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Akao S, Akao K, Rokutanda R, Suzuki T. Renal perivasculitis induced by sulfasalazine. J Nephrol 2023:10.1007/s40620-023-01820-8. [PMID: 38015314 DOI: 10.1007/s40620-023-01820-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 10/23/2023] [Indexed: 11/29/2023]
Affiliation(s)
- Satoshi Akao
- Division of Rheumatology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Kei Akao
- Department of Dermatology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Ryo Rokutanda
- Division of Rheumatology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Tomo Suzuki
- Department of Nephrology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, Japan.
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Yamamoto K, Rokutanda R. Disseminated Mycobacterium haemophilum Infection Mimicking Rheumatoid Nodules. J Rheumatol 2023; 50:1193. [PMID: 36921964 DOI: 10.3899/jrheum.221296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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Maeda A, Tsuchida N, Uchiyama Y, Horita N, Kobayashi S, Kishimoto M, Kobayashi D, Matsumoto H, Asano T, Migita K, Kato A, Mori I, Morita H, Matsubara A, Marumo Y, Ito Y, Machiyama T, Shirai T, Ishii T, Kishibe M, Yoshida Y, Hirata S, Akao S, Higuchi A, Rokutanda R, Nagahata K, Takahashi H, Katsuo K, Ohtani T, Fujiwara H, Nagano H, Hosokawa T, Ito T, Haji Y, Yamaguchi H, Hagino N, Shimizu T, Koga T, Kawakami A, Kageyama G, Kobayashi H, Aoki A, Mizokami A, Takeuchi Y, Motohashi R, Hagiyama H, Itagane M, Teruya H, Kato T, Miyoshi Y, Kise T, Yokogawa N, Ishida T, Umeda N, Isogai S, Naniwa T, Yamabe T, Uchino K, Kanasugi J, Takami A, Kondo Y, Furuhashi K, Saito K, Ohno S, Kishimoto D, Yamamoto M, Fujita Y, Fujieda Y, Araki S, Tsushima H, Misawa K, Katagiri A, Kobayashi T, Hashimoto K, Sone T, Hidaka Y, Ida H, Nishikomori R, Doi H, Fujimaki K, Akasaka K, Amano M, Matsushima H, Kashino K, Ohnishi H, Miwa Y, Takahashi N, Takase-Minegishi K, Yoshimi R, Kirino Y, Nakajima H, Matsumoto N. Efficient detection of somatic UBA1 variants and clinical scoring system predicting patients with variants in VEXAS syndrome. Rheumatology (Oxford) 2023:kead425. [PMID: 37606963 DOI: 10.1093/rheumatology/kead425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/04/2023] [Accepted: 08/01/2023] [Indexed: 08/23/2023] Open
Abstract
OBJECTIVES To efficiently detect somatic UBA1 variants and establish a clinical scoring system predicting patients with pathogenic variants in VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome. METHODS Eighty-nine Japanese patients with clinically suspected VEXAS syndrome were recruited [81 males and 8 females; median onset age (IQR) 69.3 years (62.1-77.6)]. Peptide nucleic acid-clamping PCR (PNA-PCR), regular PCR targeting exon 3 clustering UBA1 variants, and subsequent Sanger sequencing were conducted for variant screening. Partitioning digital PCR (pdPCR) or targeted amplicon deep sequencing (TAS) was also performed to evaluate the variant allele frequency (VAF). We developed our clinical scoring system to predict UBA1 variant-positive and ‑negative patients and assessed the diagnostic value of our system using receiver operating characteristic (ROC) curve analysis. RESULTS Forty patients with reported pathogenic UBA1 variants (40/89, 44.9%) were identified, including a case having a variant with VAF of 1.7%, using a highly sensitive method. Our clinical scoring system considering >50 years of age, cutaneous lesions, lung involvement, chondritis, and macrocytic anaemia efficiently predicted patients with UBA1 variants (the area under the curve for the scoring total was 0.908). CONCLUSIONS Genetic screening with the combination of regular PCR and PNA-PCR detected somatic UBA1 variants with high sensitivity and specificity. Our scoring system could efficiently predict patients with UBA1 variants.
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Affiliation(s)
- Ayaka Maeda
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Naomi Tsuchida
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- Department of Rare Disease Genomics, Yokohama City University Hospital, Yokohama, Japan
| | - Yuri Uchiyama
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- Department of Rare Disease Genomics, Yokohama City University Hospital, Yokohama, Japan
| | - Nobuyuki Horita
- Chemotherapy Center, Yokohama City University Hospital, Yokohama, Japan
| | - Satoshi Kobayashi
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan
| | - Mitsumasa Kishimoto
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan
| | - Daisuke Kobayashi
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Haruki Matsumoto
- Department of Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tomoyuki Asano
- Department of Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kiyoshi Migita
- Department of Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Ayaka Kato
- Department of General Internal Medicine, Gifu University Hospital, Gifu, Japan
| | - Ichiro Mori
- Department of General Internal Medicine, Gifu University Hospital, Gifu, Japan
| | - Hiroyuki Morita
- Department of General Internal Medicine, Gifu University Hospital, Gifu, Japan
| | - Akihiro Matsubara
- Department of Dermatology, Chita Kosei Hospital, Mihama, Aichi, Japan
| | - Yoshiaki Marumo
- Department of Hematology and Oncology, Graduated school of medicine, Nagoya City University, Nagoya, Aichi, Japan
| | - Yuji Ito
- Department of General Internal Medicine, Chutoen General Medical Center, Kakegawa, Shizuoka, Japan
| | - Tomoaki Machiyama
- Department of Rheumatology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Tsuyoshi Shirai
- Department of Rheumatology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Tomonori Ishii
- Department of Rheumatology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Mari Kishibe
- Department of Dermatology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Yusuke Yoshida
- Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Japan
| | - Shintaro Hirata
- Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Japan
| | - Satoshi Akao
- Division of Rheumatology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Akitsu Higuchi
- Division of Rheumatology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Ryo Rokutanda
- Division of Rheumatology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Ken Nagahata
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Hiroki Takahashi
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Koske Katsuo
- Department of Dermatology, Kurashiki Central Hospital, Kurashiki, Okayama, Japan
| | - Toshio Ohtani
- Department of Dermatology, Kurashiki Central Hospital, Kurashiki, Okayama, Japan
| | - Hiroshi Fujiwara
- Division of Rheumatology and Allergy, Osaka General Medical Center, Osaka, Japan
| | - Hiromichi Nagano
- Division of Rheumatology and Allergy, Osaka General Medical Center, Osaka, Japan
| | - Takashi Hosokawa
- Division of Rheumatology and Allergy, Osaka General Medical Center, Osaka, Japan
| | - Takanori Ito
- Department of Rheumatology, Daido Hospital, Nagoya, Aichi, Japan
| | - Yoichiro Haji
- Department of Rheumatology, Daido Hospital, Nagoya, Aichi, Japan
| | - Hiroyuki Yamaguchi
- Department of Rheumatology, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan
| | - Noboru Hagino
- Department of Rheumatology, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan
| | - Toshimasa Shimizu
- Departments of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomohiro Koga
- Departments of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Atsushi Kawakami
- Departments of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Goichi Kageyama
- Department of Rheumatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan
| | - Hiroshi Kobayashi
- Department of Rheumatology, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo, Japan
| | - Akiko Aoki
- Department of Rheumatology, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo, Japan
| | - Akinari Mizokami
- Department of Rheumatology, Japan Community Healthcare Organization (JCHO), Isahaya General Hospital, Isahaya, Nagasaki, Japan
| | - Yoichi Takeuchi
- Department of Rheumatology and Nephrology, Japanese Red Cross Maebashi Hospital, Maebashi, Gunma, Japan
| | - Rena Motohashi
- Department of Rheumatology and Nephrology, Japanese Red Cross Maebashi Hospital, Maebashi, Gunma, Japan
| | - Hiroyuki Hagiyama
- Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Kanagawa, Japan
| | - Masaki Itagane
- Department of Rheumatology, Okinawa Chubu Hospital, Uruma, Okinawa, Japan
| | - Hiroyuki Teruya
- Department of Allergy and Rheumatology, Graduation School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Tomohiro Kato
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
| | - Yuji Miyoshi
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
| | - Takayasu Kise
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
| | - Naoto Yokogawa
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
| | - Takako Ishida
- Department of Dermatology, Hiroshima General Hospital, Hatsukaichi, Hiroshima, JA, Japan
| | - Naoki Umeda
- Department of Dermatology, Hiroshima General Hospital, Hatsukaichi, Hiroshima, JA, Japan
| | - Shuntaro Isogai
- Division of Rheumatology, Department of Internal Medicine, Nagoya City University Hospital, Nagoya, Aichi, Japan
| | - Taio Naniwa
- Division of Rheumatology, Department of Internal Medicine, Nagoya City University Hospital, Nagoya, Aichi, Japan
| | - Toru Yamabe
- Division of Rheumatology, Department of Internal Medicine, Nagoya City University Hospital, Nagoya, Aichi, Japan
| | - Kaori Uchino
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Jo Kanasugi
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Yasushi Kondo
- Division of Rheumatology, Department of Internal medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Kazunori Furuhashi
- Division of Rheumatology, Department of Internal medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Koichi Saito
- Division of Rheumatology, Department of Internal medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Shigeru Ohno
- Center for Rheumatic Diseases, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Daiga Kishimoto
- Center for Rheumatic Diseases, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Mari Yamamoto
- Department of Rheumatology, Chubu Rosai Hospital, Nagoya, Aichi, Japan
| | - Yoshiro Fujita
- Department of Rheumatology, Chubu Rosai Hospital, Nagoya, Aichi, Japan
| | - Yuichiro Fujieda
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Sachiko Araki
- Department of Internal Medicine, Niizashiki Central General Hospital, Niiza, Saitama, Japan
| | - Hiroshi Tsushima
- Department of Internal Medicine and Rheumatology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - Kyohei Misawa
- Department of Hematology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - Akira Katagiri
- Department of Internal Medicine and Rheumatology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - Takahiro Kobayashi
- Department of General Medicine, National Defense Medical College Hospital, Tokorozawa, Saitama, Japan
| | - Kenichi Hashimoto
- Department of General Medicine, National Defense Medical College Hospital, Tokorozawa, Saitama, Japan
| | - Takehiro Sone
- Division of Hematology, Department of Internal Medicine, National Defense Medical College Hospital, Tokorozawa, Saitama, Japan
| | - Yukiko Hidaka
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Hiroaki Ida
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Ryuta Nishikomori
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Hiroshi Doi
- Department of Immunology, Shiga General Hospital, Moriyama, Shiga, Japan
| | | | - Keiichi Akasaka
- Department of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan
| | - Masako Amano
- Department of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan
| | - Hidekazu Matsushima
- Department of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan
| | - Kaori Kashino
- Department of Dermatology, Onomichi Municipal Hospital, Onomichi, Hiroshima, Japan
| | - Hidenori Ohnishi
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Yuki Miwa
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Noriyuki Takahashi
- Department of Education for Community-Oriented Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
- Department of General Medicine, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Kaoru Takase-Minegishi
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ryusuke Yoshimi
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yohei Kirino
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hideaki Nakajima
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Higuchi A, Rokutanda R. Clinical Image: Erythema ab igne: a mimicker of rheumatoid vasculitis. ACR Open Rheumatol 2023; 5:380. [PMID: 37203235 PMCID: PMC10425580 DOI: 10.1002/acr2.11545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 03/22/2023] [Accepted: 03/22/2023] [Indexed: 05/20/2023] Open
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Kitada A, Nakai T, Fukui S, Rokutanda R, Okada M, Kusaoi M, Yamaji K, Tamura N. Safety of tacrolimus use during pregnancy and related pregnancy outcomes in patients with systemic lupus erythematosus: A retrospective single-center analysis in Japan. Lupus 2023; 32:352-362. [PMID: 36633400 DOI: 10.1177/09612033221148334] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Tacrolimus is one of the drugs that can be used in pregnancies complicated with systemic lupus erythematosus (SLE), but there are still few reports on its pregnancy outcomes. Although tacrolimus has been reported to cause adverse events, such as increased blood pressure, abnormal glucose metabolism, and susceptibility to infection, there have been no studies on the impact of tacrolimus in SLE pregnancies at these points. We performed a retrospective observational study of pregnancies complicated by SLE at St Luke's International Hospital in Tokyo from April 2003 to August 2021. METHODS Basic clinical information on SLE, pregnancy outcomes, disease activity before and after pregnancy, laboratory results, blood pressure, blood glucose levels, treatment regimens, and presence of infection was extracted from electronic medical records. We defined overall adverse pregnancy outcomes (APOs) as follows: (1) fetal death after 10 gestational weeks, (2) preterm delivery, (3) delivery due to hypertensive disorders of pregnancy, preeclampsia, or placental insufficiency, or (4) the diagnosis of small for gestational age infants. We also examined whether there was a statistical difference in APO incidence between patients treated with and without tacrolimus. RESULTS Pregnancy outcomes were obtained for 48 patients with a total of 60 pregnancies complicated by SLE. In 20 (33.3%) of these pregnancies, the patients took tacrolimus, and 28 (46.7%) of the pregnancies had APOs. APO incidence did not statistically differ between the tacrolimus and non-tacrolimus groups in the multivariate analysis (p = 1.00, adjusted OR 1, 95% CI: 0.23-4.39). Multiple regression analyses indicated that tacrolimus use did not significantly affect systolic blood pressure in the third trimester (B = -2.23, p = .74) or blood glucose levels in the first trimester (B = 10.2, p = .056). Incidence of infections did not significantly differ between patients treated with and without tacrolimus in the univariate analysis (10.8% vs. 21.1%, p = .42). CONCLUSION Tacrolimus did not significantly affect pregnancy outcomes, blood pressure, or glucose levels. Further research is required to confirm its effects in a larger population.
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Affiliation(s)
- Ayako Kitada
- 83911St Luke's International Hospital, Tokyo, Japan
- Graduate School of Medicine, 12847Juntendo University, Tokyo, Japan
| | | | - Sho Fukui
- 83911St Luke's International Hospital, Tokyo, Japan
| | | | - Masato Okada
- 83911St Luke's International Hospital, Tokyo, Japan
| | - Makio Kusaoi
- Graduate School of Medicine, 12847Juntendo University, Tokyo, Japan
| | - Ken Yamaji
- Graduate School of Medicine, 12847Juntendo University, Tokyo, Japan
| | - Naoto Tamura
- Graduate School of Medicine, 12847Juntendo University, Tokyo, Japan
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Fukui S, Rokutanda R, Kawaai S, Suda M, Iwata F, Okada M, Kishimoto M. Current evidence and practical knowledge for ultrasound-guided procedures in rheumatology: Joint aspiration, injection, and other applications. Best Pract Res Clin Rheumatol 2023; 37:101832. [PMID: 37248141 DOI: 10.1016/j.berh.2023.101832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 05/31/2023]
Abstract
Ultrasound (US)-guided procedures have increasingly gained their role in the daily practice of rheumatology, owing to the growing evidence supporting their utility. The utilization of US guidance in procedures may enhance their accuracy, efficacy, and safety. This article presents a comprehensive review of the current evidence and practical knowledge pertaining to US-guided procedures in rheumatology, encompassing joint aspirations, injections, and other applications such as tendon sheath injections. We provide a detailed description of the US-guided procedure process and compare the in-plane and out-of-plane view methods, along with practical techniques based on existing evidence or our own expertise. For each joint, we summarize how to perform procedures with figures to facilitate a better understanding. Additionally, we introduce other applications of US-guided procedures for tendons, enthesis, bursae, and nerves as well as emerging therapies such as US-guided fascia hydrorelease. By utilizing these US techniques, rheumatologists can achieve the ability to manage a wider range of musculoskeletal conditions.
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Affiliation(s)
- Sho Fukui
- Division of Rheumatology, Inflammation, and Immunity, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, MA, USA; Department of Emergency and General Medicine, Kyorin University School of Medicine, Tokyo, Japan; Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo, Japan.
| | - Ryo Rokutanda
- Division of Rheumatology, Department of Internal Medicine, Kameda Medical Center, Japan.
| | - Satoshi Kawaai
- Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo, Japan
| | - Masei Suda
- Department of Rheumatology, Suwa Central Hospital, Nagano, Japan
| | - Futoshi Iwata
- Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo, Japan
| | - Masato Okada
- Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo, Japan
| | - Mitsumasa Kishimoto
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan
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Akao S, Yamagiwa G, Hazue R, Rokutanda R, Suzuki T. Kidney biopsy in patients with antineutrophil cytoplasmic antibody-associated vasculitis with mild renal abnormality. CEN Case Rep 2023; 12:50-55. [PMID: 35817952 PMCID: PMC9892410 DOI: 10.1007/s13730-022-00719-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 06/22/2022] [Indexed: 02/05/2023] Open
Abstract
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a systemic inflammation of small or medium blood vessels that includes microscopic polyangiitis. A diagnosis of ANCA-associated vasculitis can be aided by histological identification of vasculitis, and identification of renal impairment can help predict outcomes. However, kidney biopsy is not generally indicated in the absence of renal findings. We report two cases of ANCA-associated vasculitis diagnosed by kidney biopsy despite the absence of remarkable urinary abnormality and renal impairment. These patients had fever of unknown origin and were positive for myeloperoxidase (MPO)-ANCA but showed few findings that would suggest small-vessel vasculitis in the kidney. Nevertheless, kidney biopsies revealed small-vessel arteritis, necrotizing glomerulonephritis, and interstitial nephritis. Immunofluorescent antibody tests performed using samples of glomeruli were all negative, suggesting microscopic polyangiitis. Therefore, kidney biopsy may be useful in confirming the diagnosis, even if patients have completely normal urinary findings in the absence of other organ lesions.
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Affiliation(s)
- Satoshi Akao
- Department of Rheumatology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Gen Yamagiwa
- Department of Rheumatology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Ryo Hazue
- Department of Rheumatology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Ryo Rokutanda
- Department of Rheumatology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Tomo Suzuki
- Department of Nephrology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, Japan.
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Akao S, Komori K, Rokutanda R. Self-remitting Bartonella neuroretinitis without a cat scratch. IDCases 2023; 31:e01690. [PMID: 36699968 PMCID: PMC9867945 DOI: 10.1016/j.idcr.2023.e01690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/14/2023] Open
Abstract
•Bartonella infection is a leading cause in patients with neuroretinitis.•Ocular involvement occurs in 5-10% of people with cat-scratch disease (CSD).•Bartonella neuroretinitis presents without systemic signs and symptoms of CSD.•Some cases with bartonella neuroretinitis could be self-remitted.
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Hirata I, Hanaoka S, Rokutanda R, Funakoshi R, Hayashi H. Shared decision-making practices and patient values in pharmacist outpatient care for rheumatic disease: A multiple correspondence analysis. J Pharm Pharm Sci 2023; 26:11135. [PMID: 36942300 PMCID: PMC9990622 DOI: 10.3389/jpps.2023.11135] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/02/2022] [Indexed: 01/22/2023]
Abstract
Purpose: To investigate the value-to-value relationships, relationship between values and patient background, continuation rate of treatment after shared decision-making (SDM), and disease status in order to clarify the values involved in drug therapy decisions for patients with rheumatic disease. Methods: We investigated patient values (efficacy of drug therapy [effectiveness], safety, economics, daily life, and other) and the continuance rate and disease status of treatment after 6 months in 94 patients with rheumatic disease aged ≥18 years who made decisions with pharmacists and physicians in the pharmacy outpatient clinic between September 2019 and April 2021. Multiple correspondence and K-means cluster analyses were performed to show the relationship between values and basic patient information. Results: Among the selected patients, 87% and 47% selected effectiveness for multiple selections and single selection, respectively. Effectiveness was at the center of the graph; three clusters containing other values were placed around it. History of allergy or side effects caused by biologics or Janus kinase inhibitors were in the safety cluster. The non-usage history of biologics or Janus kinase inhibitors was in the economic cluster. Conclusion: Effectiveness was the most important factor for patients with rheumatic disease; the values that patients consider important may shift from effectiveness to other values based on each patient's subjective experience with the treatment and/or the stage of life in which they were treated. It is important to positively link patient values and information about the treatment plan in shared decision-making while establishing rapport with the patient.
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Affiliation(s)
- Ikkou Hirata
- Department of Pharmacy, Kameda General Hospital, Chiba, Japan
| | - Shunsuke Hanaoka
- Department of Clinical Pharmacotherapy, School of Pharmacy, Nihon University, Chiba, Japan
- *Correspondence: Shunsuke Hanaoka,
| | - Ryo Rokutanda
- Department of Rheumatology, Kameda General Hospital, Chiba, Japan
| | | | - Hiroyuki Hayashi
- Department of Clinical Pharmacotherapy, School of Pharmacy, Nihon University, Chiba, Japan
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Akao S, Higuchi A, Akao K, Rokutanda R. Idiopathic Granulomatous Mastitis, Erythema Nodosum, and Arthritis. Intern Med 2022; 61:3757-3758. [PMID: 35569987 PMCID: PMC9841096 DOI: 10.2169/internalmedicine.9517-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Affiliation(s)
- Satoshi Akao
- Division of Rheumatology, Department of Internal Medicine, Kameda Medical Center, Japan
| | - Akitsu Higuchi
- Division of Rheumatology, Department of Internal Medicine, Kameda Medical Center, Japan
| | - Kei Akao
- Department of Dermatology, Kameda Medical Center, Japan
| | - Ryo Rokutanda
- Division of Rheumatology, Department of Internal Medicine, Kameda Medical Center, Japan
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Komori K, Rokutanda R. Eosinophilic Fasciitis Without Skin Sclerosis. J Rheumatol 2022:jrheum.220600. [PMID: 36455945 DOI: 10.3899/jrheum.220600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Eosinophilic fasciitis is a rare disorder characterized by symmetrical skin undulation, peripheral eosinophilia, and eosinophil infiltration in fascia.1 A 46-year-old man presented with a 1-month history of bilateral thigh pain.
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Affiliation(s)
- Kotaro Komori
- Kotaro Komori, MD, Ryo Rokutanda, MD, Kameda Medical Center, Division of Rheumatology, Department of Medicine, Kamogawa, Chiba, Japan. Address correspondence to Dr. K. Komori, Kameda Medical Center, 929 Higashicho, Kamogawa, Chiba, 296-0041, Japan. . The authors declare no conflicts of interest relevant to this article. Ethics approval was granted by the Clinical Research Review Committee, Kameda General Hospital, Medical Corporation Tesshoukai (Case 22-009). The patient in this case provided written informed consent to have this case published with removal of all identifying information to remain anonymous and retain privacy
| | - Ryo Rokutanda
- Kotaro Komori, MD, Ryo Rokutanda, MD, Kameda Medical Center, Division of Rheumatology, Department of Medicine, Kamogawa, Chiba, Japan. Address correspondence to Dr. K. Komori, Kameda Medical Center, 929 Higashicho, Kamogawa, Chiba, 296-0041, Japan. . The authors declare no conflicts of interest relevant to this article. Ethics approval was granted by the Clinical Research Review Committee, Kameda General Hospital, Medical Corporation Tesshoukai (Case 22-009). The patient in this case provided written informed consent to have this case published with removal of all identifying information to remain anonymous and retain privacy
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Oda N, Rokutanda R, Terao T. Black fingers and dark urine: cold agglutinin disease. QJM 2022; 115:393-394. [PMID: 35385123 DOI: 10.1093/qjmed/hcac095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- N Oda
- Department of General Internal Medicine, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan
| | - R Rokutanda
- Department of Rheumatology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan
| | - T Terao
- Division of Hematology/Oncology, Department of Internal Medicine, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan
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Kawato R, Rokutanda R, Okada M, Matsushita M, Yamaji K, Tamura N. Effect of Prophylactic Dose of Trimethoprim-Sulfamethoxazole on Serum Creatinine in Japanese Patients With Connective Tissue Diseases. Clin Med�Insights�Arthritis�Musculoskelet Disord 2022; 15:11795441221085141. [PMID: 35342315 PMCID: PMC8950028 DOI: 10.1177/11795441221085141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 02/15/2022] [Indexed: 11/16/2022]
Abstract
Objectives: At normal doses of trimethoprim-sulfamethoxazole (TMP/SMX), trimethoprim inhibits tubular creatinine secretion, leading to a rapid but reversible increase in serum creatinine (SCr). Although patients with connective tissue diseases are often in the state of immunosuppression and TMP/SMX is an important prophylactic drug, clinicians often have to stop or reduce the dosage due to concerns regarding its effect on renal function. This study aimed to evaluate the effect of a prophylactic dose of TMP/SMX on SCr in Japanese patients with connective tissue diseases, the extent of SCr level elevation and the independent risk factors for creatinine elevation. Methods: A retrospective cohort study was undertaken. Participants included patients with connective tissue diseases who were treated with a prophylactic dose of TMP/SMX between 2004 and 2018. Using single and multiple regression analyses, the risk factors that affected SCr elevation were evaluated. Results: A total of 262 patients, females, n = 181; age, median (range) = 59 (19-89) years, were included. The median baseline SCr level before treatment was 0.62 (0.16-2.1) mg/dL. The median SCr elevation value was 0.07 (−0.54 to 0.84) mg/dL in 4 weeks after TMP/SMX initiation. Five (2%) participants had ⩾0.3 mg/dL SCr elevation. Multiple regression analyses, including age, baseline SCr, diuretic use, nonsteroidal anti-inflammatory drug use and diabetes mellitus, indicated that baseline SCr and advanced age were independent risk factors of SCr elevation. Conclusions: These results demonstrated that baseline SCr and advanced age were associated with SCr elevation by a prophylactic dose of TMP/SMX. However, a prophylactic dose of TMP/SMX rarely elevated the SCr level significantly. Therefore, other causes can be considered if patients show an SCr elevation ⩾0.3 mg/dL.
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Affiliation(s)
- Rui Kawato
- Department of Rheumatology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Immuno-Rheumatology Center, St. Luke’s International Hospital, Tokyo, Japan
| | - Ryo Rokutanda
- Department of Rheumatology, Kameda Medical Center, Chiba, Japan
| | - Masato Okada
- Immuno-Rheumatology Center, St. Luke’s International Hospital, Tokyo, Japan
| | - Masakazu Matsushita
- Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan
| | - Ken Yamaji
- Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan
| | - Naoto Tamura
- Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan
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Kawato R, Rokutanda R, Okada M. AB1217 THE EFFECT OF PROPHYLACTIC DOSE OF TRIMETHOPRIM-SULFAMETHOXAZOLE ON SERUM CREATININE IN JAPANESE PATIENTS WITH CONNECTIVE TISSUE DISEASES. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Trimethoprim-sulfamethoxazole (TMP/SMX) is an effective antibiotic for prevention of pneumocystis pneumonia (PCP) in immunocompromised patients with various connective tissue diseases (CTD).1)At the normal dose of TMP/SMX, trimethoprim (TMP) component inhibits tubular creatinine secretion, leading to a rapid, but ultimately reversible, increase in serum creatinine.2)However, at prophylactic dose, the effect of TMP/SMX on creatinine in patients with CTD is not clear.Objectives:We conducted this study to evaluate the effect of prophylactic dose of TMP/SMX on serum creatinine in patients with CTD.Methods:This was a retrospective cohort study in which all patients with CTD, treated with prophylactic dose of TMP/SMX during the period between 2004 and 2018, were included, while patients with acute kidney injury due to other causes, were excluded. Retrospective medical chart review was performed to collect the following data, from the baseline through 12 weeks: baseline patient characteristics, serum creatinine (SCr), creatinine clearance (CCr), urine test, serum electrolytes, and level of SCr elevation after initiation of prophylactic dose of TMP/SMX from baseline, within 12 weeks. Using single and multiple regression analyses, we explored the risk factors that affected the SCr elevation value.Results:A total of 272 patients, comprising 186 females, at an average age of 56±18 years, were included in the present study. Based on the medical chart review, this cohort was scored under the following categories: rheumatoid arthritis (RA) n=78, systemic lupus erythematosus (SLE) n=76, Vasculitis n=39, polymyalgia rheumatica/ giant cell arteritis (PMR/GCA) n=29, systemic sclerosis (SSc) n=32, polymyositis/dermatomyositis (PM/DM) n=10, mixed CTD (MCTD) n=5, and others n=56. Their average baseline creatinine level before treatment was 0.67 ± 0.25 mg/dL. They were administered with a mean dose of TMP comprising 99.2 ± 34.4 mg/day, which elevated the mean SCr level by 0.07 ± 0.12 mg/dL. Approximately 85% of the patients continued with the TMP/SMX treatment for 12 weeks, and only 5 (2%) showed creatinine elevation by more than 0.3 mg/dL. They were also administered with prednisolone at an average dose of 36.9 ± 92.3 mg/day.For multiple regression analyses, the following variables were included: age, baseline CCr, use of loop diuretics, use of spironolactone, dose of TMP/SMX, use of non-steroidal anti-inflammatory drugs, and past history of diabetes mellitus. Baseline CCr and advanced age were independent risk factors. Regression coefficients and p values for age and CCr were 0.0018 (95% CI; 0.00083 – 0.0027) and p=0.00028; and 0.0007 (95% CI; 0.0003 – 0.0010) and p=0.00038, respectively.Conclusion:In this study, we demonstrated that prophylactic dose of TMP/SMX elevates SCr by 0.07 ± 0.12 mg/dL on an average. Prophylactic dose of TMP/SMX rarely elevated the creatinine level significantly. Thus, based on our findings, other causes of renal impairment may be considered, if the patients administered with low-dose TMP/SMX show creatinine elevation by more than 0.3 mg/dL.References:[1]Prophylactic effect of trimethoprim-sulfamethoxazole for pneumocystis pneumonia in patients with rheumatic diseases exposed to prolonged high-dose glucocorticoids Park JW, et al. Ann Rheum Dis 2018;77:644–649.[2]Factors contributing to increases in serum creatinine following treatment with a sulfamethoxazole-trimethoprim combination product: retrospective analysis of Japanese patients with normal renal function. Muramori, et al. YAKUGAKU ZASSHI 133(5) 587–595 (2013)Disclosure of Interests:None declared
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Tamaki H, Ikeda Y, Fukui S, Sawada H, Kitada A, Kawato R, Suda M, Yanaoka H, Rokutanda R, Shimizu H, Tsuda T, Kishimoto M, Yamaguchi K, Okada M. 353. A PATIENT WITH EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS TREATED ONLY WITH MEPOLIZUMAB AND INTRAVENOUS IMMUNOGLOBULIN. Rheumatology (Oxford) 2019. [DOI: 10.1093/rheumatology/kez063.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - Sho Fukui
- St. Luke’s International Hospital Tokyo, Japan
| | | | | | - Rui Kawato
- St. Luke’s International Hospital Tokyo, Japan
| | - Masei Suda
- St. Luke’s International Hospital Tokyo, Japan
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Kishimoto M, Yoshida K, Ichikawa N, Inoue H, Kaneko Y, Kawasaki T, Matsui K, Morita M, Suda M, Tada K, Takizawa N, Tamura N, Taniguchi A, Taniguchi Y, Tsuji S, Haji Y, Rokutanda R, Yanaoka H, Cheung PP, Gu J, Kim TH, Luo SF, Okada M, López Medina C, Molto A, Dougados M, Kobayashi S, van der Heijde D, Tomita T. Clinical Characteristics of Patients with Spondyloarthritis in Japan in Comparison with Other Regions of the World. J Rheumatol 2019; 46:896-903. [DOI: 10.3899/jrheum.180412] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2018] [Indexed: 12/21/2022]
Abstract
Objective.To delineate clinical characteristics of patients with spondyloarthritis (SpA) in Japan in comparison to other areas of the world.Methods.Using the ASAS-COMOSPA (Assessment of Spondyloarthritis international Society–COMOrbidities in SPondyloArthritis) data, an international cross-sectional observational study of patients with SpA, we analyzed information on demographics, disease characteristics, comorbidities, and risk factors. Patients were classified by region: Japan, other Asian countries (China, Singapore, South Korea, Taiwan), and non-Asian countries (Europe, the Americas, Africa). Patient characteristics, including diagnosis and treatment, were compared.Results.Among 3984 patients included in the study, 161 were from centers in Japan, 933 from other Asian countries, and 2890 from other regions. Of patients with SpA in Japan, 42 (26.1%) had peripheral SpA, substantially more than in other countries. This trend was explained by the predominance of psoriatic arthritis (PsA) among Japanese patients with SpA. In contrast to the relatively low number in Japan, 54% of patients from other Asian countries had pure axial SpA (axSpA) without peripheral features. HLA-B27 testing, considered an integral part of the classification of axSpA, was performed in only 63.6% of Japanese patients with axSpA. More than half of Japanese patients with axSpA were classified using imaging criteria.Conclusion.In our study, there was a more substantial number of peripheral SpA cases observed in Japan compared to other parts of Asia and other regions of the world. Aside from ethnic differences, increasing recognition of PsA in Japan, as well as a potential underdiagnosis of axSpA due to the insufficient use of HLA-B27 testing, may partly explain regional discrepancies.
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Suda M, Kataoka Y, Tomishima Y, Jinta T, Rokutanda R, Kishimoto M, Okada M. Effectiveness of multi-target therapy in anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis with early-stage interstitial lung disease. Scand J Rheumatol 2017. [PMID: 28649889 DOI: 10.1080/03009742.2017.1314004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M Suda
- a Immuno-Rheumatology Center , St Luke's International Hospital , Tokyo , Japan
| | - Y Kataoka
- a Immuno-Rheumatology Center , St Luke's International Hospital , Tokyo , Japan
| | - Y Tomishima
- b Division of Pulmonary Medicine , St Luke's International Hospital , Tokyo , Japan
| | - T Jinta
- b Division of Pulmonary Medicine , St Luke's International Hospital , Tokyo , Japan
| | - R Rokutanda
- a Immuno-Rheumatology Center , St Luke's International Hospital , Tokyo , Japan
| | - M Kishimoto
- a Immuno-Rheumatology Center , St Luke's International Hospital , Tokyo , Japan
| | - M Okada
- a Immuno-Rheumatology Center , St Luke's International Hospital , Tokyo , Japan
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Rokutanda R, Tomishima Y, Okada M. Sarcoid Myofasciitis. Arthritis Rheumatol 2017; 69:1795. [PMID: 28464470 DOI: 10.1002/art.40140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 04/25/2017] [Indexed: 11/10/2022]
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Shiraishi K, Suda M, Rokutanda R, Okada M. SAT0517 Mizoribine Is as Effective Steroid-Sparing Agent as Methotrexate for Polymyalgia Rheumatica: A Retrospective Case Series Analysis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kitada A, Min C, Kataoka Y, Kaneshita S, Suda M, Takasugi K, Ohara Y, Rokutanda R, Shimizu H, Tsuda T, Kishimoto M, Yamaguchi K, Okada M. AB0262 Verification of Antibacterial Effect of Sulfasalazine in Rheumatoid Arthritis Patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Takasugi K, Okada M, Min C, Kitada A, Kataoka Y, Kaneshita S, Suda M, Ohara Y, Rokutanda R, Shimizu H, Tsuda T, Yamaguchi K, Yamaguchi K, Kishimoto M. AB0392 Safety and Tolerability of Iguratimod in Rheumatoid Arthritis with Comorbid Illnesses. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Suyama Y, Okada M, Rokutanda R, Min C, Sassé B, Kobayashi D, Takahashi O, Deshpande GA, Matsui K, Kawaguchi Y, Kishimoto M. Safety and efficacy of upfront graded administration of trimethoprim–sulfamethoxazole in systemic lupus erythematosus: A retrospective cohort study. Mod Rheumatol 2016; 26:557-61. [DOI: 10.3109/14397595.2015.1112467] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Yasuhiro Suyama
- Immuno-Rheumatology Center, St. Luke’s International Hospital, St. Luke’s International University, Tokyo, Japan,
| | - Masato Okada
- Immuno-Rheumatology Center, St. Luke’s International Hospital, St. Luke’s International University, Tokyo, Japan,
| | - Ryo Rokutanda
- Immuno-Rheumatology Center, St. Luke’s International Hospital, St. Luke’s International University, Tokyo, Japan,
| | - Chisun Min
- Immuno-Rheumatology Center, St. Luke’s International Hospital, St. Luke’s International University, Tokyo, Japan,
| | - Belinda Sassé
- Immuno-Rheumatology Center, St. Luke’s International Hospital, St. Luke’s International University, Tokyo, Japan,
| | - Daiki Kobayashi
- Center for Clinical Epidemiology, St Luke’s Life Science Institute, Tokyo, Japan,
| | - Osamu Takahashi
- Center for Clinical Epidemiology, St Luke’s Life Science Institute, Tokyo, Japan,
| | - Gautam A. Deshpande
- Center for Clinical Epidemiology, St Luke’s Life Science Institute, Tokyo, Japan,
| | - Kazuo Matsui
- Department of Rheumatology, Kameda Medical Center, Kamogawa City, Chiba, Japan, and
| | - Yasushi Kawaguchi
- Institute of Rheumatology, Tokyo Women’s Medical University, Shinjuku-Ku, Tokyo, Japan
| | - Mitsumasa Kishimoto
- Immuno-Rheumatology Center, St. Luke’s International Hospital, St. Luke’s International University, Tokyo, Japan,
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Kaneshita S, Kishimoto M, Omata F, Suda M, Min C, Ohara Y, Rokutanda R, Shimizu H, Tsuda T, Yamaguchi KI, Takeda A, Matsui Y, Okada M. The Association Between Severity of Total Eosinophilic Count and Disease Categories. J Allergy Clin Immunol 2015. [DOI: 10.1016/j.jaci.2014.12.1655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Behçet’s disease is a multi-organ disorder that is more common in countries around the Silk Road, and manifests as mucosal ulcers and skin lesions, and with ocular involvement. As a systemic disease, it can also involve gastrointestinal organs and the central nervous or cardiovascular systems. Although the etiology of Behçet’s disease is not clearly identified, the pathogenesis of the disease is most commonly hypothesized as a profound inflammatory response triggered by an infectious agent in a genetically susceptible host. As there are no single specific manifestations or specific diagnostic tests, various diagnostic criteria have been proposed around the world, and, among them, the International Study Group criteria have been most commonly used. As the clinical expression of Behçet’s disease is heterogeneous, the treatment should be individualized based on involved organs, severity of the disease, and patient’s background. The choice of therapeutic agents is limited by lack of clinical trials and is based largely on case reports, case series, and several open-label clinical trials. Corticosteroids, colchicine, and traditional immunosuppressive agents, including azathioprine and cyclosporine, have been used for the treatment of Behçet’s disease. Recently, tumor necrosis factor (TNF) inhibitors have become available for several rheumatic diseases, and considerable published data suggest that TNF inhibitors represent an important therapeutic advance for patients with severe and resistant disease, as well as for those with contraindications or intolerance to these treatments.
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Affiliation(s)
- Ryo Rokutanda
- Immuno-Rheumatology Center, St Luke's International Hospital, Tokyo, Japan
| | | | - Masato Okada
- Immuno-Rheumatology Center, St Luke's International Hospital, Tokyo, Japan
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Suyama Y, Kishimoto M, Rokutanda R, Min C, Haji Y, Ohara Y, Shimizu H, Yamaguchi KI, Matsui Y, Okada M. FRI0283 Quality Indicators for Use of Biologic Agents in Rheumatic Diseases. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rokutanda R, Haji Y, Kishimoto M, Min C, Ohara Y, Suyama Y, Shimizu H, Yamaguchi K, Takeda A, Matsui Y, Sasaki S, Okada M. SAT0087 Diagnostic Performance of Anti-Ccp Antibody at Annual Health CHECK Up. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Rokutanda R, Haji Y, Kishimoto M, Min C, Ohara Y, Suyama Y, Shimizu H, Yamaguchi K, Nomura A, Takeda A, Yukio M, Okada M. FRI0393 Efficacy and Safety of Multi-Target Therapy with Mizoribine and Tacrolimus for Lupus Nephritis: Analysis of 28 Cases. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Haji Y, Kishimoto M, Rokutanda R, Min C, Ohara Y, Suyama Y, Shimizu H, Yamaguchi KI, Deshpande GA, Ohde S, Takeda A, Matsui Y, Matsui T, Nishino J, Okada M, Tohma S. SAT0039 A Prediction Rule for Sustained Remission of Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-eular.1765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rokutanda R, Okada M, Yamaguchi K, Nozaki T, Deshpande GA, Kishimoto M. Infliximab for Behçet disease with aortic involvement: two novel case reports without concurrent use of immunosuppressive agents or corticosteroids. Mod Rheumatol 2014. [DOI: 10.3109/s10165-012-0721-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Suyama Y, Kishimoto M, Shimizu H, Rokutanda R, Min C, Ohara Y, Haji Y, Yamaguchi KI, Matsui Y, Okada M. Real world experience in the DETECT study for pulmonary artery hypertension associated with systemic sclerosis. Life Sci 2013. [DOI: 10.1016/j.lfs.2013.12.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nomura A, Kishimoto M, Shimizu H, Suyama Y, Rokutanda R, Ohara Y, Yamaguchi K, Okada M. AB0616 Efficacy and safety of multi-target therapy with mizoribine and tacrolimus for systemic lupus erythematosus with or without active nephritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rokutanda R, Kishimoto M, Yamaguchi K, Shimizu H, Suyama Y, Ohara Y, Haji Y, Min C, Takeda A, Matsui Y, Okada M, Nishioka K. AB0192 Can anti-ccp antibody titer predict the use of biologics ? Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Rokutanda R, Kishimoto M, Yamaguchi K, Shimizu H, Suyama Y, Ohara Y, Haji Y, Min C, Takeda A, Matsui Y, Matsubara T, Nishioka K, Okada M. SAT0557 Diagnostic Performance of Rheumatoid Factor and Anti-CCP Antibody for Detecting Undiagnosed Rheumatoid Arthritis in Annual Health Check. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Rokutanda R, Kishimoto M, Deshpande GA, Yamaguchi K, Okada M. Comment on predictors of preterm birth in patients with mild systemic lupus erythematosus by Clowse et al. Ann Rheum Dis 2013; 72:e2. [PMID: 23463693 DOI: 10.1136/annrheumdis-2013-203411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Okada M, Suyama Y, Rokutanda R, Ohara Y, Min C, Yamaguchi KI. Sulfonamide Hypersensitivity in Patients with Systemic Erythematosus. J Allergy Clin Immunol 2013. [DOI: 10.1016/j.jaci.2012.12.1271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Affiliation(s)
- Ryo Rokutanda
- Division of Allergy and Rheumatology, St. Luke'sInternational Hospital, Tokyo, Japan.
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Rokutanda R, Kishimoto M, Ohde S, Shimizu H, Nomura A, Suyama Y, Ohara Y, Yamaguchi K, Okada M. Safety and efficacy of mizoribine in patients with connective tissue diseases other than rheumatoid arthritis. Rheumatol Int 2013; 34:59-62. [DOI: 10.1007/s00296-012-2633-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Accepted: 12/15/2012] [Indexed: 12/01/2022]
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Nomura A, Shimizu H, Kishimoto M, Suyama Y, Rokutanda R, Ohara Y, Yamaguchi K, Okada M. Efficacy and safety of multitarget therapy with mizoribine and tacrolimus for systemic lupus erythematosus with or without active nephritis. Lupus 2012; 21:1444-9. [DOI: 10.1177/0961203312458468] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The prognosis of lupus nephritis (LN) has improved since the introduction of immunosuppressant therapies, but the safety and effectiveness of treatments can also be improved. We retrospectively assessed the treatment courses of 12 patients with systemic lupus erythematosus who were treated with glucocorticoid, mizoribine (MZR) and tacrolimus. This regimen was used as initial therapy for active LN in six patients (mean glucocorticoid dose, 66.6 mg); four of these six patients also received pulse methylprednisolone therapy. The starting doses of MZR and tacrolimus were 150 and 3 mg, respectively, and they were titrated as required. Five of six patients achieved complete remission and one achieved partial remission at 6 months. Five patients who completed 12-month analysis achieved complete remission. Another six patients were given the combination regimen for treating minor flares or for steroid sparing. The mean prednisolone doses were reduced from 11.0 mg at baseline to 6.6 mg at 12 months. Six patients experienced minor adverse events, including three minor infections. One patient stopped tacrolimus because of suspected toxicity. All 12 patients were successfully treated, and none experienced severe adverse events. Multitarget therapy combining glucocorticoid, MZR and tacrolimus may have the potential to become a treatment option which is effective and safe.
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Affiliation(s)
- A Nomura
- Division of Allergy and Rheumatology, St Luke’s International Hospital, Tokyo, Japan
- Department of Rheumatology, Chubu Rosai Hospital, Nagoya, Japan
| | - H Shimizu
- Division of Allergy and Rheumatology, St Luke’s International Hospital, Tokyo, Japan
| | - M Kishimoto
- Division of Allergy and Rheumatology, St Luke’s International Hospital, Tokyo, Japan
| | - Y Suyama
- Division of Allergy and Rheumatology, St Luke’s International Hospital, Tokyo, Japan
| | - R Rokutanda
- Division of Allergy and Rheumatology, St Luke’s International Hospital, Tokyo, Japan
| | - Y Ohara
- Division of Allergy and Rheumatology, St Luke’s International Hospital, Tokyo, Japan
| | - K Yamaguchi
- Division of Allergy and Rheumatology, St Luke’s International Hospital, Tokyo, Japan
| | - M Okada
- Division of Allergy and Rheumatology, St Luke’s International Hospital, Tokyo, Japan
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Rokutanda R, Okada M, Yamaguchi K, Nozaki T, Deshpande GA, Kishimoto M. Infliximab for Behçet disease with aortic involvement: two novel case reports without concurrent use of immunosuppressive agents or corticosteroids. Mod Rheumatol 2012; 23:412-3. [PMID: 22821442 DOI: 10.1007/s10165-012-0721-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 06/27/2012] [Indexed: 10/28/2022]
Affiliation(s)
- Ryo Rokutanda
- Division of Allergy and Rheumatology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan.
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Abstract
A 17-year-old woman was previously diagnosed with autoimmune hepatitis (AIH) by liver biopsy. Adult-onset Still's disease (AOSD) was subsequently diagnosed on the basis of high fever, arthralgia, erythema, leukocytosis (>80% granulocytes), cervical lymph node swelling, splenomegaly, and hyperferritinemia. Her symptoms and liver dysfunction improved with prednisolone of 60 mg daily and subsequently methotrexate was added. However her symptoms and liver dysfunction relapsed when prednisolone was tapered to 20 mg/day. Therefore infliximab was introduced additionally and her symptoms and liver dysfunction subsided. To our knowledge, this is the first reported case of AOSD with AIH diagnosed by liver biopsy.
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Affiliation(s)
- Kenji Fujii
- Center for Rheumatic Disease, Iizuka Hospital, Japan.
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Asashima H, Inokuma S, Nakachi S, Matsuo Y, Rokutanda R, Hagiwara K, Kobayashi S. Extremely high salivary β(2) -microglobulin and Na(+) levels in a Sjögren syndrome patient. Int J Rheum Dis 2011; 15:e31-3. [PMID: 22462432 DOI: 10.1111/j.1756-185x.2011.01678.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Doishita S, Inokuma S, Asashima H, Nakachi S, Matsuo Y, Rokutanda R, Kobayashi S, Hagiwara K, Satoh T, Akiyama O. Serum KL-6 level as an indicator of active or inactive interstitial pneumonitis associated with connective tissue diseases. Intern Med 2011; 50:2889-92. [PMID: 22129503 DOI: 10.2169/internalmedicine.50.5866] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To elucidate the cut off levels of serum KL-6 indicating patients with interstitial pneumonitis (IP) and patients with active IP associated with connective tissue diseases (CTDs). METHODS CTD patients whose serum KL-6 level was measured were included. IP was diagnosed on the basis of medical records including XP/CT findings, and active IP was assumed in case that intervention for IP was newly added. The cut off levels were determined by receiver operating characteristic (ROC) curve analysis. RESULTS Among 240 (174 females) patients, 67 (42) had IP and 15 (9) had active IP. The ages of patients with and without IP, and with active IP and with inactive IP were 70.3±9.5 and 62.8±15.3, and 72.8±8.1 and 69.6±9.8, respectively. IP was significantly more prevalent in males and the elderly. The KL-6 levels were 990±90 and 301±12 U/mL in patients with and without IP, and 1,905±236 and 726±54 U/mL in those with active IP and with inactive IP, respectively. ROC curve analysis showed a cut off level of 509 U/mL for indicating IP, and that of 1,051-1,060 U/mL for indicating active IP. CONCLUSION A serum KL-6 level of higher than 500 U/mL is a marker of the presence of IP, and a level of higher than 1,000 U/mL is a marker of the presence of active IP associated with CTDs.
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Affiliation(s)
- Satoshi Doishita
- Department of Allergy and Rheumatic Diseases, Japanese Red Cross Medical Center, Japan
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