Papers by Nobuyoshi Minemura
Nihon Naika Gakkai zasshi, Apr 10, 2023
Annals of Oncology, Jul 1, 2022
Kompass Pneumologie
Hintergrund: Die beschleunigte Nodulose (ARN) ist eine seltene Variante von Rheumaknoten (RN), di... more Hintergrund: Die beschleunigte Nodulose (ARN) ist eine seltene Variante von Rheumaknoten (RN), die durch ein schnelles Auftreten oder die Verschlimmerung von RN gekennzeichnet ist. Sie entsteht in der Regel an den Fingern von Patienten mit rheumatoider Arthritis (RA), die mit Methotrexat (MTX) behandelt werden. Es gibt nur wenige Fallberichte, in denen ARN an einer extrakutanen Stelle beschrieben wurde. Falldarstellung: Ein älterer Patient mit langjähriger RA wurde mit akutem Atemversagen in unser Krankenhaus eingeliefert. Die Computertomographie bei der Aufnahme zeigte diffuse Milchglastrübungen, die von subpleuralen retikulären Verschattungen und Wabenbildungen überlagert waren, sowie mehrere Knoten in der Lunge und der Leber. Trotz des Absetzens von MTX und der Einleitung einer immunsuppressiven Pulstherapie mit Methylprednisolon, gefolgt von einer ausschleichenden Prednisolon-Dosis und intravenösem Cyclophosphamid, verstarb der Patient an einer akuten Exazerbation (AE) der RA-be...
BMC Pulmonary Medicine, 2022
Background Accelerated nodulosis (ARN) is a rare variant of rheumatoid nodules (RNs) that is char... more Background Accelerated nodulosis (ARN) is a rare variant of rheumatoid nodules (RNs) that is characterized by a rapid onset or the worsening of RNs. It generally develops at the fingers in patients with rheumatoid arthritis (RA) receiving methotrexate (MTX). Few case reports have described ARN at an extracutaneous location. Case presentation An elderly patient with long-standing RA was admitted to our hospital with acute respiratory failure. Computed tomography upon admission showed diffuse ground-glass opacities superimposed with subpleural reticular shadowing and honeycombing and multiple nodules in the lungs and liver. Despite the discontinuation of MTX and introduction of an immunosuppressive regimen with pulse methylprednisolone followed by a tapering dose of prednisolone and intravenous cyclophosphamide, the patient died due to the acute exacerbation (AE) of RA-related interstitial lung disease (ILD) following the parallel waxing and waning of a diffuse interstitial shadow and...
Chest Journal, Feb 1, 2006
A definitive diagnosis of invasive pulmonary aspergillosis (IPA), which usually occurs in immunoc... more A definitive diagnosis of invasive pulmonary aspergillosis (IPA), which usually occurs in immunocompromised patients, is often difficult. We report two cases of cavitating IPA in a peripheral pulmonary region in patients who were receiving corticosteroids, in whom the cavity was successfully visualized and sampled during ultrathin bronchoscopy. Ultrathin bronchoscopy provides a new option for definitive diagnosis of cavitating IPA.
Journal of General Internal Medicine
A 70-year-old Japanese man presented to a local clinic with a 3-year history of weight loss and a... more A 70-year-old Japanese man presented to a local clinic with a 3-year history of weight loss and a 2-month history of anorexia. His baseline weight was 60 kg, which had decreased to approximately 50 kg at the time of presentation. He denied fever, chills, night sweats, arthralgia, rash, diarrhea, and vomiting. His past medical history included hypertension. He was not taking any medications. The patient was a retired real estate manager. He did not drink alcohol and had quit smoking tobacco 40 years prior. He never used illegal drugs and was not sexually active.
We experienced a serious interaction between miconazole gel and warfarin. The patient had just un... more We experienced a serious interaction between miconazole gel and warfarin. The patient had just undergone an aortic and mitral value replacement and thus was medicated with warfarin at a dosage according to the International Normalized Ratio (INR) of about 2.0-2.5. He was prescribed miconazole gel 400 mg/day for thrush induced by steroid for asthma. About two weeks later, he showed bleeding in the mouth and underwent a medical examination. His INR was higher than the upper of measurement limit and so he was immediately hospitalized. Vitamin K was given, miconazole gel and warfarin ware stopped. Two weeks later, his INR was less than 3.0 and thus the warfarin was restarted. But his warfarin dose was less than one third of dose that had been given before hospitalization. The interaction between miconazole gel and warfarin that we experienced by our patient while was as serious as the reports from abroad.
Journal of General Internal Medicine, 2012
Modern Rheumatology, 2012
Clinical presentation of pneumocystis pneumonia (PCP) during immunosuppressive therapy for rheuma... more 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.
Journal of General Internal Medicine
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Papers by Nobuyoshi Minemura