Internal medicine
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Changes in Hepatic Density Due to Oral Amiodarone-induced Liver injury Shown by Computed Tomography.
Amiodarone is an antiarrhythmic drug that is widely used for atrial fibrillation and other refractory arrhythmias. Although beneficial, its long-term administration is associated with adverse effects on various organs. One patient presented with amiodarone-induced liver injury, which led to liver failure. ⋯ Despite the discontinuation of the drug, the patient developed hepatic encephalopathy and subsequently died. This outcome highlights the drug's extended half-life, which caused persistent end-organ damage even after its withdrawal. Drug titration to the lowest effective dose and careful monitoring of annual liver function tests are important.
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Objectives Thymus and activation-regulated chemokine (TARC) can predict severe disease in patients with coronavirus disease 2019 (COVID-19). However, no reports have addressed the predictive value of TARC with the widespread use of vaccines and medications for COVID-19 during the Omicron variant period of the pandemic. Methods This single-center prospective cohort study enrolled COVID-19 patients admitted to our institution between December 1, 2021, and August 15, 2022. ⋯ A multivariate analysis showed that 2 vaccination doses were associated with non-severe disease, and TARC ≤174 pg/mL was associated with severe disease. Conclusion TARC was a predictive factor for severe disease, but its cutoff value was higher and its predictive accuracy lower than those in previous reports. We surmised that during the Omicron variant period of the pandemic, the widespread use of vaccines and medications for COVID-19 decreased the predictive accuracy of TARC.
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An 85-year-old woman with diffuse large B-cell lymphoma developed severe hypophosphatemia (serum phosphate 0.3 mg/dL) concomitant with acute kidney injury (serum creatinine 2.05 mg/dL) following chemotherapy. Because urine phosphate was undetectable, hypophosphatemia was likely due to the vigorous uptake of phosphate into the rapidly proliferating tumor cells, also known as tumor genesis syndrome (TGS), and acute kidney injury was potentially attributed to the antibiotics sulfamethoxazole/trimethoprim. ⋯ This case was unusual, as tumorigenesis syndrome is seldom seen in patients with lymphoma, and acute kidney injury usually leads to hyperphosphatemia. The present case emphasizes the importance of vigilance in hypophosphatemia due to TGS during chemotherapy.
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We herein report the first Japanese case of familial hypercholesterolemia (FH) caused by a specific mutation in APOE (c.500_502delTCC [p. Leu167del]). ⋯ His LDL cholesterol level was well controlled by the introduction of statins, ezetimibe, and PCSK9 inhibitors. Cascade and reverse cascade screening identified his son and father as also having FH caused by this particular mutation.
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A 45-year-old woman with Mycobacterium abscessus pulmonary disease was treated with multidrug therapy, including clofazimine, at Fukujuji Hospital. Six months after clofazimine initiation, the treatment was discontinued at the patient's request due to hyperpigmentation. ⋯ The patient's skin tone score closely correlated with the serum concentration of clofazimine. However, 14 months after the discontinuation of clofazimine, clofazimine-induced pigmentation was still not completely resolved.