Nanoparticle Albumin-Bound Paclitaxel- and/or Gemcitabine-Induced Scleroderma Accompanied by Acanthosis Nigricans-Like Skin Changes

We herein present the first case of nanoparticle albumin-bound paclitaxel (nab-paclitaxel)- and/or gemcitabine-induced scleroderma accompanied by acanthosis nigricans-like skin changes in a 54-year-old Japanese male. He was diagnosed with pancreatic cancer and received 17 courses of nab-paclitaxel and gemcitabine chemotherapy. Edema and skin sclerosis in his legs appeared after the first and third course, respectively. Histological examination of the hyperkeratotic lesion of the ankle revealed hyperkeratosis, acanthosis, papillomatosis, increased number of melanocytes in the basal layer, and dermal fibrosis. Awareness of the clinical characteristics of nab-paclitaxel- and/or gemcitabine-induced scleroderma accompanied by acanthosis nigricans-like skin changes is important for dermatologists to establish an accurate diagnosis.

Download Full-text

A rare benign genitourinary tumor in a Japanese male: urinary retention owing to aggressive angiomyxoma of the prostate

Rare Tumors ◽

10.4081/rt.2010.e15 ◽

2010 ◽

Vol 2 (1) ◽

pp. 43-45 ◽

Cited By ~ 1

Author(s):

Yugo Sawada ◽

Fumio Ito ◽

Hayakazu Nakazawa ◽

Nobuhiko Tsushima ◽

Hikaru Tomoe ◽

...

Keyword(s):

Renal Dysfunction ◽

Urinary Retention ◽

Bladder Neck ◽

English Literature ◽

Pathological Examination ◽

Aggressive Angiomyxoma ◽

Urethral Meatus ◽

First Case ◽

Japanese Male ◽

Old Japanese

Close examination of a 67-year-old Japanese man, who complained of persistent nocturia, revealed that a semitransparent polypoid tumor had developed from the bladder neck to the prostatic urethra obstructing the internal urethral meatus, which resulted in excessive urinary retention and post-renal dysfunction. The tumor was resected by a transurethral procedure and a pathological examination of specimens revealed aggressive angiomyxoma (AAM) of the prostate. AAM usually develops in the intrapelvic and perineal organs of females. So far as we know, this is the second case of primary prostatic AAM reported in the English literature, and is the first case where the patient encountered urethral obstruction.

Download Full-text

Protein C Gene Mutation in an Older Adult Patient with Clostridium perfringens Septicemia-Related Visceral Vein Thrombosis

TH Open ◽

10.1055/s-0041-1728664 ◽

2021 ◽

Vol 05 (02) ◽

pp. e171-e173

Author(s):

Kiyoko Kanosue ◽

Satomi Nagaya ◽

Eriko Morishita ◽

Masayoshi Yamanishi ◽

Shinsaku Imashuku

Keyword(s):

Gene Mutation ◽

Clostridium Perfringens ◽

Protein C ◽

Later Life ◽

Heterozygous Mutation ◽

Protein C Deficiency ◽

Vein Thrombosis ◽

Thrombosis Risk ◽

Japanese Male ◽

Old Japanese

AbstractA 78-year-old Japanese male with Clostridium perfringens septicemia and cholecystitis was found to have thrombosis in the left branch of intrahepatic portal vein as well as superior mesenteric vein. Visceral vein thrombosis (VVT) in this case was associated with protein C deficiency, due to a heterozygous mutation, p. Arg185Met. Our experience emphasizes that VVT, or other thromboembolic events, may occur in later life, triggered by environmental thrombosis risk factors, together with underlying hereditary protein C gene mutation.

Download Full-text

Repeated Enterocutaneous Fistula in a Munchausen Syndrome Patient

Case Reports in Gastroenterology ◽

10.1159/000499443 ◽

2019 ◽

Vol 13 (1) ◽

pp. 173-177

Author(s):

Toshiaki Hagiwara ◽

Shinya Munakata ◽

Shun Ishiyama ◽

Goto Michitoshi ◽

Rina Takahashi ◽

...

Keyword(s):

Enterocutaneous Fistula ◽

The Self ◽

Munchausen Syndrome ◽

Rare Type ◽

Wound Site ◽

Fistula Surgery ◽

Self Mutilation ◽

Japanese Male ◽

Old Japanese ◽

Self Harm

Munchausen syndrome is a rare type of mental disorder in which the patient fakes illness to gain attention and sympathy. Patients may lie about symptoms, make themselves appear sick, or make themselves purposely unwell. We describe a case of repeated enterocutaneous fistula in Munchausen syndrome. A 53-year-old Japanese male was admitted to our hospital for the treatment of a high-flow enterocutaneous fistula. Surgery was performed two times, but the fistula recurred each time. Chopsticks with blood on them were coincidentally detected in the trash in the patient’s room. It was revealed that the enterocutaneous fistula was caused by self-mutilation. A psychiatrist was consulted, and the patient was diagnosed with Munchausen syndrome. The psychiatrist initiated treatment and the patient admitted the self-harm. His prolonged wound site was closed and he was able to be discharged. There has been no recurrence of the self-harm as of this writing, 3 years later. The treatment of Munchausen syndrome is difficult and early detection is important.

Download Full-text

Intraparenchymal extravasation of gadolinium mimicking an enhancing brain tumor

The Neuroradiology Journal ◽

10.1177/1971400919853789 ◽

2019 ◽

Vol 32 (4) ◽

pp. 273-276 ◽

Cited By ~ 1

Author(s):

David J Ritchie ◽

Charles Q Li ◽

Reid Hoshide ◽

Daniel Vinocur

Keyword(s):

Magnetic Resonance Imaging ◽

Brain Tumor ◽

Magnetic Resonance ◽

Pediatric Patient ◽

Essential Role ◽

Accurate Diagnosis ◽

Resonance Imaging ◽

Intracranial Neoplasms ◽

Vascular Abnormalities ◽

First Case

Gadolinium (Gd)-enhanced magnetic resonance imaging plays an essential role in the detection, characterization, and staging of intracranial neoplasms and vascular abnormalities. Although Gd is helpful in a majority of situations, it can lead to diagnostic misinterpretation in the setting of active vascular extravasation. Scarce reports of intracranial extravasation of Gd are present in the literature. Here, we report the first case of surgically proven spontaneous intraparenchymal extravasation of Gd mimicking an enhancing intra-axial neoplasm in a pediatric patient. Early and accurate recognition of Gd extravasation is critical in obtaining the accurate diagnosis and triaging patients expeditiously into proper avenues of care.

Download Full-text

A case of planar-type GIST of the sigmoid colon showing diverticular structure with perforation

World Journal of Surgical Oncology ◽

10.1186/s12957-020-01906-8 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Yuka Shintaku ◽

Yuya Asano ◽

Takahiro Watanabe ◽

Takako Kihara ◽

Eri Ishikawa ◽

...

Keyword(s):

Sigmoid Colon ◽

Mutational Analysis ◽

Muscularis Propria ◽

Normal Mucosa ◽

Sudden Onset ◽

Surrounding Tissue ◽

Spindle Cells ◽

Japanese Male ◽

Old Japanese ◽

Exon 11

Abstract Background Gastrointestinal stromal tumors (GISTs) generally form well-defined mass lesions. However, some cases of the flatly distributed and muscularis propria-replacing GISTs have been reported so far. We experienced an additional case of planar-type GIST of the sigmoid colon accompanied by a diverticulum with perforation. Case presentation A 68-year-old Japanese male with sudden onset of abdominal pain was clinically diagnosed with gastrointestinal perforation, and an emergency abdominal operation was performed. A diverticulum with rupture was found in the sigmoid colon, but no apparent tumor was observed. Histological examination revealed bland spindle cells flatly proliferating and diffusely replacing the muscularis propria at the diverticular structure. The spindle cells were positive for KIT, DOG1, and CD34. Mutational analysis of the c-kit gene revealed that the lesion had a heterozygous deletion of 2 amino acids at codons 557 and 558 of exon 11. The mutation was not observed in the normal mucosa of the surrounding tissue. Conclusion We diagnosed this case as an unusual planar-type GIST. Some similar cases have been reported in the sigmoid colon and other sites. We discuss the mechanism of development of the planar-type GISTs associated with the diverticulum.

Download Full-text

Successful rechallenge with paliperidone after clozapine treatment for a patient with dopamine supersensitivity psychosis

SAGE Open Medical Case Reports ◽

10.1177/2050313x20929561 ◽

2020 ◽

Vol 8 ◽

pp. 2050313X2092956

Author(s):

Remiko Kobayashi ◽

Yasunori Oda ◽

Ryunosuke Hayatsu ◽

Nozomi Ohki ◽

Misa Akutsu ◽

...

Keyword(s):

Symptomatic Relief ◽

Psychotic Symptoms ◽

Psychotic Episode ◽

Antipsychotic Treatment ◽

Treatment Resistant ◽

Clozapine Treatment ◽

Clozapine Dose ◽

Japanese Male ◽

Old Japanese ◽

Dopamine Supersensitivity

We describe the case of a 49-year-old Japanese male patient successfully treated with a paliperidone rechallenge following 2-year treatment with clozapine for treatment-resistant schizophrenia. He had responded well to conventional antipsychotic treatment for the initial psychotic episode but gradually developed dopamine supersensitivity; even treatment with paliperidone and another antipsychotic medication (a total up to 1700 mg in chlorpromazine-equivalent dose) had not improved his psychotic symptoms. Clozapine treatment produced temporary symptomatic relief, but the clozapine dose could not be increased to > 150 mg due to the patient’s intolerance. Following low-dose clozapine treatment for 2 years, a rechallenge with paliperidone monotherapy ameliorated his psychotic symptoms. This suggests that clozapine may have the potential to release the dopamine supersensitivity state. Our patient’s case indicates that for patients with dopamine supersensitivity psychosis, a rechallenge with a previously ineffective antipsychotic after clozapine treatment may be successful.

Download Full-text

Tissue Hypoperfusion, Hypercoagulopathy, and Kidney and Liver Dysfunction after Ingestion of a Naphazoline-Containing Antiseptic

Case Reports in Emergency Medicine ◽

10.1155/2017/3968045 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5

Author(s):

Yuko Ono ◽

Nozomi Ono ◽

Kazuaki Shinohara

Keyword(s):

Liver Dysfunction ◽

Laboratory Data ◽

Japanese Woman ◽

Over The Counter ◽

Tissue Hypoperfusion ◽

First Case ◽

Old Japanese ◽

History Of ◽

History Of Depression ◽

Adrenergic Receptor Agonist

Naphazoline is a peripheral α2-adrenergic receptor agonist commonly used as a topical decongestant. In Japan, over-the-counter antiseptics often contain naphazoline to effect local hemostasis. We present the first case involving the development of hypercoagulopathy, with kidney and liver dysfunction, following a naphazoline overdose. A 22-year-old Japanese woman with a history of depression ingested 160 mL of a commercially available antiseptic containing 0.1% naphazoline. Three days later, she was brought to the emergency department because of general fatigue, nausea, and vomiting. Physical examination revealed cool, pale extremities. Laboratory data showed evidence of severe kidney and liver dysfunction (creatinine, 9.2 mg/dL; alanine aminotransferase, 2948 IU/L), hypercoagulation (D-dimers, 58.3 μg/mL), and thrombocytopenia (platelet count, 90,000/μL). After infusion of normal saline, intravenous administration of alprostadil, and hemodiafiltration, her organ function completely recovered. Because both the kidney and liver express α2-adrenergic receptors, their failure was likely associated with naphazoline overdose-induced hypoperfusion. The most plausible causes of hypercoagulation are peripheral low perfusion and subsequent microthrombus formation. This case illustrates that severe organ dysfunction can occur following over-the-counter antiseptic ingestion and serves as a caution for both drug manufacturers and healthcare professionals.

Download Full-text

Successful Renal Replacement Therapy for a Patient with Severe Hemophilia after Surgical Treatment of Intracranial Hemorrhage and Hydrocephalus

Case Reports in Nephrology ◽

10.1155/2011/824709 ◽

2011 ◽

Vol 2011 ◽

pp. 1-3 ◽

Cited By ~ 4

Author(s):

Noriko Kato ◽

Masami Chin-Kanasaki ◽

Yuki Tanaka ◽

Mako Yasuda ◽

Yukiyo Yokomaku ◽

...

Keyword(s):

Renal Failure ◽

Peritoneal Dialysis ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Hemophilia A ◽

Severe Hemophilia ◽

End Stage Renal Failure ◽

Japanese Male ◽

Old Japanese ◽

End Stage

A 21-year-old Japanese male with severe hemophilia A was developed end-stage renal failure. He was placed on combination therapy with peritoneal dialysis (PD) and hemodialysis (HD). Eight months later, he developed a hypertensive cerebral hemorrhage. After emergency surgery, he was managed with PD without HD to avoid cerebral edema. One month later, his renal replacement therapy was switched to HD (three times a week) from PD, since a ventriculoperitoneal shunt catheter was placed to treat his hydrocephalus. HD could be performed safety without anticoagulant agents on condition that factor VIII is given after every HD.

Download Full-text

Psoriasiform Drug Eruption Caused by Abatacept: Immunohistochemical Investigation of STAT Signaling

Case Reports in Dermatology ◽

10.1159/000437415 ◽

2015 ◽

Vol 7 (2) ◽

pp. 166-170 ◽

Cited By ~ 4

Author(s):

Kayo Tanita ◽

Taku Fujimura ◽

Aya Kakizaki ◽

Sadanori Furudate ◽

Yoshiyuki Kusakari ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Adverse Effects ◽

Immunohistochemical Staining ◽

Drug Eruption ◽

Psoriasis Vulgaris ◽

Basal Layer ◽

Epidermal Keratinocytes ◽

Immunological Mechanisms ◽

Stratum Spinosum ◽

Old Japanese

Abatacept is a biological immune modifier that is used for the treatment of rheumatoid arthritis. Although psoriasiform drug eruption is reported as one of the cutaneous adverse effects of abatacept, the precise mechanisms are not fully understood. In this report, we describe a 65-year-old Japanese man with psoriasiform drug eruption caused by abatacept. Interestingly, immunohistochemical staining revealed that the epidermal keratinocytes in the basal layer and lower layers of the stratum spinosum were positive for pSTAT3, partially positive for pSTAT1 and negative for pSTAT6, which is similar to conventional psoriasis vulgaris. Our present study suggests that psoriasiform drug eruption caused by abatacept might develop by similar immunological mechanisms as those of psoriasis vulgaris.

Download Full-text

Sub-Tenon Injections of Triamcinolone Acetonide Had Limited Effect on Cystoid Macular Edema Secondary to Nanoparticle Albumin-Bound-Paclitaxel (Abraxane)

Case Reports in Ophthalmological Medicine ◽

10.1155/2015/181269 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Naoki Matsuoka ◽

Hiruma Hasebe ◽

Tetsuji Mayama ◽

Takeo Fukuchi

Keyword(s):

Macular Edema ◽

Triamcinolone Acetonide ◽

Cystoid Macular Edema ◽

Treatment Options ◽

Time Lag ◽

Japanese Woman ◽

First Case ◽

Old Japanese ◽

Long Term Follow Up ◽

Near Future

Purpose. To report the first case of cystoid macular edema (CME) induced by nanoparticle albumin-bound- (nab-) paclitaxel treated with sub-Tenon injections of triamcinolone acetonide (STTA) with detailed long-term follow-up.Case. A 39-year-old Japanese woman with breast cancer presents with decreased vision in both eyes while receiving nab-paclitaxel. Two STTA treatments were administered for persistent CME in her right eye. Central retinal thickness (CRT) of the treated eye decreased after the first STTA, but there was no change after the second STTA. CRT of the other eye and bilateral visual acuity (VA) showed no change after each treatment. However, this patient experienced gradual recovery of visual function after nab-paclitaxel treatment was completed, 3 months after the second STTA. Improvements in VA and CRT did not overlap in time. Moreover, there was a big improvement time lag in VA between the eyes.Conclusion. Cessation of nab-paclitaxel could lead to resolution of CME more than STTA, although STTA had some effect. Since nab-paclitaxel has been recently approved for treating more types of malignancies, the number of the patients with this CME is expected to increase in the near future. Patients and physicians should understand this side effect and prepare for other treatment options.

Download Full-text