Publications by authors named "Yoshinori Taniguchi"

101 Publications

Clinical Image: Splinter hemorrhage as a diagnostic clue of muscular polyarteritis nodosa.

ACR Open Rheumatol 2021 Jul 29. Epub 2021 Jul 29.

Kochi Medical School Hospital, Nankoku, Japan.

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http://dx.doi.org/10.1002/acr2.11313DOI Listing
July 2021

SARS-CoV2-triggered acute arthritis: Viral arthritis rather than reactive arthritis.

J Med Virol 2021 Jul 23. Epub 2021 Jul 23.

Department of Internal Medicine and Rheumatology, Juntendo University, Tokyo, Japan.

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http://dx.doi.org/10.1002/jmv.27229DOI Listing
July 2021

Reactive Arthritis After Intravesical Bacillus Calmette-Guérin Therapy.

J Clin Rheumatol 2021 Jul 17. Epub 2021 Jul 17.

From the Department of Endocrinology, Metabolism, Nephrology, and Rheumatology, Kochi Medical School Hospital, Kochi University, Nankoku Department of Rheumatology, Bay Side Misato Marine Hospital, Kochi Rheumatic Disease Center, Kurashiki Medical Center, Kurashiki Department of Internal Medicine (Rheumatology), Juntendo Koshigaya Hospital, Koshigaya, Japan.

Abstract: Reactive arthritis (ReA) is a sterile arthritis that occurs in genetically predisposed individuals secondary to an extra-articular infection, usually of the gastrointestinal or genitourinary tract. Sterile arthritis associated with instillation of intravesical bacillus Calmette-Guérin (iBCG) therapy used for bladder cancer can also be included under ReA based on the pathogenic mechanism. Similar to spondyloarthritis, HLA-B27 positivity is a known contributor to the genetic susceptibility underlying iBCG-associated ReA. Other genetic factors, such as HLA-B39 and HLA-B51, especially in Japanese patients, can also be involved in the pathophysiology of iBCG-associated ReA. The frequencies of ReA- and ReA-related symptoms are slightly different between Japanese and Western studies. Proper understanding of possible complications, their epidemiology and pathogenesis, and their management is important for the rheumatologist when noting symptomatic patients using iBCG. Herein, we will review the most current information on ReA after iBCG therapy.
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http://dx.doi.org/10.1097/RHU.0000000000001768DOI Listing
July 2021

Expanding the spectrum of reactive arthritis (ReA): classic ReA and infection-related arthritis including poststreptococcal ReA, Poncet's disease, and iBCG-induced ReA.

Rheumatol Int 2021 Aug 1;41(8):1387-1398. Epub 2021 May 1.

Department of Internal Medicine and Rheumatology, Juntendo University Koshigaya Hospital, Saitama, Japan.

Reactive arthritis (ReA) is a form of sterile arthritis that occurs secondary to an extra-articular infection in genetically predisposed individuals. The extra-articular infection is typically an infection of the gastrointestinal tract or genitourinary tract. Infection-related arthritis is a sterile arthritis associated with streptococcal tonsillitis, extra-articular tuberculosis, or intravesical instillation of bacillus Calmette-Guérin (iBCG) therapy for bladder cancer. These infection-related arthritis diagnoses are often grouped with ReA based on the pathogenic mechanism. However, the unique characteristics of these entities may be masked by a group classification. Therefore, we reviewed the clinical characteristics of classic ReA, poststreptococcal ReA, Poncet's disease, and iBCG-induced ReA. Considering the diversity in triggering microbes, infection sites, and frequency of HLA-B27, these are different disorders. However, the clinical symptoms and intracellular parasitism pathogenic mechanism among classic ReA and infection-related arthritis entities are similar. Therefore, poststreptococcal ReA, Poncet's disease, and iBCG-induced ReA could be included in the expanding spectrum of ReA, especially based on the pathogenic mechanism.
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http://dx.doi.org/10.1007/s00296-021-04879-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8091991PMC
August 2021

Yellow Nail Syndrome Associated With Rheumatoid Arthritis.

J Rheumatol 2021 May;48(5):785

Department of Rheumatology, Bay Side Misato Medical Center, Kochi, Japan.

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http://dx.doi.org/10.3899/jrheum.200908DOI Listing
May 2021

Optic Neuropathy with Headache and Palpable Temporal Arteries Due to Hypertrophic Pachymeningitis Rather than Giant Cell Arteritis.

Ocul Immunol Inflamm 2021 Apr 1:1-4. Epub 2021 Apr 1.

Department of Ophthalmology and Visual Science, Kochi Medical School, Kochi University, Nankoku City, Kochi, Japan.

: To report a case of optic neuropathy diagnosed by color Doppler ultrasonography and Gadolinium-enhanced cerebral magnetic resonance imaging (MRI).: A 79-year-old woman presented with headache and vision loss in her left eye. Although her bilateral temporal arteries were palpable and rope-like, color Doppler ultrasonography showed normal flow in both arteries with no signs of arteritis. MRI revealed increased enhancement of the pachymeninges enveloping both cerebral hemispheres, suggestive of hypertrophic pachymeningitis.: Symptoms and laboratory data are similar for both hypertrophic pachymeningitis and giant cell arteritis (GCA). The present case suggests the utility of ultrasonography and MRI as rapid, convenient, and noninvasive tools for differential diagnosis of optic neuropathy.
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http://dx.doi.org/10.1080/09273948.2021.1881561DOI Listing
April 2021

Acute Digital Necrosis Due to Interferon-α-Induced Antineutrophil Cytoplasmic Antibody-Associated Vasculitis.

Arthritis Rheumatol 2021 Aug 5;73(8):1542. Epub 2021 Jul 5.

Juntendo-Koshigaya Hospital, Koshigaya, Japan.

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http://dx.doi.org/10.1002/art.41700DOI Listing
August 2021

Validation of the diagnostic criteria for IgG4-related kidney disease (IgG4-RKD) 2011, and proposal of a new 2020 version.

Clin Exp Nephrol 2021 Feb 4;25(2):99-109. Epub 2021 Jan 4.

Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.

Background: In 2011, the IgG4-related kidney disease (IgG4-RKD) working group of the Japanese Society of Nephrology proposed diagnostic criteria for IgG4-RKD. The aim of the present study was to validate those criteria and develop a revised version.

Methods: Between April 2012 and May 2019, we retrospectively collected Japanese patients with kidney disease, for whom data on serum IgG4 values and/or immunohistological staining for IgG4 in renal biopsy samples were available. These patients were classified as IgG4-RKD or non-IgG4-RKD based on the diagnostic criteria for IgG4-RKD 2011, and the results were evaluated by expert opinion. Accordingly, we developed some revised versions of the criteria, and the version showing the best performance in the present cohort was proposed as the IgG4-RKD criteria for 2020.

Results: Of 105 included patients, the expert panel diagnosed 55 as having true IgG4-RKD and 50 as mimickers. The diagnostic criteria for IgG4-RKD 2011 had a sensitivity of 72.7% and a specificity of 90.0% in this cohort. Of the 15 patients with true IgG4-RKD who were classified as non-IgG4-RKD, all lacked biopsy-proven extra-renal lesions, although many had clinical findings highly suggestive of IgG4-RD. The revised version to which "bilateral lacrimal, submandibular or parotid swelling, imaging findings compatible with type 1 autoimmune pancreatitis or retroperitoneal fibrosis" was added as an item pertaining to extra-renal organ(s) improved the sensitivity to 90.9% while the specificity remained at 90.0%.

Conclusion: The revised version has considerably improved test performance after addition of the new extra-renal organ item (imaging and clinical findings).
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http://dx.doi.org/10.1007/s10157-020-01993-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7880946PMC
February 2021

Iliopsoas Muscle Involvement due to Granulomatosis with Polyangiitis.

J Rheumatol 2020 10;47(10):1582-1583

Department of Endocrinology, Metabolism, Nephrology and Rheumatology, Kochi Medical School Hospital, Nankoku, Japan.

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http://dx.doi.org/10.3899/jrheum.191310DOI Listing
October 2020

The Diagnosis and Treatment of Adult Patients with SAPHO Syndrome: Controversies Revealed in a Multidisciplinary International Survey of Physicians.

Rheumatol Ther 2020 Dec 24;7(4):883-891. Epub 2020 Sep 24.

Department of Rheumatology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Introduction: This study aimed to investigate the current practice in the diagnosis and treatment of SAPHO syndrome among the international rheumatology and dermatology communities.

Methods: We conducted an electronic survey among the members of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), the Japan Spondyloarthritis, and Israeli Societies of Rheumatology.

Results: A total of 78 physicians participated in the survey: rheumatologists (83%, n = 65), dermatologists (11.5%, n = 9), and orthopedics (3.8%, n = 3). SAPHO was considered a subtype of spondyloarthritis by 48.7% (n = 38), a subtype of psoriatic arthritis by 19.2% (n = 15), a separate entity by 25.6% (n = 20), and a subtype of reactive arthritis by 6.4% (n = 5). Palmoplantar pustulosis was the most prevalent cutaneous manifestation (n = 44, 56.4%) and anterior chest pain-the most prevalent osteoarticular manifestation (n = 66, 84.6%). The majority (84.6%, n = 66) voted for the update of the present diagnostic criteria by Khan 1994. Magnetic resonance imaging was considered the preferred imaging modality for the diagnosis of SAPHO by 41% (n = 32). Conduction of bone biopsy for diagnosis of non-infectious osteitis was supported only by 10.3% (n = 8). Patient-reported outcomes were considered the most appropriate measure for the assessment of disease activity by 47.4% (n = 37). The treatment approach was overall similar among the rheumatology and dermatology communities, including non-steroidal anti-inflammatory drugs, bisphosphonates, conventional disease-modifying anti-inflammatory drugs, and biologics.

Conclusions: Our study underlines the controversy on diagnosis and treatment of SAPHO syndrome among specialists in rheumatology and dermatology and emphasizes an unmet need for update and validation of diagnostic criteria and treatment approach.
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http://dx.doi.org/10.1007/s40744-020-00235-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695776PMC
December 2020

Is serum cholinesterase level a predictor of the extent of organ involvement in immunoglobulin G4-related disease?

Rheumatol Adv Pract 2020 7;4(2):rkaa031. Epub 2020 Jul 7.

Department of Endocrinology, Metabolism, Nephrology and Rheumatology, Kochi Medical School Hospital, Nankoku, Japan.

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http://dx.doi.org/10.1093/rap/rkaa031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7494081PMC
July 2020

Atypical extensive pancreatic pseudocyst with hemorrhage in a hemodialysis patient.

Radiol Case Rep 2020 Sep 2;15(9):1415-1418. Epub 2020 Jul 2.

Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School Hospital, Kochi University, Nankoku, Kochi, Japan.

Pancreatic pseudocysts are a common complication of both acute and chronic pancreatitis. The complications of pancreatic pseudocysts include compression of abdominal great vessels, gastric or duodenal stenosis, cholestasis due to stenosis of common bile duct, infection, and hemorrhage into the cyst. Moreover, pancreatic pseudocysts most commonly occur around the pancreas; however, extension into the adjacent viscera including spleen, liver, transverse colon, anterior or posterior pararenal space, retroperitoneum and mediastinum does occur infrequently. Here, we report a rare case of atypical extensive pancreatic pseudocyst with hemorrhage in a hemodialysis patient.
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http://dx.doi.org/10.1016/j.radcr.2020.06.018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7334557PMC
September 2020

Multifamily QTL analysis and comprehensive design of genotypes for high-quality soft wheat.

PLoS One 2020 11;15(3):e0230326. Epub 2020 Mar 11.

Division of Field Crops and Horticulture Research, Tohoku Agricultural Research Center, National Agriculture and Food Research Organization, Morioka, Iwate, Japan.

Milling properties and flour color are essential selection criteria in soft wheat breeding. However, high phenotypic screening costs restrict selection to relatively few breeding lines in late generations. To achieve marker-based selection of these traits in early generations, we performed genetic dissection of quality traits using three doubled haploid populations that shared the high-quality soft wheat variety Kitahonami as the paternal parent. An amplicon sequencing approach allowed effective construction of well-saturated linkage maps of the populations. Marker-based heritability estimates revealed that target quality traits had relatively high values, indicating the possibility of selection in early generations. Taking advantage of Chinese Spring reference sequences, joint linkage maps of the three populations were generated. Based on the maps, multifamily quantitative trait locus (QTL) analysis revealed a total of 86 QTLs for ten traits investigated. In terms of target quality traits, 12 QTLs were detected for flour yield, and 12 were detected for flour redness (a* value). Among these QTLs, six for flour yield and nine for flour a* were segregating in more than two populations. Some relationships among traits were explained by QTL collocations on chromosomes, especially group 7 chromosomes. Ten different ideotypes with various combinations of favorable alleles for the flour yield and flour a* QTLs were generated. Phenotypes of derivatives from these ideotypes were predicted to design ideal genotypes for high-quality wheat. Simulations revealed the possibility of breeding varieties with better quality than Kitahonami.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0230326PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7065826PMC
June 2020

Esophageal Aphthae and Ulcers Due to Behçet Disease as Cause of Neck and Precordial Chest Pain.

J Clin Rheumatol 2020 Mar;26(2):e33

From the Department of Endocrinology, Metabolism, Nephrology and Rheumatology, Kochi Medical School Hospital, Kochi University, Nankoku, Japan.

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http://dx.doi.org/10.1097/RHU.0000000000000821DOI Listing
March 2020

Breathlessness, pleural effusions, fibromas, and Meigs syndrome: look beyond the chest and don't delay!

Lancet 2020 02;395(10223):e32

Department of Endocrinology, Metabolism, Nephrology and Rheumatology, Kochi Medical School Hospital, Kochi University, Kochi, Japan.

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http://dx.doi.org/10.1016/S0140-6736(20)30111-2DOI Listing
February 2020

Dyskeratotic cells in persistent pruritic skin lesions as a prognostic factor in adult-onset Still disease.

Medicine (Baltimore) 2020 Feb;99(6):e19051

Department of Endocrinology, Metabolism, Nephrology and Rheumatology, Kochi Medical School Hospital, Nankoku.

Adult-onset Still disease (AOSD), a systemic inflammatory disorder, is characterized by high fever, evanescent rash, arthritis, and hyperferritinaemia. AOSD is also reported to be associated with other skin lesions, including persistent pruritic papules and plaques. This study aimed to assess the significance of dyskeratotic skin lesions in Japanese AOSD patients.We retrospectively assessed the histology of persistent pruritic skin lesions and evanescent rashes and the relationship between dyskeratotic cells, serum markers, and outcomes in 20 Japanese AOSD patients, comparing AOSD histology with that of dermatomyositis (DM), drug eruptions, and graft-versus-host disease (GVHD).As the results, Persistent pruritic lesions were characterized by scattered single keratinocytes with an apoptotic appearance confined to the upper layer of the epidermis and horny layer without inflammatory infiltrate. In contrast to AOSD, the histology of DM, drug eruption, and GVHD demonstrated dyskeratotic cells in all layers of the epidermis with inflammatory infiltrate. AOSD with evanescent rash showed no dyskeratotic cells. The dyskeratotic cells in pruritic AOSD lesions stained positive for ssDNA and terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling, indicating apoptosis. Serum IL-18 was significantly higher in AOSD patients with dyskeratotic cells than those without, and generally required higher doses of glucocorticoids, immunosuppressants, and biologic agents. Two of ten AOSD patients with dyskeratotic cells died from hemophagocytic lymphohistiocytosis.In conclusion, Persistent pruritic AOSD skin lesions are characterized by dyskeratotic cells with apoptotic features, involving the upper layers of the epidermis. There may be a link to elevated IL-18. This dyskeratosis may be a negative prognostic indicator.
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http://dx.doi.org/10.1097/MD.0000000000019051DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7015626PMC
February 2020

Recurrent Optic Perineuritis as the First Manifestation of Relapsing Polychondritis.

J Neuroophthalmol 2019 12;39(4):513-514

Departments of Ophthalmology and Visual Science (YM, KF, AF), Endocrinology, Metabolism, and Nephrology (YT), and Otolaryngology (MK), Kochi Medical School, Kochi University, Nankoku City, Japan.

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http://dx.doi.org/10.1097/WNO.0000000000000820DOI Listing
December 2019

Clinical characteristics of cancer-associated myositis complicated by interstitial lung disease: a large-scale multicentre cohort study.

Rheumatology (Oxford) 2020 01;59(1):112-119

Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Japan.

Objective: To clarify the incidence, risk factors, and impact of malignancy in patients with PM/DM-associated interstitial lung disease (ILD).

Methods: This study used data from 497 patients with PM/DM-associated ILD enrolled in a multicentre, retrospective and prospective cohort of incident cases. Cancer-associated myositis (CAM) was defined as malignancy diagnosed within 3 years before or after PM/DM diagnosis. Demographic and clinical information was recorded at the time of diagnosis, and data about the occurrence of mortality and malignancy was collected.

Results: CAM was identified in 32 patients with PM/DM-associated ILD (6.4%). Patients with CAM were older (64 vs 55 years, P < 0.001), presented with arthritis less frequently (24% vs 49%, P = 0.01), and showed a lower level of serum Krebs von den Lungen-6 (687 vs 820 IU/l, P = 0.03) than those without CAM. The distribution of myositis-specific autoantibodies, including anti-melanoma differentiation-associated gene 5, anti-aminoacyl tRNA synthetase, and anti-transcriptional intermediary factor 1-γ antibodies, did not differ between the groups. Survival analysis demonstrated that CAM patients had a poorer survival than non-CAM patients (P = 0.006), primarily due to excess deaths by concomitant malignancy, while mortality due to ILD-related respiratory failure was similar between the groups (P = 0.51).

Conclusion: Concomitant malignancy can occur in patients with PM/DM-associated ILD, and has significant impact on mortality. Older age, lack of arthritis, and a lower level of serum Krebs von den Lungen-6 at diagnosis are predictors of concomitant malignancy.
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http://dx.doi.org/10.1093/rheumatology/kez238DOI Listing
January 2020

Efficacy of abatacept for Felty's syndrome.

Rheumatology (Oxford) 2020 01;59(1):256-259

Department of Endocrinology, Metabolism, Nephrology and Rheumatology, Kochi Medical School Hospital, Kochi University, Nankoku, Japan.

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http://dx.doi.org/10.1093/rheumatology/kez262DOI Listing
January 2020

Phaeohyphomycosis Due to in an Immunocompromised Host.

J Rheumatol 2019 06;46(6):652

Department of Endocrinology, Metabolism, Nephrology and Rheumatology, Kochi Medical School Hospital, Nankoku, Kochi, Japan.

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http://dx.doi.org/10.3899/jrheum.180774DOI Listing
June 2019

Serum dickkopf-related protein 1 and sclerostin may predict the progression of chronic kidney disease in Japanese patients.

Nephrol Dial Transplant 2019 08;34(8):1426-1427

Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Nankoku, Japan.

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http://dx.doi.org/10.1093/ndt/gfz078DOI Listing
August 2019

Clinical Characteristics of Patients with Spondyloarthritis in Japan in Comparison with Other Regions of the World.

J Rheumatol 2019 08 15;46(8):896-903. Epub 2019 Feb 15.

From the Immuno-Rheumatology Center, St. Luke's International Hospital, St. Luke's International University; Institute of Rheumatology, Tokyo Women's Medical University; Department of Orthopedic Surgery, Juntendo University School of Medicine; Division of Rheumatology, Department of Rheumatology, Keio University School of Medicine, Tokyo; Department of Orthopedic Surgery, Shiga University of Medical Science, Shiga; Department of Rheumatology, Tonan Hospital, Hokkaido; Department of Orthopedic Surgery, Fujita Health University, Aichi; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo; Department of Rheumatology, Chubu Rosai Hospital, Aichi; Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi; Department of Orthopedics, Osaka Minami Medical Center, Osaka; Department of Rheumatology, Daido Hospital, Aichi; Department of Internal Medicine, Juntendo University Koshigaya Hospital, Saitama; Department of Orthopedic Biomaterial Science, Osaka University Graduate School of Medicine, Osaka, Japan; departments of Epidemiology and Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; Division of Rheumatology, National University Hospital, Singapore; Division of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea; Department of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan; Hospital Universitario Reina Sofía/IMIBIC/University of Córdoba, Córdoba, Spain; Department of Rheumatology, Paris Descartes University, Cochin Hospital, Paris, France; INSERM Unit 1183, CRESS, Paris, France; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands.

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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http://dx.doi.org/10.3899/jrheum.180412DOI Listing
August 2019

Necrosis of the Fingers and Toes.

N Engl J Med 2018 Dec;379(26):2557

Kochi Medical School, Nankoku, Japan

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http://dx.doi.org/10.1056/NEJMicm1802619DOI Listing
December 2018

Asymptomatic Coronary Artery Disease in Japanese Patients With the Acute Ischemic Stroke.

J Stroke Cerebrovasc Dis 2019 Mar 22;28(3):612-618. Epub 2018 Nov 22.

Department of Cardiology, Tachikawa Medical Center, Niigata, Japan. Electronic address:

Objective: To investigate the prevalence and outcomes of asymptomatic coronary artery disease (CAD) in patients with the first episode of ischemic stroke.

Methods: Patients admitted to our hospital between November 2001 and January 2009 for the episode of an acute ischemic stroke/transient ischemic attack were included. Stress-Tl-201 scintigraphy was performed and followed by coronary angiography (CAG). The prevalence and risks for asymptomatic CAD, and long-term outcomes were studied.

Results: Of 1309 patients, only 15 (1.1%) patients presented with a history of CAD. Excluding 406 patients because of severity, systemic infection, early transfer to another hospital, or a refusal to participate, myocardial scintigraphy was performed in 903 patients (mean age, 72 ± 10 years, male 63.9%), and myocardial ischemia was diagnosed in 214 patients (23.7%). Of these patients, 76 patients underwent CAG, and showed significant stenosis (>75%) of a coronary artery in 61 (80.3%) patients. The risk factors for positive scintigraphy findings and CAG were high-grade premature complexes via Holter monitoring (P < .0001), enlarged left ventricle (P = .0051) and wall motion abnormalities (P = .0014) observed on echocardiography, and carotid artery stenosis observed in magnetic resonance angiography imaging (P < .0001). During the follow-up periods of 83 ± 47 months and of 91 ± 47 months, 17.2% of scintigraphy-positive and 2.8% of scintigraphy-negative patients developed episodes of myocardial ischemia, respectively (P < .001).

Conclusions: Symptomatic CAD was rare in Japanese patients with the first episode of ischemic stroke, but asymptomatic CAD was identified by stress Tl-201 myocardial scintigraphy in one-quarter of the patients. Positive scintigraphy was associated with asymptomatic CAD and future cardiac events.
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.10.035DOI Listing
March 2019

Thymic plasma cell neoplasm infiltration in Sjögren's syndrome with monoclonal gammopathy.

Rheumatology (Oxford) 2018 Mar 24. Epub 2018 Mar 24.

Department of Endocrinology, Metabolism, Nephrology and Rheumatology, Kochi Medical School Hospital, Kochi University, Nankoku, Japan.

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http://dx.doi.org/10.1093/rheumatology/key074DOI Listing
March 2018

Knockout of the interleukin-36 receptor protects against renal ischemia-reperfusion injury by reduction of proinflammatory cytokines.

Kidney Int 2018 03 11;93(3):599-614. Epub 2017 Dec 11.

Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Japan. Electronic address:

IL-36, a newly named member of the IL-1 cytokine family, includes 3 isoforms, IL-36α, IL-36β, and IL-36γ, all of which bind to a heterodimer containing the IL-36 receptor (IL-36R). Little is known about the role of the IL-36 axis in acute kidney injury (AKI) pathogenesis. Therefore, we evaluated IL-36 function in the bilateral renal ischemia-reperfusion injury model of AKI using IL-36R knockout and wild-type mice. IL-36R was found to be expressed in the kidney, mainly in proximal tubules. In IL-36R knockout mice, plasma creatinine, blood urea nitrogen, and IL-6 levels after ischemia-reperfusion injury were significantly lower than those in wild-type mice. Immunohistological analysis revealed mild tubular injury. IL-36α/β/γ levels were increased after ischemia-reperfusion injury, and IL-36α was expressed in lymphocytes and proximal tubular cells, but post-ischemia-reperfusion injury mRNA levels of IL-6 and TNF-α were low in IL-36R knockout mice. In primary cultures of renal tubular epithelial cells, IL-36α treatment upregulated NF-κB activity and Erk phosphorylation. Notably, in patients with AKI, urine IL-36α levels were increased, and IL-36α staining in renal biopsy samples was enhanced. Thus, IL-36α/IL-36R blockage could serve as a potential therapeutic target in AKI.
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http://dx.doi.org/10.1016/j.kint.2017.09.017DOI Listing
March 2018

Retinal and Choroidal Detachment in Antineutrophil Cytoplasmic Antibody-Associated Scleritis and Retinal Vasculitis Mimicking Choroidal Tumor.

J Clin Rheumatol 2017 Jun;23(4):236-237

Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Nankoku, Japan. Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Nankoku, Japan Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Nankoku, Japan.

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http://dx.doi.org/10.1097/RHU.0000000000000539DOI Listing
June 2017

Immunoglobulin G4-related disease associated with extensive granulomatous changes.

Rheumatology (Oxford) 2017 08;56(8):1430-1433

Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Nankoku.

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http://dx.doi.org/10.1093/rheumatology/kex154DOI Listing
August 2017
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