Internal medicine
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Case Reports
Crescentic Glomerulonephritis with Fibrinoid Vasculitis after Administration of Influenza Vaccine: A Case Report.
A 66-year-old man was admitted to our hospital because of a low-grade fever and arthralgia. The symptoms started on the third day after influenza vaccine administration and persisted for two months. Serum creatinine was 1.0 mg/dL; C-reactive protein, 16.1 mg/dL; and myeloperoxidase antineutrophil cytoplasmic antibodies (MPO-ANCA), 4,170 IU/mL. ⋯ Microscopic polyangiitis was diagnosed. After five months of steroid pulse therapy and rituximab administration, the patient entered remission. There have been very few reports of this condition after influenza vaccine administration.
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Case Reports
Lambert-Eaton Myasthenic Syndrome Recurrence Induced by Pembrolizumab in a Patient with Non-small-cell Lung Cancer.
A 73-year-old woman in complete remission from localized small-cell lung cancer associated with Lambert-Eaton myasthenic syndrome (LEMS) 22 years earlier was referred to our hospital and diagnosed with non-small-cell lung cancer. After three courses of pembrolizumab, an immune checkpoint inhibitor, the patient complained of muscle weakness, fatigue, ptosis, and dysarthria. ⋯ We diagnosed her with recurrence of LEMS as an immune-related adverse event (irAE) induced by pembrolizumab. After intravenous immunoglobulin therapy, the patient's symptoms improved, and she was discharged.