Publications by authors named "Hiroshi Kajiyama"

Background: Pneumocystis jirovecii pneumonia (PCP) is an opportunistic infection in patients undergoing immunosuppressive therapy, such as glucocorticoid (GC) medication, for systemic autoimmune diseases like systemic lupus erythematosus (SLE). Despite the confirmed effectiveness of PCP prophylaxis, its clinical administration, especially in conjunction with GC dosage, remains unclear. We aimed to describe the clinical practice of PCP prophylaxis in association with SLE in Japan, evaluate the relationship between GC dosage and PCP prophylaxis, and explore the practice patterns associated with PCP prophylaxis.

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  • Bacteremia is a serious and often deadly condition, particularly in cases with massive intravascular hemolysis, gas gangrene, and septic shock, as highlighted by the autopsy of an 84-year-old female patient.
  • The patient experienced rapid health decline, progressing to septic shock within an hour of symptoms and ultimately dying a few hours later, linked to the development of gas-filled abscesses from gas-producing bacteria.
  • The study revealed a connection between specific bacterial toxins and the patient's severe inflammatory responses, indicating that the identified bacteria were responsible for the patient's severe condition and rapid demise.
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  • The study focuses on late-onset systemic lupus erythematosus (LoSLE) in Japan, highlighting its unique characteristics compared to early-onset systemic lupus erythematosus (EoSLE), which complicates diagnosis.
  • Data from the Lupus Registry in Japan were analyzed, comparing patients with LoSLE (50+ years old at onset) to those with EoSLE (under 50), revealing differences in symptoms and demographics, such as a higher male-to-female ratio in LoSLE patients.
  • Key findings indicated that LoSLE patients had a higher occurrence of myositis, lower occurrences of skin rash and alopecia, and distinct treatment patterns, with more EoS
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  • * Results showed that patients with higher health-related quality of life (HR-QOL) scores at baseline had a significantly lower increase in damage over time, suggesting a link between better HR-QOL and slower disease progression.
  • * The study emphasizes the value of focusing on disease-specific HR-QOL metrics for assessing long-term prognosis in SLE patients, highlighting that certain aspects of HR-QOL like cognitive and physical health are particularly important.
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  • The study explored the relationship between cancer incidence in patients with systemic lupus erythematosus (SLE) and the use of calcineurin inhibitors (CNIs) like cyclosporine and tacrolimus, amid conflicting prior evidence on cancer risk in these patients.
  • It analyzed data from 704 SLE patients using the standardized incidence ratio (SIR), considering various factors such as age, sex, treatment history, and comorbidities.
  • The findings indicated no significant increase in cancer risk related to CNI use, with a SIR of 1.08 and cancer complications occurring in only 5.4% of patients, primarily gynecological malignancies.
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  • Recent advances in single-cell RNA sequencing have enhanced our understanding of rheumatoid arthritis (RA), focusing on the immune cell compositions in the synovium of East Asian patients.
  • The study analyzed synovial tissues from 41 Japanese RA patients, revealing three distinct synovial subtypes characterized by unique immune cell profiles and high activation of inflammatory pathways.
  • The findings suggest that understanding the specific inflammatory signals in each subtype may guide personalized treatment options for RA.
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Objective: Fatigue is one of the most common complaints and is a potentially modifiable issue in systemic lupus erythematosus (SLE). Studies suggest that alcohol consumption has a protective effect against the development of SLE; however, an association between alcohol consumption and fatigue in patients with SLE has not been studied. Here, we assessed whether alcohol consumption was associated with fatigue using lupus patient-reported outcomes (LupusPRO).

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Introduction: Patients with systemic lupus erythematosus (SLE) frequently change attending physicians. The number of changes in attending physicians is related to the accumulated organ damage in patients with diabetes mellitus and inflammatory bowel disease, although similar results are not known for patients with SLE. This study investigated whether the number of attending physicians after the onset of SLE is associated with organ damage.

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Objective: It is still unclear how glucocorticoids (GCs) affect the long-term clinical course of patients with SLE. The objective of this study is to explore the factors associated with GC-free treatment status.

Methods: Using data from the lupus registry of nationwide institutions, GC dose at registration was compared between short, middle and long disease durations of <5, 5-20 and ≥20 years, respectively.

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Background: Infection is a major cause of mortality in patients with systemic lupus erythematosus (SLE). Therefore, minimizing the risk of infection is an important clinical goal to improve the long-term prognosis of SLE patients. Treatment with ≥7.

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Background: Although vitamin D concentration is reportedly associated with the pathogenesis and pathology of systemic lupus erythematosus (SLE), benefits of vitamin D supplementation in SLE patients have not been elucidated, to our knowledge. We investigated the clinical impacts of vitamin D supplementation in SLE.

Methods: A cross-sectional analysis was performed using data from a lupus registry of nationwide institutions.

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Herein, we report the case of a 67-year-old man with severe coronavirus disease (COVID-19) pneumonia and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine breakthrough infection during immunosuppressive therapy for connective tissue disease-related interstitial lung disease (CTD-ILD). The patient received glucocorticoids combined with tacrolimus as maintenance therapy. His serum anti-SARS-CoV-2-immunoglobulin G (IgG) antibody levels were extremely low at the onset of COVID-19 pneumonia, even after the second dose of SARS-CoV-2 mRNA vaccine (BNT162b2).

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  • - The study examined 99 patients with chronic musculoskeletal pain who used NSAIDs for 12 months, then switched to tramadol/acetaminophen (TA) for another 12 months to investigate NSAID-related kidney issues.
  • - Results showed a significant drop in estimated glomerular filtration rate (eGFR) after the NSAID usage, with some patients showing partial recovery when switching to TA, especially those using celecoxib.
  • - The findings suggest that long-term NSAID use can impair kidney function, but switching to a multimodal pain management approach like TA may help mitigate these side effects.
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) uses its S1 spike protein to bind to angiotensin-converting enzyme 2 (ACE2) on human cells in the first step of cell entry. Tryptanthrin, extracted from leaves of the indigo plant, , using -limonene (17.3 µg/ml), is considered to inhibit ACE2-mediated cell entry of another type of coronavirus, HCoV-NL63.

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Aims: Cell adhesion molecule 1 (CADM1) mediates interepithelial adhesion and is upregulated in crowded epithelial monolayers. This study aimed to examine CADM1 expression in the human endometrium of proliferative and secretory phases, and its transcriptional regulation in terms of estrogen stimuli and higher cellularity.

Main Methods: CADM1 immunohistochemistry was conducted on endometrial tissues from women in their 40s and adult mice subcutaneously injected with estradiol following ovariectomy.

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Background: While survival of systemic lupus erythematosus (SLE) patients has improved substantially, problems remain in the management of their emotional health. Medium to high-dose glucocorticoid doses are known to worsen emotional health; the effect is unclear among patients receiving relatively low-dose glucocorticoids. This study aims to investigate the association between low glucocorticoid doses and emotional health in lupus low disease activity state (LLDAS).

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We report here two cases of membranoproliferative glomerulonephritis that developed during treatment of rheumatoid arthritis with tocilizumab. In both cases, the initial findings were proteinuria and haematuria, followed by development of bilateral lower leg oedema. One of the patients was weakly positive for anti-nuclear antibody; both had hypocomplementaemia.

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Most of the anti-methicillin-resistant drugs available in Japan are administered intravenously, except for linezolid, which can also be administered orally. Here, we report a lupus patient with methicillin-resistant induced osteomyelitis. Linezolid had to be stopped due to severe anemia.

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Noninvasive biomarkers of disease activity are needed to monitor response to therapy and predict disease recurrence in patients with glomerulonephritis. The leukocyte surface markers integrin Mac-1 and CD16b have been implicated in the pathogenesis of lupus nephritis (LN). Mac-1 comprises a unique α subunit (CD11b) complexed with a common β2 subunit, which are released along with CD16b from specific leukocyte subsets under inflammatory conditions including glomerulonephritis.

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  • The study aimed to find genetic factors associated with idiopathic inflammatory myopathies (IIMs), focusing on polymyositis, dermatomyositis, and clinically amyopathic dermatomyositis (CADM) in an Asian population.
  • Researchers examined over 496,000 single nucleotide polymorphisms in 576 IIM patients and compared them with 6,270 control subjects, using advanced genetic analyses to understand disease mechanisms.
  • A significant genetic variant associated with CADM was identified, linked to the expression of specific immune response genes, indicating that it plays a crucial role in the disease's development and inflammation, particularly through interactions with immune receptors.
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Urinary nephrin is a potential non-invasive biomarker of disease. To date, however, most studies of urinary nephrin have been conducted in animal models of diabetic nephropathy, and correlations between urinary nephrin-to-creatinine ratio and other parameters have yet to be evaluated in animal models or patients of kidney disease with podocyte dysfunction. We hypothesized that urinary nephrin-to-creatinine ratio can be up-regulated and is negatively correlated with renal nephrin mRNA levels in animal models of kidney disease, and that increased urinary nephrin-to-creatinine ratio levels are attenuated following administration of glucocorticoids.

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We herein report the case of a Japanese man with polyarteritis nodosa (PAN) accompanied by multiple myeloma (MM). The patient was diagnosed with PAN. Concurrently, IgG kappa paraprotein was detected, and bone marrow changes indicative of MM were observed.

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