CONCLUSION: The efficacy and safety of TOF, BAR, PEF and UPA were not significantly different for the treatment of patients with rheumatoid arthritis.Nov. 2023, Rheumatology (Oxford, England), English, International magazineScientific journal
- BACKGROUND: β2-glycoprotein I (β2GPI) complexed with human leukocyte antigen DR (β2GPI/HLA-DR) was found to be a major autoantibody target in antiphospholipid syndrome (APS). This study aimed to reveal the association between anti-β2GPI/HLA-DR antibodies and vascular thromboses in women with systemic rheumatic diseases. METHODS: We conducted a retrospective longitudinal study. We measured anti-β2GPI/HLA-DR antibodies and compared them with anti-phospholipid antibody (aPL) profiles and the adjusted global antiphospholipid syndrome score (aGAPSS). Using receiver operating characteristic (ROC) analysis, we determined the best cut-off value for arterial thrombosis. We also evaluated the validity of anti-β2GPI/HLA-DR antibodies by adding to conventional cardiovascular risk factors in multivariate logistic analysis. RESULTS: We evaluated 704 patients, including 66 (obstetric or thrombotic) APS, 13 primary APS, and 78 asymptomatic aPL carriers. Seventy-seven patients had a history of arterial thrombosis, and 14 patients had both arterial and venous thrombosis. These 14 patients, as well as patients with aGAPSS > 10 or triple-positive aPL profiles, displayed high anti-β2GPI/HLA-DR antibody titers. The ROC curve showed a sensitivity, specificity, and area under the curve (AUC) for arterial thrombosis of 33.8%, 91.4%, and 0.6009, respectively, with a cut-off value of 172.359 U/mL. The anti-β2GPI/HLA-DR antibody positivity using this cut-off value yielded an odds ratio of 5.13 (95%CI: 2.85-9.24), significantly improving the AUC from 0.677 to 0.730. CONCLUSION: Anti-β2GPI/HLA-DR antibodies are associated with arterial thrombosis in female patients with systemic rheumatic diseases.Oct. 2023, Arthritis research & therapy, 25(1) (1), 195 - 195, English, International magazineScientific journal
- (一社)日本リウマチ学会, Mar. 2023, 日本リウマチ学会総会・学術集会プログラム・抄録集, 67回, 526 - 526, Japanese疫学1:RA/関節型JIAの治療 高齢関節リウマチ患者における疾患活動性の年次変化に関する検討 関西多施設共同研究ANSWER Cohort study
- (一社)日本リウマチ学会, Mar. 2023, 日本リウマチ学会総会・学術集会プログラム・抄録集, 67回, 621 - 621, JapaneseJAK阻害薬-4 tsDMARDsとbDMARDsにより関節リウマチ患者の非炎症性疼痛へ及ぼす効果の比較 関西多施設共同研究ANSWER Cohortを用いた検討
- PURPOSE: To achieve a better patient experience with self-injection, an assessment of potential demographic, physical, and psychological barriers is necessary. The aim of this study was to examine the demographic, physical, and psychological characteristics associated with the experiences of self-injection in patients with rheumatoid arthritis (RA). PATIENTS AND METHODS: In this study, overall patient experience with subcutaneous self-injection was assessed using the Self-Injection Assessment Questionnaire. Upper limb function was assessed using the three domains of the Health Assessment Questionnaire associated with upper extremity disability (dressing and grooming, eating, and grip). Structural equation modeling was used to estimate the association between the demographic and clinical characteristics of patients with RA and their experiences with self-injection in the theoretical model. RESULTS: Data from 83 patients with RA were analyzed. Compared with younger patients, elderly patients were more likely to experience lower self-confidence, self-image, and ease of use. Female patients had lower ease of use than male patients. In terms of upper limb function, patients with more difficulty in performing activities of daily living were more likely to have a lower self-image. Self-injection perceptions before learning the method of injection, such as fear of needles and anxiety about self-injection, were associated with post-injection feelings, injection site reactions, self-confidence, and ease of use. CONCLUSION: To optimize patients' experiences with self-injection, healthcare workers should assess each patient's age, sex, upper limb function, and pre-self-injection perceptions as demographic, physical, and psychological barriers.2023, Patient preference and adherence, 17, 1551 - 1559, English, International magazineScientific journal
- (一社)日本リウマチ学会, Mar. 2022, 日本リウマチ学会総会・学術集会プログラム・抄録集, 66回, 376 - 376, Japanese関節リウマチの治療(csDMARDs) MTXの継続率と生活習慣病の関連 関西多施設ANSWERコホートを用いた検討
- Resolvins, are specialized pro-resolving mediators (SPMs) derived from n-3 polyunsaturated fatty acids. They contribute actively to the resolution of inflammation, but little is known concerning their role in chronic inflammation, such as in rheumatoid arthritis (RA). Here, we performed lipid mediator (LM) profiling in tissues from the paws of SKG arthritic mice using lipid chromatography (LC)/mass spectrometry (MS)/MS-based LM metabololipidomics. We found elevated levels of SPMs including resolvin D5 (RvD5) in these tissues. Moreover, RvD5 levels were significantly correlated with arthritis disease activity. From experiments to assess the role of RvD5 in the pathology of RA, we concluded that RvD5 suppressed Th17 cell differentiation and facilitated regulatory T cell differentiation, as well as inhibiting CD4+ T cell proliferation. Furthermore, RvD5 attenuated osteoclast differentiation and interfered with osteoclastogenesis. Targeting the resolution of inflammation could be promising as a novel treatment for RA.Aug. 2021, Scientific reports, 11(1) (1), 17312 - 17312, English, International magazineScientific journal
- BACKGROUND: Systemic sclerosis (SSc) is a chronic autoimmune-mediated connective tissue disorder. Although the etiology of the disease remains undetermined, SSc is characterized by fibrosis and proliferative vascular lesions of the skin and internal organs. SSc involves the gastrointestinal tract in more than 90 % of patients. Soluble guanylate cyclase (sGC) stimulator is used to treat pulmonary artery hypertension (PAH) and has been shown to inhibit experimental skin fibrosis. METHODS: Female C57BL/6J mice were treated with BLM or normal saline by subcutaneous implantation of osmotic minipump. These mice were sacrificed on day 28 or day 42. Gastrointestinal pathologies were examined by Masson Trichrome staining. The expression of fibrosis-related genes in gastrointestinal tract was analyzed by real-time PCR, and the levels of collagen in the tissue were measured by Sircol collagen assay. To evaluate peristaltic movement, the small intestinal transport (ITR%) was calculated as [dyeing distance × (duodenum - appendix)] - 1 × 100 (%). We treated BLM-treated mice with sGC stimulator or DMSO orally and analyzed them on day 42. RESULTS: Histological examination revealed that fibrosis from lamina propria to muscularis mucosa in the esophagus was significantly increased in BLM-treated mice, suggesting that BLM induces esophageal hyperproliferative and prefibrotic response in C57BL/6J mice. In addition, the gene expression levels of Col3a1, CCN2, MMP-2, MMP-9, TIMP-1, and TIMP-2 in the esophagus were significantly increased in BLM-treated mice. More severe hyperproliferative and prefibrotic response was observed in the mice sacrificed on day 42 than the mice sacrificed on day 28. The ITR% was found to be significantly lower in BLM-treated mice, suggesting that gastrointestinal peristaltic movement was reduced in BLM-treated mice. Furthermore, we demonstrated that sGC stimulator treatment significantly reduced hyperproliferative and prefibrotic response of esophagus and intestine in BLM-treated mice, by histological examination and Sircol collagen assay. CONCLUSIONS: These findings suggest that BLM induces gastrointestinal hyperproliferative and prefibrotic response in C57BL/6J mice, and treatment with sGC stimulator improves the BLM-induced gastrointestinal lesion.May 2021, Arthritis research & therapy, 23(1) (1), 133 - 133, English, International magazineScientific journal
- (一社)日本リウマチ学会, Mar. 2021, 日本リウマチ学会総会・学術集会プログラム・抄録集, 65回, 381 - 381, JapaneseSLE・抗リン脂質抗体症候群(臨床):バイオマーカー 当院における抗DNA抗体検出法についての検討 Farr法とCLIA法の比較について
- (一社)日本リウマチ学会, Mar. 2021, 日本リウマチ学会総会・学術集会プログラム・抄録集, 65回, 401 - 401, Japanese多発性筋炎・皮膚筋炎:ケースプレゼンテーション 皮膚硬化を呈した抗ミトコンドリア抗体陽性筋炎の1例
- (一社)日本リウマチ学会, Mar. 2021, 日本リウマチ学会総会・学術集会プログラム・抄録集, 65回, 612 - 612, Japanese異所性石灰化病変を合併した全身性エリテマトーデス患者に対してテリパラチドにより異所性石灰化と骨粗鬆症を同時に治療しえた一例
- (一社)日本リウマチ学会, Mar. 2021, 日本リウマチ学会総会・学術集会プログラム・抄録集, 65回, 665 - 665, Japanese中型血管炎による難治性多発消化管潰瘍を呈した顕微鏡的多発血管炎の一例
- (一社)日本リウマチ学会, Aug. 2020, 日本リウマチ学会総会・学術集会プログラム・抄録集, 64回, 634 - 634, Japanese間質性肺炎を有するRA患者におけるDMARDsの安全性に関する系統的レビュー
- (一社)日本リウマチ学会, Aug. 2020, 日本リウマチ学会総会・学術集会プログラム・抄録集, 64回, 636 - 636, Japanese悪性腫瘍を有するRA患者におけるDMARDsの安全性に関する系統的レビュー
- (一社)日本リウマチ学会, Aug. 2020, 日本リウマチ学会総会・学術集会プログラム・抄録集, 64回, 697 - 697, Japanese高用量ステロイド治療中の膠原病患者におけるニューモシスティス肺炎(PCP)予防薬の効果
- (一社)日本リウマチ学会, Aug. 2020, 日本リウマチ学会総会・学術集会プログラム・抄録集, 64回, 763 - 763, Japaneseステロイド、DMARDs加療中のRA患者へのワクチン接種の有効性、安全性に関する系統的レビュー
- AIM: Subjective well-being (SWB) is a psychological construct that is synonymous with happiness. Many variables including age, sex, income, employment, and marital status are related to SWB. Health is also an important determinant of SWB that can be adversely affected in patients with chronic conditions such as rheumatoid arthritis (RA). In this study, we evaluate the SWB of RA patients and compare it with that of healthy controls. METHODS: We obtained the original dataset from the "Quality of Life Survey, 2013", which was conducted by the Economic and Social Research Institute, Cabinet Office, Government of Japan. In this survey, SWB was determined by asking participants to rate their happiness between 0 (very unhappy) and 10 (very happy). The survey also included a 56-point questionnaire regarding well-being-related variables. This questionnaire was administered to RA patients recruited from Kobe University Hospital, and clinical and treatment data were simultaneously collected. RESULTS: Multivariate analysis revealed that RA patients with high or moderate disease activity had SWB scores that were similar to those of controls. However, the SWB scores of RA patients in remission or with low disease activity were higher than those of controls (P = .013). SWB was associated with household income, self-assessment of living costs, self-assessment of health, depression/ anxiety, and social connection. CONCLUSIONS: For RA patients, achieving the therapeutic target can result in better SWB than that of healthy controls. Financial status, self-assessment of health, psychological stress, and social network are also important determinants for the SWB of RA patients.Oct. 2019, International journal of rheumatic diseases, 22(10) (10), 1863 - 1870, English, International magazine[Refereed]Scientific journal
- Glutamine metabolism and the mechanistic target of rapamycin (mTOR) pathway are activated cooperatively in the differentiation and activation of inflammatory immune cells. But the combined inhibition of both pathways was rarely investigated. This study investigated how inhibiting both glutamine metabolism with 6-diazo-5-oxo-L-norleucine (DON) and mTOR with rapamycin affects immune cells and the arthritis in a mouse model. We revealed that rapamycin and DON additively suppressed CD4+ T cell proliferation, and both of them inhibited Th17 cell differentiation. While DON inhibited the differentiation of dendritic cells and macrophages and facilitated that of Ly6G+ granulocytic (G)-MDSCs more strongly than did rapamycin, G-MDSCs treated with rapamycin but not DON suppressed CD4+ T cell proliferation in vitro. The combination of rapamycin and DON significantly suppressed the arthritis in SKG mice more strongly than did each monotherapy in vivo. The numbers of CD4+ T and Th17 cells in the spleen were lowest in mice treated with the combination therapy. Thus, combined treatment with rapamycin and DON additively ameliorated the arthritis in SKG mice, possibly by suppressing CD4+ T cell proliferation and Th17 differentiation. These results suggest the combination of rapamycin and DON may be a potential novel therapy for arthritis.Apr. 2019, Scientific reports, 9(1) (1), 6374 - 6374, English, International magazine[Refereed]Scientific journal
- Recent studies have revealed a relationship between cellular metabolism and cell function in immune cells. Cellular metabolism not only provides supplemental ATP, but also supports dynamic changes in cell proliferation and differentiation. For example, T cells exhibit subset-specific metabolic profiles, and require certain types of metabolism for their functions. Determining the metabolic profiles that support inflammatory immune responses may lead to novel treatment strategies for chronic inflammatory diseases such as rheumatoid arthritis (RA). However, the mechanisms by which metabolism modulates cell function have been unclear. Recent studies have begun to unveil unexpected non-metabolic functions for metabolic enzymes in the context of inflammation, including roles in signaling and gene regulation. Here we describe recent findings related to immunometabolism, the metabolome of RA patients, and the metabolically independent functions of glycolytic enzymes. We discuss how metabolic processes impact immune cells, especially T cells and fibroblast like synoviocytes, which are considered the orchestrators of autoimmune arthritis.Sep. 2018, Immunological medicine, 41(3) (3), 89 - 97, English, International magazine[Refereed]Scientific journal
- Recent studies have shown that cellular metabolism plays an important role in regulating immune cell functions. In immune cell differentiation, both interleukin-17-producing T (Th17) cells and dendritic cells (DCs) exhibit increased glycolysis through the upregulation of glycolytic enzymes, such as hexokinase-2 (HK2). Blocking glycolysis with 2-deoxyglucose was recently shown to inhibit Th17 cell differentiation while promoting regulatory T (Treg) cell generation. However, 2-DG inhibits all isoforms of HK. Thus, it is unclear which isoform has a critical role in Th17 cell differentiation and in rheumatoid arthritis (RA) pathogenesis. Here we demonstrated that 3-bromopyruvate (BrPA), a specific HK2 inhibitor, significantly decreased the arthritis scores and the histological scores in SKG mice, with a significant increase in Treg cells, decrease in Th17 cells, and decrease in activated DCs in the spleen. In vitro, BrPA facilitated the differentiation of Treg cells, suppressed Th17 cells, and inhibited the activation of DCs. These results suggested that BrPA may be a therapeutic target of murine arthritis. Although the role of IL-17 is not clarified in the treatment of RA, targeting cell metabolism to alter the immune cell functions might lead to a new therapeutic strategy for RA.Feb. 2017, Scientific reports, 7, 42412 - 42412, English, International magazine[Refereed]Scientific journal
- To evaluate the effects of tocilizumab (TCZ) on adult-onset Still's disease (AOSD), we reviewed medical records of seven patients with refractory AOSD treated with TCZ at our institution. TCZ therapy might allow rapid corticosteroid tapering and help maintain remission status, that is, resolution of clinical symptoms and normalization of biomarkers such as CRP and ferritin. Patients, however, should be monitored for the development of macrophage activation syndrome when TCZ is administered for active AOSD.2016, Modern rheumatology, 26(2) (2), 297 - 301, English, International magazine[Refereed]Scientific journal
- We report a case of interstitial cystitis (IC) associated with primary Sjögren's syndrome (SS) successfully controlled with combination therapy of tacrolimus and a corticosteroid. In 2011, a 69-year-old female, who had been diagnosed with primary SS 23 years ago, developed IC and was successfully treated with tacrolimus and prednisolone combination therapy. The mechanism of IC, including the involved autoimmunity, has not been elucidated. Clinical observation studies suggest a potential association between SS and IC. However, IC is currently thought to be underdiagnosed in patients with SS as well as in the general population. Based on our case and others reported previously, IC associated with SS responds well to immunosuppressive therapy. In particular, a combination of a calcineurin inhibitor (tacrolimus or cyclosporine) with a corticosteroid seems to be highly effective. The possibility of IC in patients with SS complaining of lower urinary tract symptoms without features of infection or other identifiable causes should be given attention.2016, Modern rheumatology, 26(3) (3), 445 - 9, English, International magazine[Refereed]
- OBJECTIVE: Relapsing polychondritis (RPC) is relatively rare and early diagnosis is difficult. We investigated the utility of fluorodeoxyglucose (FDG)-PET/CT for the diagnosis of RPC and evaluation of disease activity. METHODS: Five RPC patients undergoing FDG-PET/CT in our hospital between 2006 and 2012 were studied. Eight RPC cases examined by PET reported in the literature were also assessed. Data from a total of 13 patients were analysed. RESULTS: Typical FDG accumulation was noted in the tracheobronchial trees of nine patients, the costal cartilage of five, joints of five, larynx of four, nasal cavity/paranasal sinuses of three, auricles of three, lymph nodes of three and the aorta of one. One patient showed nasal chondritis on a PET scan despite the absence of nasal changes on physical examination. Of five patients with costochondritis, four remained asymptomatic. Of nine patients with airway FDG accumulation, eight developed respiratory symptoms and all had CT abnormalities. In the other patient, airway FDG accumulation was evident despite the absence of airway symptoms and a lack of abnormalities in the respiratory function test and CT. PET also revealed bronchial chondritis in asymptomatic patients. The mean maximum standardized uptake values (SUVmax) of the upper and lower airways was 5.79 (s.d. 2.87) and 6.47 (s.d. 4.08), respectively. In five patients with a PET after treatment, FDG accumulation had diminished with symptomatic and inflammatory improvement. CONCLUSION: FDG-PET/CT is a potentially powerful tool for the early diagnosis of RPC, especially in patients without easily biopsied organ involvement. This modality also facilitates evaluation of disease extent and disease activity during treatment.Aug. 2014, Rheumatology (Oxford, England), 53(8) (8), 1482 - 90, English, International magazine[Refereed]Scientific journal
- [A miliary tuberculosis case without lung involvement difficult to distinguish from autoimmune hepatitis exacerbation].A 48-year-old female with a past history of systemic lupus erythematosus had developed autoimmune hepatitis (AIH) at the age of 45 years, and administration of PSL 30 mg/day was initiated. However, AIH exacerbation was suspected based on elevation of hepatic and biliary tract enzymes such as ALP (1207U/L) with a fever of 38 degrees C after tapering off the steroids to PSL 7.5 mg daily, and she was thus hospitalized. A liver biopsy was recommended, but she refused. Thus, we suspected concomitant AIH and autoimmune cholangitis (AIC). Although high-dose steroid treatment including steroid pulse therapy was administered, there was no improvement. We performed a liver biopsy on the 66th hospital day, after obtaining the patient's consent. Epithelioid granuloma was detected in the liver leaflet as the background of the AIH and AIC findings. In addition, acid fast bacteria were detected with auramine and Ziehl-Neelsen staining, raising the possibility of tuberculosis. Additionally, granuloma was also seen in her bone marrow, and miliary tuberculosis was suspected. Anti-tuberculous therapy with isoniazid, rifampicin, ethambutol and pyrazinamide was initially administered, but the regimen was changed to levofloxacin, ethambutol, and streptomycin due to the side effects of the earlier medications. Liver functions improved and the inflammatory reaction became negative. The patient was discharged on the 138th hospital day. Ultimately, no acid fast bacteria were detected with culture, PCR of her bone marrow, or liver biopsy. However, miliary tuberculosis was definitively diagnosed from the pathological findings and her clinical course. AIH was an underlying disease, and the discrimination from AIH exacerbation was difficult. Consequently, the diagnosis was miliary tuberculosis without the lung involvement and the main lesion was in the liver. It is important to take account of miliary tuberculosis in the differential diagnosis of fevers of unknown origin with elevation of hepatic and biliary tract enzymes, and to make a definitive diagnosis with a liver biopsy.Jul. 2014, Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases, 88(4) (4), 459 - 62, Japanese, Domestic magazine[Refereed]Scientific journal
- OBJECTIVES: To evaluate the possible correlation of malignant neoplasms and paraneoplastic rheumatologic syndromes. METHODS: We studied a series of 10 patients with paraneoplastic rheumatological syndromes collected from our Division of Rheumatic Disease between 2006 and 2012. RESULTS: Our series consisted of four males and six females, with a mean age of 65.5 years (range, 57-78 years). Of the 10 patients recruited, six had hematological malignancies and four had solid cancers. Malignancies were diagnosed after rheumatic symptoms were reported in all patients. Compared to solid tumors, hemopathy was diagnosed at a later time point (16.2 vs. 7.3 months). Extra-articular symptoms were associated with rheumatologic musculoskeletal manifestations in 100% of the patients. Polyarthritis was the main rheumatologic musculoskeletal manifestation (50% of the patients). The other manifestations were oligopolyarthritis and polymyalgia rheumatic-like symptoms (20% of the patients). Symmetric arthritis was present in 60% of the patients, and the remaining patients developed asymmetric arthritis. Musculoskeletal manifestations completely regressed in 66.7% of the patients after cancer therapy. When tumor relapse was observed, rheumatic symptoms did not recur in any of our patients (100%). CONCLUSIONS: Rheumatic disorders with atypical clinical presentation in older patients, poor response to usual treatment and systemic features such as weight loss and clinical findings compatible with well-recognized paraneoplastic syndromes should alert clinicians to the possible coexistence of an occult malignancy. Especially in cases of paraneoplastic rheumatic/musculoskeletal manifestations associated with hemopathy, the primary disease is unlikely to have manifested yet, making the diagnosis difficult. Thus, caution is required.May 2014, Modern rheumatology, 24(3) (3), 492 - 8, English, International magazine[Refereed]Scientific journal
- [Obstructive pneumonia and brain abscess due to Nocardia elegans in a patient with systemic lupus erythematosus].We herein report on a 69-year-old male who developed lung nocardiosis and brain abscessation. In April 2011, he was diagnosed as having systemic lupus erythematosus complicated by peripheral neuropathy. Immunosuppressive therapy with high-dose prednisolone was begun. In November 2011, he developed cryptococcal pneumonia and meningitis, which was treated with liposomal amphotericin and flucytosine for 4 weeks and was maintained with fluconazole. In April 2012, consolidation and peripheral atelectasis in the right middle lobe appeared. Bronchoscopy revealed edematous mucosa in the right middle bronchus and occlusive change of the right B4 and B5, but biopsy and culture results provided no etiological information. In late June, he developed an intermittent fever, and obstructive pneumonia of the right middle lobe was suspected. Nocardia species were detected from the sputum culture and were thought to be the causative pathogen. Brain CT and MRI revealed a contrast-enhanced lesion in the right cerebellar hemisphere. The patient was diagnosed as having lung nocardiosis and brain abscessation. Considering that the nocardiosis had developed under prophylaxis for Pneumocystis jirovecii pneumonia using one tablet per day of a sulfamethoxazole-trimethoprim combination, meropenem and amikacin were administered in addition to the sulfamethoxazole-trimethoprim combination for 6 and 4 weeks, respectively. After N. elegans had been identified from the sputum, antibiotics were switched to a sulfamethoxazole-trimethoprim combination and clarithromycin based on the susceptibility results. The patient's clinical and radiological findings were improved and have been well sustained.May 2014, Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases, 88(3) (3), 282 - 7, Japanese, Domestic magazine[Refereed]Scientific journal
- We experienced three patients with refractory or severe hemophagocytic syndrome associated with the activity of systemic lupus erythematosus, so-called acute lupus hemophagocytic syndrome (ALHS). All patients were successfully treated with intermittent intravenous injections of cyclophosphamide (IVCY). In each patient, hemophagocytosis was found during bone marrow examination, and infectious causes of hemophagocytic syndrome were carefully excluded. Patients 1 and 2 were refractory to combination therapy with a high-dose corticosteroid and rituximab or cyclosporine and were successfully treated with additive IVCY. Patient 3 had very severe ALHS that developed after cardiac surgery but was successfully treated with a high-dose corticosteroid and IVCY. We conducted a literature review of adult ALHS and analyzed 54 cases reported from 2006 to 2013. Although the clinical and laboratory features were diverse, fever, bicytopenia or pancytopenia, and hyperferritinemia were almost universal. Including our 3 patients, a total of 16 have reportedly been treated with IVCY-containing regimens, and ALHS was successfully controlled in most of them without switching or adding other therapies. We suggest that combination therapy with IVCY and corticosteroids may be useful to treat severe or refractory ALHS.Feb. 2014, Clinical rheumatology, 33(2) (2), 281 - 6, English, International magazine[Refereed]
- Cytomegalovirus disease of the upper gastrointestinal tract (CMV-UGT) is a rare but significant complication in patients with rheumatic diseases. We reviewed records for January 2004 to December 2012 and investigated the occurrence of CMV-UGT in patients with rheumatic diseases to evaluate clinical characteristics, the value of the CMV antigenemia assay, and the association between immunosuppressive therapy and CMV-UGT. Ten CMV-UGT events (six gastric ulcer, two esophagitis, one gastritis, and one duodenal ulcer) in nine patients (three rheumatoid arthritis, three systemic lupus erythematosus, one dermatomyositis, one systemic sclerosis, and one overlap syndrome) were identified based on pathology. Mean age was 66.5 (range, 53-76) years. The CMV antigenemia assay was negative in five cases (50 %). All ten cases received glucocorticoids and six (60 %) received pulsed glucocorticoids. Mean prednisolone dose was 31.3 (range, 7.5-40) mg/day at diagnosis. Concomitant immunosuppressive agents were used in eight cases (80 %). Considering other published cases, the most common immunosuppressive drug was cyclophosphamide (ten cases; 45 %). Notably, two of our patients who were treated with low-dose glucocorticoids plus other milder immunosuppressive drugs (methotrexate and cyclosporine) also developed CMV-UGT. Life-threatening complications such as massive bleeding or perforated ulcer occurred in two patients. These results suggest that patients receiving intensive immunosuppressive therapy such as high-dose glucocorticoids and cyclophosphamide are at higher risk for developing CMV-UGT. Moreover, CMV-UGT can occur even with low-dose glucocorticoid therapy and relatively mild immunosuppressive agents. The value of the CMV antigenemia assay for predicting CMV-UGT appears to be limited.Nov. 2013, Clinical rheumatology, 32(11) (11), 1683 - 90, English, International magazine[Refereed]Scientific journal
- [A rapidly progressive case of mediastinitis in which the patient developed inflammation of the soft tissue surrounding the pulmonary artery].A 51-year-old male patient with no underlying illness developed a fever of 38-39 degrees C in June 2009. The fever persisted for 4 days and, because elevated hepatobiliary enzymes, leukocytopenia and thrombocytopenia were observed, along with chest CT findings of inflammation of the soft tissues surrounding the left pulmonary artery, the patient was admitted for further examination. Three days after admission, the patient's blood pressure rapidly decreased, resulting in respiratory failure. Rapid proliferation of the soft tissue surrounding the pulmonary artery and mediastinum was observed on an emergency chest CT. Malignant lymphoma was initially considered as a possible differential diagnosis; however, neither pleural effusion nor infiltration of malignant cells could be observed on bone marrow examination. In addition, because the patient responded well to antibiotics, a diagnosis of acute mediastinitis was reached. Mediastinal drainage was not performed because the quantity of accumulated fluid was small and because the patient, both in terms of his clinical symptoms and imaging results, showed improvement with the continuation of antibiotics alone. The patient was ambulatory and was discharged after 24 days of hospitalization. Acute mediastinitis often follows a rapidly progressive and fatal course without specific symptoms. In the event of unknown infection following an aggressive course, as in the present case, acute mediastinitis must be considered with the goal of early diagnosis and treatment.Nov. 2013, Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases, 87(6) (6), 746 - 51, Japanese, Domestic magazine[Refereed]Scientific journal
- OBJECTIVES: The clinical and therapeutic aspects of primary Sjögren syndrome (PSS) in patients with peripheral neuropathy were analyzed and the specifics of individual case studies are discussed. METHODS: We retrospectively studied six patients (four women, two men; mean age 64.5 years) presenting with PSS with peripheral neurological involvement over a five-year period (2008-2012). All patients had neurological examinations, including nerve conduction studies, somatosensory evoked potentials, and sural nerve biopsies. Treatment regimens included corticosteroids, intravenous gammaglobulin, or immunosuppressive treatment. RESULTS: Peripheral neuropathy was observed in six (7.9 %) of 76 patients with SS as the underlying disease; three were cases of multiple mononeuropathy, two cases had sensory ataxic neuropathy, one of which was autonomic neuropathy, and one case was diagnosed as painful sensory neuropathy without sensory ataxia. Four of the six patients were diagnosed with SS after the onset of neurological symptoms. Individual peripheral neuropathies had distinct neurological, electrophysiological, and pathological characteristics. The effect of steroids and intravenous gammaglobulin differed depending on the case. CONCLUSIONS: In PSS patients, a precise diagnosis is important, because the therapeutic strategy and response varies depending on the type of neuropathy. In clinical practice, it is important to consider a diagnosis of SS when patients present with peripheral neuropathy.Sep. 2013, Modern rheumatology, 23(5) (5), 925 - 33, English, International magazine[Refereed]Scientific journal
- Chorea in systematic lupus erythematosus; a case report.We report a 33-year-old female who developed a movement disorder during maintenance therapy for systemic lupus erythematosus (SLE). She was diagnosed with SLE at the age of 25, and experienced an episode of SLE-associated hemophagocytic syndrome at age 27, which was successfully treated with intensive immunosuppressive therapy. In November 2012, during maintenance therapy with prednisolone (PSL) 5 mg/day and tacrolimus 0.5 mg/day, she developed acute-onset involuntary movements that were classified as chorea in combination with athetosis in her right limbs and right homonymous hemianopia, which subsided after about 1 h. Her laboratory tests on admission showed an elevated serum anti-double- stranded DNA antibody, positive serum anti-cardiolipin IgG, and an elevated IgG index in cerebrospinal fluid. Magnetic resonance imaging (MRI) showed no significant abnormality on admission, but an ischemic change in her left pallidum appeared on day 7. She was treated with a combination of high-dose corticosteroid, immunosuppressive agents (rituximab, cyclophosphamide, mycofenolate mofetil), antithrombotic therapy (heparin, cilostazol), and dopamine antagonists. Her symptoms remitted partially. Chorea in SLE is recognized as an anti-phospholipid-antibody-associated disorder. In our case, both immunological and ischemic mechanisms were thought to be involved.2013, Nihon Rinsho Men'eki Gakkai kaishi = Japanese journal of clinical immunology, 36(6) (6), 467 - 72, English, Domestic magazine[Refereed]
- BACKGROUND: Although patients with systemic lupus erythematosus (SLE) may experience various gastrointestinal disorders, SLE and Crohn's disease (CD) rarely coexist. The diseases may have gastrointestinal (GI) manifestations, laboratory results, and radiographic findings that appear similar and consequently differentiating between GI involvement in CD and in SLE may be difficult. We present the case of a patient with SLE and CD who developed continuous GI bleeding and diarrhea that was initially treated as SLE-related colitis to little effect. CASE PRESENTATION: A 55-year-old Japanese woman with systemic lupus erythematosus (SLE) developed continuous gastrointestinal bleeding and diarrhea since the patient was aged 30 years that was initially treated as SLE-related colitis. Although a longitudinal ulcer and aphthous ulcers in the colon were observed every examination, biopsy showed only mild inflammation and revealed neither granuloma nor crypt abscess. The patient underwent surgery for anal fistulas twice at 50 and 54 years of age and her symptoms were atypical of lupus enteritis. Colonoscopy was performed again when the patient was 55 years of age because we suspected she had some type of inflammatory bowel disease (IBD). Cobblestone-like inflammatory polyps and many longitudinal ulcers were detected between the descending colon and the cecum. Macroscopic examination strongly suggested CD. Histopathological examination revealed non-caseating granuloma and no evidence of vasculitis, consistent with CD. Introduction of infliximab dramatically relieved the patient's melena and abdominal symptoms. CONCLUSION: Diagnostic criteria for CD and SLE overlap, making them difficult to diagnose correctly. It is important to consider CD for patients who have SLE with gastrointestinal manifestations. The pathology of lupus enteritis should be clarified through the accumulation of cases of SLE combined with CD.Dec. 2012, BMC gastroenterology, 12, 174 - 174, English, International magazine[Refereed]Scientific journal
- Clinical presentation of pneumocystis pneumonia (PCP) during immunosuppressive therapy for rheumatic diseases was compared between patients with rheumatoid arthritis (RA; n = 7) and those without RA (non-RA; n = 12) based on a chart review. Both RA and non-RA patients with PCP were treated with methotrexate (n = 7) combined with steroids (n = 6) and/or biologics (n = 4). RA-PCP patients were found to have a higher mortality rate than non-RA-PCP patients (3/7 vs. 0/12, respectively; p = 0.036) due to a later exacerbation of interstitial pneumonia and a higher presentation rate of diffuse pulmonary lesions (4/7 vs. 1/12, respectively; p = 0.036) despite lower mean levels of serum beta-D: -glucan (314 ± 214 vs. 1139 ± 1114 pg/ml, respectively; p = 0.02) that suggested a lower burden of Pneumocystis jirovecii. In conclusion, PCP in RA patients with existing pulmonary lesions may trigger subsequent progression to lethal interstitial pneumonia.Aug. 2012, Modern rheumatology, 22(4) (4), 509 - 14, English, International magazine[Refereed]Scientific journal
- [A case of Stevens-Johnson syndrome (SJS) progressive toxic epidermal necrolysis (TEN) onset during hyposensitization therapy for pulmonary tuberculosis complicated with dermatomyositis].A 58-year-old female with a history of dermatomyositis was receiving large oral doses of steroids. She had pulmonary tuberculosis and developed a fever, systemic exudative erythema, exanthema, and epidermolysis covering 30% of her body surface area while being treated with four agents, including isoniazid (INH) and rifampicin (RFP). Histopathologically, eosinophilic necrosis was observed in all layers of the epidermis and a diagnosis of Stevens-Johnson syndrome (SJS) progressive toxic epidermal necrolysis (TEN) was made. The drugs suspected in the drug-induced lymphocyte stimulation test (DLST) re-testing were INH and RFP, and the DLST was considered to be important during the recovery period as well as in the acute phase. Early treatment with plasma exchange therapy and large quantities of intravenous immunoglobulin (IVIG) was successful. Plasma exchange therapy and IVIG are extremely effective when SJS and TEN occur in a patient already on high-dose steroid therapy. Note that the incidence of SJS and TEN is believed to be higher in patients with collagen disease, such as in our case, as compared to the general population.Jul. 2012, Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases, 86(4) (4), 419 - 24, Japanese, Domestic magazine[Refereed]Scientific journal
- [A case of adult-onset varicella pneumonia and varicella-zoster virus (VZV) meningitis resulting from a reoccurrence of varicella].The patient was a 74-year old male who presented with a skin rash, cough, and impaired consciousness. A diffuse, systemic, dark red rash was observed and he was admitted. Varicella infection was diagnosed based on the varicella-zoster virus (VZV)-IgM levels. The extremely high VZV- IgG levels observed were unlikely to be present in an initial infection and the infection was thought to be a reoccurrence. Diffuse nodular shadows measuring < or = 5 mm in diameter were observed on chest computed tomography (CT);this was consistent with the typical imaging findings of varicella pneumonia. The cerebrospinal fluid (CSF) was positive for CSF VZV-IgM antibody, CSF VZV-PCR, and CSF antibody titer index. A diagnosis of varicella meningitis was made. When both respiratory and neurological symptoms are observed in patients with varicella infection, it is necessary to consider a combined diagnosis of varicella pneumonia and varicella meningitis/encephalitis and perform chest imaging and a CSF examination. Repeated asymptomatic re-infection is considered necessary in order to maintain a lifelong immunity to varicella; however, the opportunities for asymptomatic re-infection are decreasing with the declining birth rate and trend toward small families. As a result, reoccurrences of varicella infection in the elderly are expected to increase with rapidly increasing longevity.May 2012, Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases, 86(3) (3), 306 - 9, Japanese, Domestic magazine[Refereed]Scientific journal
- [A case of rheumatoid arthritis involving disseminated torichosporonosis].A 75-year-old man who developed disseminated trichosporonosis had a long history of immunosuppressive therapy with weekly methotrexate and low-dose prednisolone for rheumatoid arthritis (RA). He had been administered 30 mg of prednisolone per day for organizing pneumonia, probably due to the RA, for about 3 months before admission for a lumbar compression fracture. He then developed bilateral aspiration pneumonia with pleural effusion, treated successfully with broad-spectrum antibiotics meropenem and ciprofloxacin, and fluid management. He then developed acute, progressive respiratory failure with changes in both lung lobes in chest computed tomography (CT). Meropenem, ciprofloxacin, micafungin, and pulsed steroid administration were ineffective. He died of respiratory failure, after which Trichosporon asahii was first detected in blood and urine culture. Disseminated trichosporonosis was determined based on positive blood culture, elevated serum glucuronoxylomannan antigen and beta-D glucan, and the man's lack of clinical progress. He had numerous risk factors for trichosporonosis, including neutrophilic dysfunction due to prolonged steroid therapy, administration of broad-spectrum antibiotics and micafungin, and central venous catheterization. Disseminated trichosporonosis is a chiefly hematological infection and case reports without hematological disorders are rare, so we report this instructive case.Sep. 2011, Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases, 85(5) (5), 532 - 6, Japanese, Domestic magazine[Refereed]
- [Successful bosentan therapy in a case of pulmonary arterial hypertention developed during immunosuppressive therapy for lupus nephritis].We report a 43-year-old female who developed pulmonary arterial hypertension (PAH) during intensive immunosuppressive therapy for systematic lupus erythematosus (SLE). She was diagnosed as SLE at the age of 32 years based on serological and hematological abnormalities, oral ulcers, and facial erythema. She experienced frequent flare-ups of disseminated discoid lupus between the ages of 33 and 36 years and developed immune thrombocytopenia at the age of 39 years. In 2007 when she was 43 years old, she developed lupus nephritis (LN) with elevated serum anti-double stranded DNA antibodies and urine protein of less than 1 g/day. Combination therapy for the LN with 35 mg/day prednisolone and intravenous cyclophosphamide (IVCY) led to renal remission. After the seventh monthly session of IVCY, she developed dyspnea on exertion. PAH was diagnosed based on enlarged main pulmonary arteries on the chest x-ray, right ventricular outflow and a peak tricuspid regurgitant pressure gradient exceeding 45 mmHg on echocardiography, an elevated plasma brain natriuretic peptide (BNP) level of 260 pg/ml, the exclusion of pulmonary thromboembolism, and no lung fibrosis. The PAH was treated successfully with bosentan. At present the tricuspid regurgitation has disappeared, and the plasma BNP level has normalized.2011, Nihon Rinsho Men'eki Gakkai kaishi = Japanese journal of clinical immunology, 34(2) (2), 99 - 104, English, Domestic magazine[Refereed]
- Epstein-Barr virus-induced infectious mononucleosis after two separate episodes of virus-associated hemophagocytic syndrome.A 24-year-old man, who had suffered previous two episodes of non- Epstein-Barr virus (EBV)-associated hemophagocytic syndrome (HPS) at the ages of 16 and 18, developed EBV-induced infectious mononucleosis. His antibody pattern to EBV highlighted the initial infection. The disease took a self-limited course without developing into HPS. No reactivation of EBV infection was noted over the following 6 years. The patient may have attained immune competency in adulthood, which was somehow impaired during his adolescence.2009, Internal medicine (Tokyo, Japan), 48(13) (13), 1169 - 73, English, Domestic magazine[Refereed]Scientific journal
- (一社)日本リウマチ学会, Mar. 2024, 日本リウマチ学会総会・学術集会プログラム・抄録集, 68回, 561 - 561, JapaneseSLEの患者報告アウトカム Lupus Patient-Reported Outcome tool(LupusPRO)のSLICC/ACR damage indexに対する予測的妥当性 LUNAレジストリ
- (一社)日本リウマチ学会, Mar. 2022, 日本リウマチ学会総会・学術集会プログラム・抄録集, 66回, 584 - 584, Japaneseアバタセプト継続率と血球分画の関連 ANSWERコホートを用いた研究
- (一社)日本リウマチ学会, Mar. 2021, 日本リウマチ学会総会・学術集会プログラム・抄録集, 65回, 381 - 381, JapaneseSLE・抗リン脂質抗体症候群(臨床):バイオマーカー 当院における抗DNA抗体検出法についての検討 Farr法とCLIA法の比較について
- (一社)日本リウマチ学会, Mar. 2021, 日本リウマチ学会総会・学術集会プログラム・抄録集, 65回, 401 - 401, Japanese多発性筋炎・皮膚筋炎:ケースプレゼンテーション 皮膚硬化を呈した抗ミトコンドリア抗体陽性筋炎の1例
- (一社)日本リウマチ学会, Mar. 2021, 日本リウマチ学会総会・学術集会プログラム・抄録集, 65回, 612 - 612, Japanese異所性石灰化病変を合併した全身性エリテマトーデス患者に対してテリパラチドにより異所性石灰化と骨粗鬆症を同時に治療しえた一例
- (一社)日本リウマチ学会, Mar. 2021, 日本リウマチ学会総会・学術集会プログラム・抄録集, 65回, 665 - 665, Japanese中型血管炎による難治性多発消化管潰瘍を呈した顕微鏡的多発血管炎の一例
- Oct. 2020, ARTHRITIS & RHEUMATOLOGY, 72, EnglishCombined Inhibition of Autophagy and Glutamine Metabolism Suppresses Cell Growth of RA Synoviocytes and Ameliorates Arthritis in SKG MiceSummary international conference
- Oct. 2020, ARTHRITIS & RHEUMATOLOGY, 72, EnglishResolvin D5 Modulates Th17/Treg Cell Differentiation and Suppresses OsteoclastogenesisSummary international conference
- (一社)日本骨粗鬆症学会, Sep. 2020, 日本骨粗鬆症学会雑誌, 6(Suppl.1) (Suppl.1), 268 - 268, Japanese異所性石灰化病変を合併した全身性エリテマトーデス患者に対してテリパラチドにより異所性石灰化と骨粗鬆症を同時に治療しえた一例
- (一社)日本リウマチ学会, Aug. 2020, 日本リウマチ学会総会・学術集会プログラム・抄録集, 64回, 634 - 634, Japanese間質性肺炎を有するRA患者におけるDMARDsの安全性に関する系統的レビュー
- (一社)日本リウマチ学会, Aug. 2020, 日本リウマチ学会総会・学術集会プログラム・抄録集, 64回, 636 - 636, Japanese悪性腫瘍を有するRA患者におけるDMARDsの安全性に関する系統的レビュー
- (一社)日本リウマチ学会, Aug. 2020, 日本リウマチ学会総会・学術集会プログラム・抄録集, 64回, 697 - 697, Japanese高用量ステロイド治療中の膠原病患者におけるニューモシスティス肺炎(PCP)予防薬の効果
- (一社)日本リウマチ学会, Aug. 2020, 日本リウマチ学会総会・学術集会プログラム・抄録集, 64回, 763 - 763, Japaneseステロイド、DMARDs加療中のRA患者へのワクチン接種の有効性、安全性に関する系統的レビュー
- Oct. 2019, ARTHRITIS & RHEUMATOLOGY, 71, EnglishThe Comparative Efficacy of Pneumocystis Pneumonia Prophylactic Regimens in Patients with Connective Tissue Diseases Receiving Prolonged High-dose GlucocorticoidsSummary international conference
- (一社)日本臨床免疫学会, Oct. 2019, 日本臨床免疫学会総会プログラム・抄録集, 47回, 112 - 112, Japaneseベーチェット病に伴う仙腸関節炎に対して抗TNFα阻害薬で治療中に、食道穿通病変と回盲部潰瘍が出現し、内科的治療で治療しえた腸管型ベーチェット病の1例
- Jun. 2019, ANNALS OF THE RHEUMATIC DISEASES, 78, 1559 - 1559, EnglishSummary international conference
- (一社)日本リウマチ学会, Mar. 2019, 日本リウマチ学会総会・学術集会プログラム・抄録集, 63回, 623 - 623, Japaneseアダリムマブの寛解後休薬についての検討
- (一社)日本リウマチ学会, Mar. 2019, 日本リウマチ学会総会・学術集会プログラム・抄録集, 63回, 729 - 729, Japanese当施設におけるニューモシスティス肺炎に対する治療の実態
- (一社)日本リウマチ学会, Mar. 2019, 日本リウマチ学会総会・学術集会プログラム・抄録集, 63回, 735 - 735, JapaneseSLEとの鑑別を要した自己免疫性溶血性貧血と特発性膜性腎症の合併例
- (一社)日本リウマチ学会, Mar. 2019, 日本リウマチ学会総会・学術集会プログラム・抄録集, 63回, 758 - 758, Japanese関節リウマチとSLEを合併した強皮症オーバーラップ症候群の一例
- (一社)日本リウマチ学会, Mar. 2019, 日本リウマチ学会総会・学術集会プログラム・抄録集, 63回, 767 - 767, Japanese抗TIF1γ抗体陽性皮膚筋炎症例の臨床的特徴
- (一社)日本リウマチ学会, Mar. 2019, 日本リウマチ学会総会・学術集会プログラム・抄録集, 63回, 784 - 784, JapaneseANCA関連血管炎の寛解導入療法中に、リツキシマブに起因する急性血小板減少が疑われた3例
- (一社)日本臨床免疫学会, Nov. 2018, 日本臨床免疫学会総会プログラム・抄録集, 46回, 83 - 83, Japanese顔面から頸部の表在感覚障害をきたしたIgA血管炎の1例
- (一社)日本臨床免疫学会, Nov. 2018, 日本臨床免疫学会総会プログラム・抄録集, 46回, 85 - 85, Japaneseトファシチニブは骨髄由来抑制性細胞(MDSC)の増殖を促しSKGマウスの間質性肺炎を抑制する
- (一社)日本臨床免疫学会, Nov. 2018, 日本臨床免疫学会総会プログラム・抄録集, 46回, 110 - 110, Japanese顔面から頸部の表在感覚障害をきたしたIgA血管炎の1例
- (一社)日本臨床免疫学会, Nov. 2018, 日本臨床免疫学会総会プログラム・抄録集, 46回, 124 - 124, Japaneseトファシチニブは骨髄由来抑制性細胞(MDSC)の増殖を促しSKGマウスの間質性肺炎を抑制する
- (一社)日本臨床免疫学会, Nov. 2018, 日本臨床免疫学会総会プログラム・抄録集, 46回, 138 - 138, Japaneseサイトメガロウイルス食道炎・胃炎による門脈ガス血症を来した多発血管炎性肉芽腫症
- (一社)日本リウマチ学会, Mar. 2018, 日本リウマチ学会総会・学術集会プログラム・抄録集, 62回, 415 - 415, English感染症 RA患者の疾患活動性に対するtrimethoprim-sulfamethoxazoleの効果 ANSWER縦断的コホート研究(Infection The effects of trimethoprim-sulfamethoxazole on disease activity in patients with RA: ANSWER longitudinal cohort study)[Refereed]
- (一社)日本リウマチ学会, Mar. 2018, 日本リウマチ学会総会・学術集会プログラム・抄録集, 62回, 517 - 517, Japanese関節リウマチの治療評価と予測1 血清メタボローム解析による関節リウマチ患者の生物学的製剤治療反応性の予測バイオマーカーの同定
- (一社)日本リウマチ学会, Mar. 2018, 日本リウマチ学会総会・学術集会プログラム・抄録集, 62回, 525 - 525, Japanese血管炎5:大型血管炎症例集積研究 高安動脈炎における当院での治療成績とトシリズマブの有効性についての検討
- (一社)日本臨床免疫学会, Aug. 2017, 日本臨床免疫学会会誌, 40(4) (4), 308 - 308, Japanese
- Jun. 2017, ANNALS OF THE RHEUMATIC DISEASES, 76, 487 - 488, EnglishSummary international conference
- Jun. 2017, ANNALS OF THE RHEUMATIC DISEASES, 76, 699 - 699, EnglishSummary international conference
- (一社)日本リウマチ学会, Mar. 2017, 日本リウマチ学会総会・学術集会プログラム・抄録集, 61回, 545 - 545, Japanese骨粗鬆症と骨代謝/変形性関節症・軟骨 ステロイド骨粗鬆症(GIO)に対するデノスマブの有効性 2年間の使用成績
- (一社)日本臨床免疫学会, Aug. 2016, 日本臨床免疫学会会誌, 39(4) (4), 376 - 376, Japanese
- (一社)日本臨床免疫学会, Aug. 2016, 日本臨床免疫学会会誌, 39(4) (4), 410 - 410, Japanese
- Jun. 2016, ANNALS OF THE RHEUMATIC DISEASES, 75, 113 - 113, EnglishSummary international conference
- Jun. 2016, ANNALS OF THE RHEUMATIC DISEASES, 75, 963 - 963, EnglishSummary international conference
- Jun. 2016, ANNALS OF THE RHEUMATIC DISEASES, 75, 170 - 170, EnglishSummary international conference
- (一社)日本リウマチ学会, Mar. 2016, 日本リウマチ学会総会・学術集会プログラム・抄録集, 60回, 344 - 344, Japaneseリウマチ性疾患の基礎研究 SKGマウス肺病変の進展に伴って増加するCD11b+Gr1dim cellはGM-CSFによって誘導される
- (一社)日本リウマチ学会, Mar. 2016, 日本リウマチ学会総会・学術集会プログラム・抄録集, 60回, 361 - 361, Japaneseベーチェット病 特殊型ベーチェット病に対するTNF阻害剤の有効性
- (一社)日本リウマチ学会, Mar. 2016, 日本リウマチ学会総会・学術集会プログラム・抄録集, 60回, 447 - 447, Japanese関節リウマチの治療評価と予測 疼痛評価VASが高い患者の健康状態全般評価VASは過小申告されていることがある(ROCKoコホート研究から)
- (一社)日本リウマチ学会, Mar. 2016, 日本リウマチ学会総会・学術集会プログラム・抄録集, 60回, 456 - 456, Japanese関節リウマチの治療 QOL 治療目標に到達した関節リウマチ患者の主観的幸福度は、一般的な日本人より高い(ROCKoコホート研究から)
- (一社)日本リウマチ学会, Mar. 2016, 日本リウマチ学会総会・学術集会プログラム・抄録集, 60回, 468 - 468, Japaneseリウマチ性疾患の疫学 関節リウマチ患者における社会経済的要因が疾患活動性、日常生活動作に与える影響の検討(ROCKoコホート研究から)
- (一社)日本リウマチ学会, Mar. 2015, 日本リウマチ学会総会・学術集会プログラム・抄録集, 59回, 369 - 369, Japaneseその他の膠原病 脊椎関節炎51例の臨床的検討
- (一社)日本リウマチ学会, Mar. 2015, 日本リウマチ学会総会・学術集会プログラム・抄録集, 59回, 657 - 657, Japanese原発性シェーグレン患者における睡眠障害の検討
- (一社)日本臨床免疫学会, Aug. 2014, 日本臨床免疫学会会誌, 37(4) (4), 375 - 375, Japanese
- (一社)日本臨床免疫学会, Aug. 2014, 日本臨床免疫学会会誌, 37(4) (4), 379 - 379, Japanese
- (一社)日本感染症学会, Jul. 2014, 感染症学雑誌, 88(4) (4), 459 - 462, Japanese
- (一社)日本感染症学会, May 2014, 感染症学雑誌, 88(3) (3), 282 - 287, Japanese
- (一社)日本リウマチ学会, Mar. 2014, 日本リウマチ学会総会・学術集会プログラム・抄録集, 58回, 411 - 411, Japanese血管炎 当科におけるANCA関連血管炎に伴う肺胞出血合併例の集計
- (一社)日本リウマチ学会, Mar. 2014, 日本リウマチ学会総会・学術集会プログラム・抄録集, 58回, 671 - 671, Japanese再発性多発軟骨炎の早期診断及び疾患活動性評価におけるFDG-PET/CTの有用性
- (一社)日本臨床免疫学会, Dec. 2013, 日本臨床免疫学会会誌, 36(6) (6), 467 - 472, Japanese
- (一社)日本感染症学会, Nov. 2013, 感染症学雑誌, 87(6) (6), 746 - 751, Japanese
- (一社)日本リウマチ学会, Mar. 2013, 日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集, 57回・22回, 381 - 381, JapaneseRA特殊病態 傍腫瘍性リウマチ様筋骨格系症状を呈した10症例の特徴
- (一社)日本リウマチ学会, Mar. 2013, 日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集, 57回・22回, 515 - 515, JapaneseSLEに伴う横断性脊髄炎 重症例およびMMF有効例
- (一社)日本リウマチ学会, Mar. 2013, 日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集, 57回・22回, 650 - 650, Japanese難治性成人発症Still病(AOSD)にtocilizumab(TCZ)が奏功した8例
- 日本内科学会-関東地方会, Feb. 2013, 日本内科学会関東地方会, 594回, 47 - 47, Japanese肝への好酸球浸潤を伴う好酸球性肉芽腫性多発血管炎(Churg-Strauss症候群)の1例
- (一社)日本感染症学会, Jul. 2012, 感染症学雑誌, 86(4) (4), 419 - 424, Japanese
- (一社)日本感染症学会, May 2012, 感染症学雑誌, 86(3) (3), 306 - 309, Japanese
- (一社)日本リウマチ学会, Mar. 2012, 日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集, 56回・21回, 293 - 293, Japaneseリウマチ性疾患の画像(2) 不明熱の診断におけるFDG-PET/CTの有用性 当科における集計
- (一社)日本リウマチ学会, Mar. 2012, 日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集, 56回・21回, 333 - 333, Japanese感染症と自己免疫疾患(1) 免疫抑制治療中に発症したサイトメガロウイルス感染による上部消化管病変の検討
- 日本内科学会-関東地方会, Feb. 2012, 日本内科学会関東地方会, 585回, 46 - 46, Japanese多関節炎発症後、早期に汎血球減少を来した1例
- (一社)日本感染症学会, Sep. 2011, 感染症学雑誌, 85(5) (5), 532 - 536, Japanese
- (一社)日本リウマチ学会, Jun. 2011, 日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集, 55回・20回, 326 - 326, Japaneseトシリズマブ HBV既往感染のリウマチ患者に対するトシリズマブの使用経験
- (一社)日本リウマチ学会, Jun. 2011, 日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集, 55回・20回, 608 - 608, Japanese免疫抑制治療中に出現したサイトメガロウイルス抗原血症陽性例の検討
- (一社)日本臨床免疫学会, Apr. 2011, 日本臨床免疫学会会誌, 34(2) (2), 99 - 104, Japanese
- (株)南江堂, Oct. 2010, 内科, 106(4) (4), 731 - 735, Japanese
- (一社)日本リウマチ学会, Mar. 2010, 日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集, 54回・19回, 571 - 571, Japanese肺病変 MTX治療中の関節リウマチに抗TNF-α抗体療法を追加後、間質性肺炎を生じた3例
- (一社)日本リウマチ学会, Mar. 2010, 日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集, 54回・19回, 684 - 684, Japaneseウイルス肝炎罹患例におけるリウマチ治療