Papers - UMEKITA Kunihiko
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Antiviral immune response against HTLV-1 invalidates T-SPOT.TB® results in patients with HTLV-1-positive rheumatic diseases. Reviewed
Kimura M, Umekita K, Iwao C, Kawano K, Hashikura Y, Hashiba Y, Hidaka T, Sugata K, Satou Y, Miyazaki T.
Front Immunol. 15 1480506 2024.10
Publishing type：Research paper (scientific journal)
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Crucial role of dendritic cells in the generation of anti-tumor T-cell responses and immunogenic tumor microenvironment to suppress tumor development. Reviewed
Tominaga M, Uto T, Fukaya T, Mitoma S, Riethmacher D, Umekita K, Yamashita Y, Sato K.
Front Immunol. 15 1200461 2024.8
Publishing type：Research paper (scientific journal)
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Nine-year seroepidemiological study of severe fever with thrombocytopenia syndrome virus infection in feral horses in Cape Toi, Japan. Reviewed
Mekata H, Yamada K, Umeki K, Yamamoto M, Ochi A, Umekita K, Kobayashi I, Hirai T, Okabayashi T.
BMC Vet Res. 20 ( 1 ) 190 2024.5
Publishing type：Research paper (scientific journal)
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Purification Method of Extracellular Vesicles Derived from Human T-Cell Leukemia Virus Type 1-Infected Cells without Virions. Reviewed
Kawano K, Hashikura Y, Umekita K.
Viruses. 16 ( 2 ) 249 2024.2
Publishing type：Research paper (scientific journal)
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Performance evaluation of Espline HTLV-I/II, a newly developed rapid immunochromatographic antibody test for different diagnostic situations. Reviewed
Kuramitsu M, Momose H, Uchida Y, Ishitsuka K, Kubota R, Tokunaga M, Utsunomiya A, Umekita K, Hashikura Y, Nosaka K, Koh K-R, Nakamura H, Sagara Y, Sobata R, Satake M, Nagata K, Hasegawa Y, Sasaki D, Hasegawa H, Sato T, Yamano Y, Hiraga K, Tezuka K, Ikebe E, Matsuoka S, Okuma K, Watanabe T, Miura K, Hamaguchi I.
Microbiol Spectr. 11 ( 6 ) e0207823 2023.12
Publishing type：Research paper (scientific journal)
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Differences in muscle magnetic resonance imaging findings between anti-signal recognition particle antibody-positive myopathy and anti-aminoacyl-tRNA synthetase antibody-positive myositis Reviewed
Kimura M, Aizawa A, Kudou R, Rikitake Y, Iwao C, Rikitake M, Iwao K, Kariya Y, Kawaguchi T, Matsuda M, Miyauchi S, Takajo I, Umekita K
Clin Exp Rheumatol. doi: 10.55563/clinexprheumatol/fjfkfs 2023.7
Publishing type：Research paper (scientific journal)
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Nosocomial Severe Fever with Thrombocytopenia Syndrome in Companion Animals, Japan, 2022 Reviewed
Mekata H., Umeki K., Yamada K., Umekita K., Okabayashi T.
Emerging Infectious Diseases 29 ( 3 ) 614 - 617 2023.3
Language：English Publishing type：Research paper (scientific journal) Publisher：Emerging Infectious Diseases
In Japan, 2 cats that underwent surgery in a room where a sick dog had been euthanized became ill within 9 days of surgery. Severe fever with thrombocytopenia syndrome virus was detected in all 3 animals; nucleotide sequence identity was 100%. Suspected cause was an uncleaned pulse oximeter probe used for all patients.
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Seroprevalence of severe fever with thrombocytopenia syndrome virus in medium-sized wild mammals in Miyazaki, Japan. Reviewed
Kaneko C, Mekata H, Umeki K, Sudaryatma PE, Irie T, Yamada K, Misawa N, Umekita K, Okabayashi T.
Ticks Tick Borne Dis. 14 ( 2 ) 102115 2023.3
Publishing type：Research paper (scientific journal)
DOI： 10.1016/j.ttbdis.2022.102115. Epub 2022 Dec 22. PMID: 36577308
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HAS-Flow May Be an Adequate Method for Evaluating Human T-Cell Leukemia Virus Type 1 Infected Cells in Human T-Cell Leukemia Virus Type 1-Positive Rheumatoid Arthritis Patients Receiving Antirheumatic Therapies: A Retrospective Cross-Sectional Observation Study Reviewed
Umekita K, Hashikura Y, Takaki A, Kimura M, Kawano K, Iwao C, Miyauchi S, Kawaguchi T, Matsuda M, Hashiba Y, Hidaka T.
Viruses 15 ( 2 ) 468 2023.2
Publishing type：Research paper (scientific journal)
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Mekata Hirohisa, Kawaguchi Takeshi, Iwao Kosho, Umeki Kazumi, Yamada Kentaro, Umekita Kunihiko, Okabayashi Tamaki
Japanese Journal of Infectious Diseases advpub ( 0 ) 211 - 214 2023.1
Language：English Publishing type：Research paper (scientific journal) Publisher：National Institute of Infectious Diseases
Severe fever with thrombocytopenia syndrome (SFTS) is caused by the severe fever with thrombocytopenia syndrome virus (SFTSV). Although SFTS is a fatal tick-borne zoonosis, it can infect humans without tick bite exposure. Recently, direct transmission of SFTSV from companion pets to humans has become a major problem. We present a case of SFTSV transmission from a dead community cat to a woman who buried the cat in Miyazaki Prefecture, Japan. The community cat died without a diagnosis of SFTS, and the woman buried it without taking any precautions. She developed symptoms of SFTS 9 days later. The woman tested positive for SFTS viral RNA and anti-SFTSV antibodies. The cat’s carcass was exhumed, and tissue samples were collected to confirm the viral infection. Numerous copies of viral RNA were detected. The SFTSV M segment sequences in the cat and the woman were 100% homologous. The woman claimed that she had touched blood that had leaked from the cat’s body while burying it. However, she could have been infected while transporting the cat to the animal hospital. This study highlights the risk of SFTSV infection from contact with sick or dead community cats.
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Neuropsychiatric Systemic Lupus Erythematosus with Cerebral Vasculitis and Lupus Nephritis Successfully Treated with High-dose Glucocorticoids and Mycophenolate Mofetil: A Case Report. Reviewed
Tanaka S, Kawaguchi T, Kudo R, Kimura M, Rikitake Y, Iwao C, Rikitake M, Iwao K, Aizawa A, Kariya Y, Matsuda M, Miyauchi S, Takajo I, Umekita K.
Intern Med 61 ( 20 ) 3131 - 3135 2022.10
Publishing type：Case report
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High incidence of serious infections requiring hospitalisation in human T-cell leukaemia virus type 1-positive rheumatoid arthritis: A case-controlled observational study. Reviewed
Hashiba Y, Umekita K, Kimura M, Iwao C, Iwao K, Kariya Y, Kubo K, Miyauchi S, Kudou R, Rikitake Y, Kawaguchi T, Matsuda M, Takajo I, Inoue E, Hidaka T, Okayama A.
Mod Rheumatol 32 ( 5 ) 866 - 874 2022.8
Publishing type：Research paper (scientific journal)
DOI： 10.1093/mr/roab077.
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Neutralizing mAbs against SFTS Virus Gn Protein Show Strong Therapeutic Effects in an SFTS Animal Model. Reviewed
Shimojima M, Sugimoto S, Umekita K, Onodera T, Sano K, Tani H, Takamatsu Y, Yoshikawa T, Kurosu T, Suzuki T, Takahashi Y, Ebihara H, Saijo M.
Viruses. 14 ( 8 ) 1665 2022.7
Publishing type：Research paper (scientific journal)
DOI： 10.3390/v14081665.
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Effect of HTLV-1 Infection on the Clinical Course of Patients with Rheumatoid Arthritis Invited Reviewed
Umekita K.
Viruses 14 ( 7 ) 2022.7
Authorship：Lead author Language：English Publishing type：Research paper (scientific journal) Publisher：Viruses
Human T-cell leukemia virus type 1 (HTLV-1) is the causative agent of adult T-cell leukemia/lymphoma (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). The effects of HTLV-1 on health are not fully elucidated. Epidemiological studies have shown that the prevalence of HTLV-1 infection is high in patients with rheumatic diseases. The prevalence of comorbidities, such as Sjögren’s syndrome and rheumatoid arthritis (RA), is higher in patients with HAM/TSP than the in general population. Studies have shown the effects of HTLV-1-infection on the clinical course of RA. Major questions on the association between HTLV-1 infection and RA: (1) Is it possible that HTLV-1 infection causes RA? (2) Do patients with RA who are infected with HTLV-1 have different clinical features? (3) Are immunosuppressants associated with an increased prevalence of HAM/TSP or ATL in RA patients with HTLV-1 infection? Is ATL an immunosuppressive therapy-associated lymphoproliferative disorder? No large-scale studies have investigated the incidence of ATL in patients with RA. However, several studies have reported the development of ATL in patients with RA who have HTLV-1 infection. This review aimed to shed light on the association between HTLV-1 infection and RA and summarize the unmet medical needs of RA patients with HTLV-1 infection.
DOI： 10.3390/v14071460
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HTLV-1陽性全身性強皮症の臨床的特徴. Reviewed
宮内俊一, 工藤理紗, 木村賢俊, 岩尾千紘, 力武雄幹, 岩尾浩昭, 力武真央, 相澤彩子, 川口剛, 仮屋裕美, 松田基弘, 梅北邦彦, 高城佳人子, 高城一郎, 岡山昭彦.
九州リウマチ 41 ( 1 ) 37 - 42 2022.3
Authorship：Corresponding author Publishing type：Research paper (scientific journal)
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Severe Fever with Thrombocytopenia Syndrome Accompanied by Invasive Pulmonary Aspergillosis: An Autopsy Case. International journal
Kosho Iwao, Takeshi Kawaguchi, Masatoshi Kimura, Chihiro Iwao, Mao Rikitake, Ayako Aizawa, Yumi Kariya, Motohiro Matsuda, Syunichi Miyauchi, Ichiro Takajo, Takumi Kiwaki, Tsuyoshi Fukushima, Hiroaki Kataoka, Tadaki Suzuki, Akihiko Okayama, Kunihiko Umekita
Viruses 13 ( 6 ) 2021.6
Language：Japanese Publishing type：Research paper (scientific journal)
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tickborne infectious disease in China, Korea, and Japan caused by the SFTS virus (SFTSV). SFTS has a high mortality rate due to multiorgan failure. Recently, there are several reports on SFTS patients with mycosis. Here, we report a middle-aged Japanese SFTS patient with invasive pulmonary aspergillosis (IPA) revealed by an autopsy. A 61-year-old man with hypertension working in forestry was bitten by a tick and developed fever, diarrhea, and anorexia in 2 days. On day 4, consciousness disorder was appearing, and the patient was transferred to the University of Miyazaki Hospital. A blood test showed leukocytopenia, thrombocytopenia, as well as elevated levels of alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and creatine kinase. The SFTSV gene was detected in serum using a reverse-transcription polymerase chain reaction. On day 5, respiratory failure appeared and progressed rapidly, and on day 7, the patient died. An autopsy was performed that revealed hemophagocytosis in the bone marrow and bleeding of several organs. IPA was observed in lung specimens. SFTSV infection may be a risk factor for developing IPA. Early diagnosis and treatment of IPA may be important in patients with SFTS.
DOI： 10.3390/v13061086
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Corticosteroids May Have Negative Effects on the Management of Patients with Severe Fever with Thrombocytopenia Syndrome: A Case-Control Study. Reviewed International journal
Takeshi Kawaguchi, Kunihiko Umekita, Atsushi Yamanaka, Seiichiro Hara, Tetsuro Yamaguchi, Eisuke Inoue, Akihiko Okayama
Viruses 13 ( 5 ) 2021.5
Authorship：Corresponding author Language：Japanese Publishing type：Research paper (scientific journal)
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral hemorrhagic fever in China, Korea, and Japan. To date, no standardized treatment protocol for SFTS has been established. Corticosteroids (CS) may be administered to patients with SFTS and hemophagocytic syndrome, but its effectiveness and safety are still debatable. We conducted a retrospective case series review at four medical facilities in Miyazaki, Japan. Based on the medical records, clinical data, including the patients background, symptoms, physical findings, laboratory data at initial presentation, treatment, and outcome, were compared between the CS-treated and the non-CS-treated group. A total of 47 patients with confirmed SFTS in each hospital were enrolled in this study; there were 14 fatal cases and 33 nonfatal cases. The case fatality ratio was 29.8%. After adjusting patients' background by propensity score matching, the case fatality ratio was higher (p = 0.04) and complications of secondary infections, including invasive pulmonary aspergillosis, tended to be more frequent (p = 0.07) in the CS-treated group than in the non-CS-treated group. These data suggested that administration of CS to patients with SFTS should be carefully considered.
DOI： 10.3390/v13050785
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Survey of actual conditions of erythema marginatum as a prodromal symptom in Japanese patients with hereditary angioedema. Reviewed
Ohsawa I, Fukunaga A, Imamura S, Iwamoto K, Tanaka A, Hide M, Honda D, Yamashita K, Fujiwara C, Ishikawa O, Yamaguchi T, Maehara J, Hirose T, Ieko M, Umekita K, Nakamura Y, Gotoh H.
World Allergy Organ J 14 ( 2 ) 100511 2021.2
Publishing type：Research paper (scientific journal)
DOI： doi.org/10.1016/j.waojou.2021.100511 Online publication
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Strongyloides stercoralis colitis in a patient positive for human T-cell leukemia virus with rheumatoid arthritis during an anti-rheumatic therapy: a case report. Reviewed
Hashiba Y, Umekita K, Minami H, Kawano A, Nagayasu E, Maruyama H, Hidaka T, Okayama A.
Mod Rheumatol Case Rep 5 ( 1 ) 16 - 21 2021.1
Authorship：Corresponding author Publishing type：Research paper (scientific journal)
DOI： doi:10.1080/24725625.2020.1808304. Online ahead of print.
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Impact of C-Reactive Protein Levels on Differentiating of Severe Fever With Thrombocytopenia Syndrome From Japanese Spotted Fever. Reviewed International journal
Takeshi Kawaguchi, Kunihiko Umekita, Atsushi Yamanaka, Seiichiro Hara, Tetsuro Yamaguchi, Eisuke Inoue, Akihiko Okayama
Open forum infectious diseases 7 ( 11 ) ofaa473 2020.11
Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)
Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral hemorrhagic fever in China, Korea, and Japan. Japanese spotted fever (JSF), which belongs to spotted fever group rickettsioses, is also endemic to Western Japan. Patients with SFTS and those with JSF display many of the same clinical manifestations. Sudden fever, rash, tick bite, and neurological and gastrointestinal symptoms may be seen in both infections, but the frequency and severity of each disease have not been compared and studied. Because laboratory confirmation of pathogens takes time, it is important to predict diagnosis of SFTS vs JSF based on the features of the clinical characteristics at the initial presentation, particularly in primary care settings. Methods: We conducted a case series review at 4 medical facilities in Miyazaki, Japan. Based on the medical records, clinical and laboratory characteristics were compared between patients with SFTS and those with JSF. Results: Eighty-one patients were enrolled in this study, including 41 with SFTS and 40 with JSF. The absence of rash (P < .001), leukopenia (P < .001), and normal C-reactive protein (CRP) levels (P < .001) were the variables distinguishing SFTS from JSF. Normal CRP levels (≤1.0 mg/dL) had a 95% sensitivity (84%-99%) and 97% specificity (87%-100%) for SFTS, with a positive likelihood ratio of 37.1 (5.35-257). Conclusions: Normal serum CRP levels were shown to differentiate SFTS from JSF with a very high probability.
DOI： 10.1093/ofid/ofaa473
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特集 HTLV-1母子感染をもっと知ろう HTLV-1関連疾患 ATL、HAM以外の関連疾患の概要 Invited
梅北 邦彦, 岡山 昭彦
周産期医学 50 ( 10 ) 1703 - 1706 2020.10
Authorship：Lead author Publishing type：Research paper (scientific journal) Publisher：(株)東京医学社
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Detection of anti-SFTSV nuclear protein antibody in the acute phase sera of patients using double-antigen ELISA and immunochromatography. Reviewed
Umeki K, Yasuda A, Umekita K, Megumi R, Nomura H, Kawaguchi T, Matsuda M, Takajo I, Shimojima M, Okayama A
Journal of virological methods 285 113942 2020.8
Language：English Publishing type：Research paper (scientific journal)
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Effective Treatment with Tocilizumab in a Rheumatoid Arthritis Patient Complicated with Human T-cell Leukemia Virus Type 1-associated Myelopathy: A Case Report. Reviewed
Iwao C, Umekita K, Miyauchi S, Kimura M, Rikitake Y, Iwao K, Rikitake M, Aizawa A, Kawaguchi T, Kariya Y, Matsuda M, Takajo I, Shiomi K, Okayama A.
Intern Med 59 ( 15 ) 1891 - 1897 2020.8
Publishing type：Research paper (scientific journal)
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Human T-cell leukemia virus type 1 may invalidate T-SPOT.TB assay results in rheumatoid arthritis patients: A retrospective case-control observational study. Reviewed International journal
Kunihiko Umekita, Yayoi Hashiba, Kosho Iwao, Chihiro Iwao, Masatoshi Kimura, Yumi Kariya, Kazuyoshi Kubo, Shunichi Miyauchi, Risa Kudou, Yuki Rikitake, Katoko Takajo, Takeshi Kawaguchi, Motohiro Matsuda, Ichiro Takajo, Eisuke Inoue, Toshihiko Hidaka, Akihiko Okayama
PloS one 15 ( 5 ) e0233159 2020.5
Authorship：Lead author, Corresponding author Language：English Publishing type：Research paper (scientific journal)
BACKGROUND: CD4-positive T cells are the main target of human T-cell leukemia virus type 1 (HTLV-1). Interferon-γ release assays rely on the fact that T-lymphocytes release this cytokine when exposed to tuberculosis-specific antigens and are useful in testing for latent tuberculosis infection before initiating biologic therapy, such as anti-tumor necrosis factor agents. However, the reliability of interferon-γ release assays in detecting tuberculosis infection among HTLV-1-positive patients with rheumatoid arthritis (RA) remains unclear. The present study aimed to evaluate the use of the T-SPOT.TB assay in HTLV-1-positive RA patients. METHODS: Overall, 29 HTLV-1-positive RA patients and 87 age- and sex-matched HTLV-1-negative RA patients (controls) were included from the HTLV-1 RA Miyazaki Cohort Study. Results of the T-SPOT.TB assay for latent tuberculosis infection screening were collected from medical records of patients. RESULTS: Approximately 55% of the HTLV-1-positive RA patients showed invalid T-SPOT.TB assay results (odds ratio: 108, 95% confidence interval: 13.1-890, p < 0.0001) owing to a spot count of >10 in the negative controls. HTLV-1 proviral load values were significantly higher in patients with invalid results compared with those without invalid results (p = 0.003). CONCLUSION: HTLV-1 infection affects T-SPOT.TB assay results in RA patients. Assay results in HTLV-1 endemic regions should be interpreted with caution when screening for latent tuberculosis infection before initiation of biologic therapy.
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A case of lupus vasculopathy presenting favorable renal outcome. Reviewed
Ishizaki Y, Aizawa A, Ochiai S, Minakawa A, Miyauchi S, Umekita K, Sato Y, Ogawa Y, Kushida Y, Okayama A, Uesugi N, Fujimoto S.
CEN Case Rep 9 ( 1 ) 74 - 80 2020.2
Publishing type：Research paper (scientific journal)
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Effectiveness and safety of non-tumor necrosis factor inhibitor therapy for anti-human T-cell leukemia virus type 1 antibody-positive rheumatoid arthritis. Reviewed International journal
Yushiro Endo, Shoichi Fukui, Kunihiko Umekita, Takahisa Suzuki, Junya Miyamoto, Shimpei Morimoto, Toshimasa Shimizu, Tomohiro Koga, Shin-Ya Kawashiri, Naoki Iwamoto, Kunihiro Ichinose, Mami Tamai, Tomoki Origuchi, Akitomo Okada, Keita Fujikawa, Akinari Mizokami, Naoki Matsuoka, Toshiyuki Aramaki, Yukitaka Ueki, Katsumi Eguchi, Yumi Kariya, Yayoi Hashiba, Toshihiko Hidaka, Akihiko Okayama, Atsushi Kawakami, Hideki Nakamura
Modern rheumatology 31 ( 5 ) 972 - 978 2020
Language：English Publishing type：Research paper (scientific journal)
OBJECTIVES: Our previous study showed that the effectiveness of tumor necrosis factor (TNF) inhibitors was attenuated in anti-human T-cell leukemia virus type 1 (HTLV-1) antibody-positive patients with rheumatoid arthritis (RA). We aimed to evaluate the effectiveness and safety of non-TNF inhibitors in anti-HTLV-1 antibody-positive patients with RA. METHODS: We reviewed patients with RA who received abatacept or tocilizumab as the first biologic agent. We used the data of patients treated with TNF inhibitors from our previous study to compare the effectiveness between the anti-HTLV-1 antibody-positive patients treated with TNF inhibitors and non-TNF inhibitors using the inverse probability of treatment weights (IPTW) method. RESULTS: A total of 359 patients were divided into anti-HTLV-1 antibody-negative and -positive patients of 332 and 27, respectively. No statistically significant difference was observed in the change in the clinical disease activity index between the anti-HTLV-1 antibody-positive and -negative patients. The results using the IPTW method showed a significant association between the non-TNF inhibitors treatment and a better response. None of the patients developed adult T-cell leukemia/lymphoma or HTLV-1-associated myelopathy/tropical spastic paraparesis during the 24 weeks. CONCLUSION: Our results indicate that non-TNF inhibitors treatment is safety, and the effectiveness is not attenuated also in anti-HTLV-1 antibody-positive patients.
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Umekita K., Hashiba Y., Kariya Y., Kubo K., Miyauchi S., Aizawa A., Umeki K., Nomura H., Kawaguchi T., Matsuda M., Takajo I., Hidaka T., Okayama A.
Modern Rheumatology 29 ( 5 ) 795 - 801 2019.9
Authorship：Lead author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Modern Rheumatology
© 2018, © 2018 Japan College of Rheumatology. Objective: This study aimed to investigate the time-sequential changes of risk factors for adult T-cell leukemia (ATL) development in human T-cell leukemia virus type 1 (HTLV-1)-positive rheumatoid arthritis (RA) patients. Methods: HTLV-1 infection was screened using particle agglutination assay and confirmed via western blotting in 365 RA patients. Twenty-three HTLV-1-positive RA patients were included in the study cohort. Blood samples were obtained from these patients at each observation time point. The values of HTLV-1 proviral load (PVL) and serum soluble IL-2 receptor (sIL2-R), which are risk factors for ATL development, were measured using real-time PCR and enzyme immunoassay, respectively. Results: The study cohort comprised 79 person-years. The median HTLV-1 PVL and sIL2-R values of the HTLV-1-positive RA patients were 0.44 copies per 100 white blood cells (WBCs) and 406 U/mL, respectively. Three HTLV-1-positive RA patients showed a high PVL value. No remarkable changes were observed in the PVL and sIL2-R values during the observation period. However, one elderly HTLV-1-positive RA patient who had a high PVL value developed ATL during treatment with methotrexate and infliximab. Conclusion: A thorough clinical assessment of the risk factors for ATL development may be necessary in daily clinical practice for RA patients in HTLV-1-endemic areas in Japan.
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Takajo Ichiro, Umekita Kunihiko, Ikei Yoshihiko, Oshima Koichi, Okayama Akihiko
Internal Medicine 57 ( 14 ) 2071 - 2075 2018.7
Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：一般社団法人 日本内科学会
The patient was a 74-year-old Japanese woman with rheumatoid arthritis (RA) who developed generalized lymphadenopathy with elevated levels of lactase dehydrogenase (LD), and soluble IL-2 receptor (sIL-2R). She was found to be positive for anti-human T-cell leukemia virus type 1 (HTLV-1) antibodies. Her symptoms and laboratory abnormalities spontaneously regressed after the cessation of methotrexate (MTX), suggesting that she had an MTX-associated lymphoproliferative disorder; however, her lymphadenopathy appeared again approximately 14 months later with LD and sIL-2R elevation. A histopathological analysis and Southern blotting of a lymph node biopsy specimen for HTLV-1 provirus supported the diagnosis of adult T-cell leukemia/lymphoma (ATL) (lymphoma type). These data confirmed that an HTLV-1 positive RA patient may develop ATL.
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Suzuki T., Fukui S., Umekita K., Miyamoto J., Umeda M., Nishino A., Okada A., Koga T., Kawashiri S., Iwamoto N., Ichinose K., Tamai M., Fujikawa K., Aramaki T., Mizokami A., Matsuoka N., Ueki Y., Eguchi K., Sato S., Hidaka T., Origuchi T., Okayama A., Kawakami A., Nakamura H.
Arthritis and Rheumatology 70 ( 7 ) 1014 - 1021 2018.7
Language：English Publishing type：Research paper (scientific journal) Publisher：Arthritis and Rheumatology
© 2018, American College of Rheumatology Objective: To evaluate the effectiveness of tumor necrosis factor (TNF) inhibitors for the treatment of human T lymphotropic virus type I (HTLV-I)–positive patients with rheumatoid arthritis (RA) in an area endemic for HTLV-I infection. Methods: We conducted an observational study of 585 RA patients in whom TNF inhibitors were newly introduced as a first biologic disease-modifying antirheumatic drug in an area in southwestern Japan that is endemic for HTLV-I infection. Results: Fifty patients (8.5%) were anti–HTLV-I antibody–positive. The ages of the patients in this group were significantly higher at entry compared with the ages of patients who were anti–HTLV-I antibody–negative (n = 535). The median Disease Activity Score in 28 joints using the erythrocyte sedimentation rate (DAS28-ESR) was 5.21. Among the total group of patients, 82% were anti–citrullinated protein antibody (ACPA)–positive. The persistence rate of TNF inhibitors at 24 weeks was 89%. The median DAS28-ESR was significantly decreased at 24 weeks in each group. The European League Against Rheumatism (EULAR) response rate was significantly better in the anti–HTLV-I antibody–negative patients (P = 0.0277). Multiple regression analysis demonstrated that anti–HTLV-I antibody status was significantly associated with the EULAR response rate and change in the DAS28-ESR and was prominent especially in the ACPA-negative subjects. No patients developed adult T cell leukemia/lymphoma (ATL) or HTLV-I–associated myelopathy (HAM) during the 24-week treatment period. Conclusion: The efficacy of TNF inhibitors may be attenuated in anti–HTLV-I antibody–positive patients with RA. ATL and HAM did not develop when TNF inhibitors were used for 24 weeks, but the long-term risk is not known.
DOI： 10.1002/art.40461
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Remission of chronic type ATL in a patient with rheumatoid arthritis after withdrawing methotrexate and infliximab combination therapy: a case report. Reviewed
Hashiba Y, Hidaka T, Umekita K, Nishi E, Kai Y, Kubo K, Okayama A.
Modern Rheumatology Case Reports. 2 ( 1 ) 9 - 13 2018.1
Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)
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Umeki K., Umekita K., Hashikura Y., Yamamoto I., Kubo K., Nagatomo Y., Okayama A.
Clinical Laboratory 63 ( 2 ) 227 - 233 2017.2
Language：English Publishing type：Research paper (scientific journal) Publisher：Clinical Laboratory
Background: Human T-Iymphotropic virus type 1 (HTLV-1) has been recognized as a cause of adult T-cell leuke- mia/lymphoma, HTLV-1-associated myelopathy/tropical spastic paraparesis, and HTLV-1-associated uveitis. HTLV-1 infection is normally detected by screening for HTLV-1 antibodies, and positive samples are confirmed by Western blot (WB). However, WB fails to confirm some samples that were positive for HTLV-1 antibodies on screening. Line immunoassay (LIA) is commonly used in Europe and Brazil, but not in Japan. Therefore, we evaluated the performance of LIA as a method of confirming HTLV-1 antibodies using samples in Japan. Methods: LIA was compared with polymerase chain reaction (PCR) and WB using 50 negative and 70 positive samples tested by chemiluminescent enzyme immunoassay (CLEIA) in Miyazaki, Japan, an HTLV-1 endemic area. LIA (INNO-LIA HTLVI/II Score) and WB (Problot HTLV-I) were performed according to the manufacturer's instructions. Real-time PCR for HTLV-1 pX region was performed using DNA derived from white blood cells. The samples that tested negative by real-time PCR were further tested by nested PCR. Results: All 50 CLEIA negative samples were determined to be negative by LIA and PCR. Of the 70 positive samples, 66 tested positive by both of LIA and PCR. Three samples tested negative by LIA and PCR, and the remaining sample (PCR negative) showed non-specific staining in LIA and WB. WB showed more indeterminate results than LIA. Gp21 antibody in LIA demonstrated a high ability to discriminate between positive and negative PCR results. Furthermore, the degree of gp21 antibody reaction by LIA showed correlation with HTLV-1 proviral loads (PVLs). Conclusions: Our results indicate that LIA performs well in confirming HTLV-1 seropositivity by showing a low incidence of indeterminate results and good agreement with PCR using samples in Japan, although the number of samples tested was small. In addition, semi-quantitative antibody titer to gp21 correlated well with HTLV-1 PVLs. Further study including larger samples is necessary to determine the positioning of LIA for HTLV-1 detection in Japan.
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Successful treatment of disseminated cryptococcosis with liposomal amphotericin B and isavuconazole in an adult living with HIV: A case report and literature review. Reviewed
Kawaguchi T, Kitamura A, Kimura M, Rikitake Y, Iwao C, Iwao K, Sumiyoshi M, Kariya Y, Matsuda M, Umekita K, Takajo I, Moriguchi-Goto S, Yamashita A, Matsumoto K, Miyazaki T.
J Infect Chemother. 31 ( 1 ) 102534 2025.1
Publishing type：Case report
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Kawaguchi T., Matsuda M., Umekita K., Miyazaki T.
Respirology Case Reports 12 ( 7 ) e01428 2024.7
Language：English Publishing type：Case report Publisher：Respirology Case Reports
Nintedanib has been demonstrated to inhibit the rate of forced vital capacity decline in patients with progressive fibrosing interstitial lung diseases (PF-ILD) at a dose of 200 or 300 mg/day in the INBUILD trial. Although concomitant use of nintedanib with P-glycoprotein inhibitors reportedly increases the plasma concentrations of the former, tacrolimus, a P-glycoprotein inhibitor, is often used to treat connective tissue diseases-related interstitial lung diseases. The optimal dose of nintedanib in combination with tacrolimus for the treatment of PF-ILD with connective tissue disease is unknown. We herein present two patients with PF-ILD with anti-aminoacyl-tRNA synthetase antibody-positive dermatomyositis who were successfully treated with low-dose nintedanib (<200 mg/day) in combination with tacrolimus.
DOI： 10.1002/rcr2.1428
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Human granulocytic anaplasmosis with rash and rhabdomyolysis: A case report Reviewed
Kawaguchi T., Rikitake Y., Rikitake M., Kimura M., Iwao C., Iwao K., Aizawa A., Sumiyoshi M., Kariya Y., Matsuda M., Miyauchi S., Umekita K., Takajo I., Ohashi N., Miyazaki T.
Journal of Infection and Chemotherapy 2024
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Infection and Chemotherapy
Human granulocytic anaplasmosis (HGA) is a tick-borne infection caused by Anaplasma phagocytophilum. Only seven cases of HGA have been reported in Japan to date. We report the case of a 61-year-old female farmer who developed HGA with rash and rhabdomyolysis. The patient had fever and erythema covering the entire body, including the palms. An induration with an eschar was observed on the right leg, indicating that the patient had been bitten by a tick. Elevated serum creatinine and creatinine kinase levels and hematuria indicated rhabdomyolysis. We suspected Japanese spotted fever, a tick-borne illness caused by Rickettsia Japonica, and administered minocycline and ciprofloxacin for a week. Transient neutropenia and thrombocytopenia were observed, but the symptoms improved. Polymerase chain reaction (PCR) and antibody tests for R. japonica and Orientia tsutsugamushi, which causes scrub typhus, were both negative. The PCR test for severe fever with thrombocytopenia syndrome virus was also negative. Antibodies against A. phagocytophilum–related proteins were detected by western blotting, indicating seroconversion of IgG with paired serum samples, and the patient was diagnosed with HGA. HGA should be suspected in acute febrile patients with a history of outdoor activity and cytopenia, with or without a rash. A testing system and the accumulation of cases in Japan are necessary for the early diagnosis and appropriate treatment of HGA.
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Luteibacter jiangsuensis blood stream infection: a first case report. Reviewed
Horiguchi T, Sumiyoshi M, Nagatomo E, Sakamoto K, Ogawa S, Ichinari N, Yamada A, Rikitake Y, Iwao C, Kawaguchi T, Umekita K, Takajo I, Yamamoto S, Miyazaki T.
BMC Infect Dis. 23 ( 1 ) 863 2023.12
Publishing type：Case report
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Coronavirus disease 2019 in a patient with pulmonary fibrosis and emphysema: An autopsy report. Reviewed
Kudo R, Kawaguchi T, Kimura M, Rikitake Y, Iwao C, Rikitake M, Iwao K, Aizawa A, Kariya Y, Matsuda M, Miyauchi S, Takajo I, Sato Y, Asada Y, Miyazaki T, Umekita K.
Heliyon. 9 ( 11 ) e22221 2023.11
Publishing type：Case report
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血液腫瘍関連の遺伝子検査 Reviewed
橋倉悠輝、猪﨑みさき、梅北邦彦
生物試料分析 46 ( 3 ) 115 - 121 2023.6
Publishing type：Research paper (other academic)
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Analysis of the genus <i>Malassezia</i> isolated in our hospital Reviewed
YANAGI Masaki, YAMADA Akiteru, HASHIKURA Yuki, IZAKI Misaki, KAWAKAMI Megumi, MEGUMI Ryoya, UMEKITA Kunihiko
Japanese Journal of Medical Technology 72 ( 2 ) 191 - 196 2023.4
Authorship：Last author, Corresponding author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japanese Association of Medical Technologists
<i>Malassezia</i> is a yeast-like fungus that is endemic to human and animal skin. It can be pathogenic bacteria for various diseases such as tinea versicolor, <i>Malassezia</i> folliculitis, seborrheic dermatitis, atopic dermatitis, and others. <i>Malassezia</i> is a lipid-requiring fungus and difficult to isolate by conventional culture methods. The morphological and biochemical findings of <i>Malassezia</i> spp. are similar, making it very difficult to identify the species on the basis of phenotype alone. Therefore, molecular biological methods to identify fungi at the species level are used, but few laboratories are available. Recently, selective culture media have been developed, allowing for easy cultivation. However, there are only a few studies on the analysis of the isolation of <i>Malassezia</i> in detail. In this study, we analyzed the frequency of isolation, identification of fungi at the species level by molecular biological methods, and detection of fungi in various types of the sample using a selective culture medium. The results showed a ninefold increase in the separation frequency when using the selective medium compared with cultivation in the olive oil-stratified medium. <i>Malassezia</i> spp. were detected in five types of sample: otorrhea (20/43), skin (10/43), nasal swabs (9/43), sputum (3/43), and eye discharge (1/43) using 43 clinical isolates and preserved strains. All the <i>Malassezia</i> spp. detected were identified at the species level using molecular biological techniques. These results indicate that the selective medium increases the frequency of fungal isolation and, when combined with molecular biological techniques, identifies the species. In the future, it will be necessary to further improve the culture method and establish a simple and rapid identification method using a mass spectrometer.
DOI： 10.14932/jamt.22-79
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骨髄標本のスマッジ細胞集簇像が診断の契機となった血管内大細胞型B細胞リンパ腫 Reviewed
河野克海、橋倉悠輝、髙木覚、松浦成美、長安真由美、久冨木庸子、梅北邦彦.
医学検査 71 ( 3 ) 574 - 580 2022.7
Publishing type：Case report
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特集 ウイルス性皮膚疾患アップデート 臨床例 全身性強皮症と関節リウマチで治療中の患者に生じた尖圭コンジローマ,bowenoid papulosisの合併例 Reviewed
西元 順子, 成田 幸代, 梅北 邦彦, 天野 正宏
皮膚病診療 44 ( 4 ) 334 - 337 2022.4
Language：Japanese Publishing type：Case report Publisher：協和企画
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全身性強皮症と関節リウマチで治療中の患者に生じた尖圭コンジローマ，bowenoid papulosisの合併例 Reviewed
西元順子、 成田幸代、梅北邦彦、天野 正宏
皮膚病診療 44 ( 4 ) 334 - 337 2022.4
Publishing type：Case report
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宮崎県内で初めて人工呼吸器管理を要した重症新型コロナウイルス感染症. Reviewed
工藤理紗, 高城一郎, 力武雄輝, 岩尾浩昭, 力武真央, 相澤彩子, 仮屋裕美, 川口剛, 松田基弘, 宮内俊一, 梅北邦彦, 高城佳人子, 川名遼, 森定淳, 松元信弘, 谷口正彦, 落合秀信, 岡山昭彦.
宮崎県医師会医学会誌 45 ( 1 ) 44 - 49 2021.3
Publishing type：Research paper (scientific journal)
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TNF阻害療法経過中に肺 Mycobacterium avium complex 感染症を発症したHTLV-1陽性関節リウマチ患者への生物学的製剤治療経験. Reviewed
木村賢俊, 梅北邦彦, 工藤理紗, 岩尾千紘, 力武雄幹, 力武真央, 岩尾浩昭, 相澤彩子, 川口剛, 仮屋裕美, 松田基弘, 宮内俊一, 高城佳人子, 高城一郎, 岡山昭彦.
九州リウマチ 40 ( 1 ) 34 - 40 2020.3
Language：Japanese Publishing type：Research paper (scientific journal)
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HTLV-1 Infection and Rheumatic Diseases
Umekita K., Okayama A.
Frontiers in Microbiology 11 152 2020.2
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Frontiers in Microbiology
Some major research and clinical questions about human T-cell leukemia virus type 1 (HTLV-1) infection and rheumatic diseases remain: (1) Does HTLV-1 infection cause rheumatic diseases? (2) Do patients with rheumatic diseases display different responses to treatment with anti-rheumatic agents when they are HTLV-1 carriers? (3) Is adult T-cell leukemia/lymphoma (ATL) or HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) more prevalent in HTLV-1 carriers with rheumatic diseases who are treated with anti-rheumatic agents? These questions are important because increasing numbers of patients with rheumatic diseases are currently receiving treatment with aggressive medicines such as immunosuppressants and biologics. Studies on HTLV-1 gene-transgenic mice have shown manifestations resembling rheumatic diseases. Epidemiological studies have shown a high incidence of HTLV-1 infection in patients with rheumatic diseases including rheumatoid arthritis (RA), Sjogren’s syndrome, and polymyositis. HTLV-1-positive and HTLV-1-negative patients with RA have displayed similar immunological features including the seroprevalence of anti-citrullinated peptide antibodies. Conversely, attenuated effectiveness of tumor necrosis factor inhibitors for HTLV-1-positive patients with RA in Japan has been reported. Therefore, although no direct evidence has shown that HTLV-1 infection alone causes rheumatic diseases, HTLV-1 may affect the inflammation of RA. Although the incidence of ATL or HAM/TSP among patients with rheumatic diseases has not been investigated in large-scale studies, ATL or HAM/TSP has developed among HTLV-1-positive patients with rheumatic diseases. HTLV-1 infection may affect the clinical course of patients with rheumatic diseases, particularly after receiving anti-rheumatic agents. Because studies on these issues are limited, further investigation with large sample sizes is necessary.
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抗HTLV-1抗体陽性関節リウマチにおける非TNF阻害薬の臨床効果と安全性
遠藤 友志郎, 中村 英樹, 梅北 邦彦, 岡田 覚丈, 藤川 敬太, 荒牧 俊幸, 松岡 直樹, 植木 幸孝, 日高 利彦, 川上 純
日本内科学会雑誌 109 ( Suppl. ) 254 - 254 2020.2
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(一社)日本内科学会
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Umekita K., Miyauchi S., Nomura H., Umeki K., Okayama A.
Clinical and experimental rheumatology 37 ( 5 ) 834 - 841 2019.9
Language：English Publishing type：Research paper (scientific journal) Publisher：Clinical and experimental rheumatology
OBJECTIVES: Damage-associated molecular patterns (DAMPs) are proposed to drive aberrant stimulation of Toll-like receptors (TLRs) in rheumatoid arthritis (RA) inflamed joints. In the current study we investigated the role of the neutrophil-derived lactoferrin (LTF), as an endogenous ligand for TLR4 in the inflammatory response of RA synovial fibroblasts (RASFs). METHODS: RASFs were stimulated with LTF, and the expressions of inflammatory cytokines in RASFs were measured. To clarify the TLR4 signalling pathway associated with LTF stimulation, a small molecular inhibitor of TLR4 (TAK242) and NF-κB inhibitor were used. The role of nuclear factor of activated T cells 5 (NFAT5) was identified using small interfering RNA. To reveal the interaction between NF-κB and NFAT5, cerulenin, which disrupts their interaction, was used. RESULTS: Stimulation of RASFs with LTF significantly increased the expressions of inflammatory cytokines and chemokines, such as IL-6, CCL20 and IL-8, in RASFs. LTF enhanced the mRNA expressions of these cytokines in RASFs stimulated by TNF-α. TAK242 almost completely inhibited the expressions of inflammatory cytokines and chemokines in RASFs stimulated by LTF. The NF-κB inhibitor partially repressed the expressions of IL-6 and IL-8 mRNAs induced by LTF, but not CCL20 mRNA expression. On the other hand, NFAT5 silencing decreased the expressions of CCL20 and IL-8 mRNAs induced by LTF, but not IL-6 mRNA expression. Cerulenin repressed the expressions of IL-6, CCL20 and IL-8 in RASFs stimulated by LTF. CONCLUSIONS: Neutrophil-derived LTF may play a role as an endogenous ligand for TLR4 expressed on RASFs. NFAT5-NF-κB enhanceosome might regulate the expressions of LTF-TLR4-responsive genes in RASFs.
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Peliosis Hepatis Due to Corticosteroid in Systemic Lupus Erythematosus Reviewed
Kimura Masatoshi, Aizawa Ayako, Miyauchi Shunichi, Hasuike Satoru, Umekita Kunihiko
Internal Medicine 58 ( 11 ) 1663 - 1664 2019.6
Language：English Publishing type：Research paper (scientific journal) Publisher：一般社団法人 日本内科学会
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Insight of diagnostic performance using B-cell epitope antigens derived from triple P44-related proteins of Anaplasma phagocytophilum Reviewed
Su H., Ito K., Kawarasaki Y., Morita H., Nose H., Ikeda K., Nakadouzono F., Gokuden M., Kamiyama S., Tokaji A., Rikitake Y., Kawaguchi T., Umekita K., Oishi S., Abe F., Kanda T., Kawabata H., Ando S., Ohashi N.
Diagnostic Microbiology and Infectious Disease 95 ( 2 ) 125 - 130 2019.5
Language：English Publishing type：Research paper (scientific journal) Publisher：Diagnostic Microbiology and Infectious Disease
© 2019 Elsevier Inc. Human granulocytic anaplasmosis (HGA) is caused by Anaplasma phagocytophilum. Indirect immunofluorescence assay (IFA) is generally used for HGA serodiagnosis. A. phagocytophilum immunodominant P44 major outer membrane proteins are encoded by p44/msp2 multigene family, responsible for IFA reactivity. However, because multiple P44-related proteins may involve immunoreactivity in IFA, the available diagnostic antigens remain obscure. In this study, we identified 12 B-cell epitopes on triple P44-related proteins using peptide array that reacted with 4 HGA patients' sera. Then, peptide spot immunoassay using 14 synthetic peptides derived from those 12 epitopes as antigens was applied for the detection of antibody to A. phagocytophilum from patients with fever of unknown origin. The sensitivities and diagnostic efficiencies of this immunoassay were higher than those of Western blot analysis using 3 recombinant proteins previously developed. Thus, the immunoassay using our epitope-derived antigens, which has higher diagnostic performances, may have significant benefit for HGA serodiagnosis.
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Diversity of cell phenotypes among MT-2 cell lines affects the growth of U937 cells and cytokine production. Reviewed
Nomura H, Umekita K, Hashikura Y, Umeki K, Yamamoto I, Aratake Y, Saito M, Hasegawa H, Yanagihara K, Okayama A
Human cell 32 ( 2 ) 185 - 192 2019.4
Language：English Publishing type：Research paper (scientific journal)
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IgG4関連涙腺・唾液腺炎に認められた回腸末端部の隆起性病変. Reviewed
岩尾浩昭, 梅北邦彦, 岩尾千紘, 力武雄幹, 力武真央, 相澤彩子, 川口剛, 松田基弘, 宮内俊一, 高城一郎, 長安真由美, 秋山裕, 片岡寛章, 前川和也, 浅田祐士郎, 岡山昭彦.
九州リウマチ 39 ( 1 ) 40 - 48 2019.3
Language：Japanese Publishing type：Research paper (scientific journal)
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Yamada A, Umeki K, Saeki Y, Hashikura Y, Nomura H, Yamamoto I, Umekita K, Takajo I, Koshimoto C, Okayama A.
Journal of Microbiological Methods 155 42 - 48 2018.12
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Microbiological Methods
© 2018 Elsevier B.V. Although isolation and identification of bacteria in a clinical specimen constitute essential steps for the diagnosis of bacterial infection, positive results of the bacterial culture are not always attained, despite observing the bacteria by Gram staining. As bacteria phagocytosed by the leukocytes are considered as the causative agents of infectious diseases, this study aims to introduce a new approach for the collection of only bacteria phagocytosed by the neutrophils in an animal model using laser capture microdissection (LCM) followed by the DNA identification using polymerase chain reaction (PCR). We inoculated representative bacteria (Escherichia coli and Staphylococcus aureus) into the abdominal cavities of specific pathogen-free C57BL/6 J mice. After 6 h inoculation, we collected the fluid samples from the peritoneal cavities of mice and demonstrated peritonitis by the increase of neutrophils. Then, we smeared the neutrophils on the membrane slides and collected single-cell phagocytosing bacteria by LCM. The supernatant of the cell lysate was supplied for the PCR reaction to amplify the 16S rRNA gene, and we validated the DNA sequences specific for the inoculated bacteria. In addition, PCR using specific primers for E. coli and S. aureus identified each species of bacteria. Hence, this study suggests that the combination of LCM and PCR could be a novel approach to determine bacteria in infectious diseases. Nevertheless, further investigation is warranted to test various additional bacterial taxa to demonstrate the general applicability of this method to clinical samples.
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Takajo, I., Yamada, A., Umeki, K., Saeki, Y., Hashikura, Y., Yamamoto, I., Umekita, K., Urayama-Kawano, M., Yamasaki, S., Taniguchi, T., Misawa, N., Okayama, A.
Journal of Microbiological Methods 144 22 - 28 2018.10
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Microbiological Methods
© 2017 Elsevier B.V. Vibrio furnissii and V. fluvialis are closely related, the discrimination of which by conventional biochemical assay remains a challenge. Investigation of the sequence of the 16S rRNA genes in a clinical isolate of V. furnissii by visual inspection of a sequencing electropherogram revealed two sites of single-nucleotide polymorphisms (SNPs; positions 460 A/G and 1261 A/G) in these genes. A test of 12 strains each of V. fluvialis and V. furnissii revealed these SNPs to be common in V. furnissii but not in V. fluvialis. Divergence of SNP frequency was observed among the strains of V. furnissii tested. Because the SNPs described in V. furnissii produce a difference in the target sequence of restriction enzymes, a combination of polymerase chain reaction (PCR) of the 16S rRNA genes using conventional primers and restriction fragment length polymorphism analysis using Eco RV and Eae I was shown to discriminate between V. fluvialis and V. furnissii. This method is simple and alleviates the need for expensive equipment or primer sets specific to these bacteria. Therefore, we believe that this method can be useful, alongside specific PCR and mass spectrometry, when there is a need to discriminate between V. fluvialis and V. furnissii.
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Infliximab as an alternative therapy for refractory adult onset Kawasaki disease A case report Reviewed
Kawaguchi T., Rikitake Y., Tsuruda T., Kawata C., Rikitake M., Iwao K., Aizawa A., Kariya Y., Matsuda M., Miyauchi S., Umekita K., Takajo I., Okayama A.
Medicine (United States) 97 ( 40 ) e12720 - e12720 2018.10
Language：English Publishing type：Research paper (scientific journal) Publisher：Medicine (United States)
Copyright © 2018 the Author(s). Rationale: Kawasaki disease (KD) is an acute febrile illness predominantly affecting children less than 5 years of age and characterized by systemic inflammation in all medium-sized arteries. Adult-onset KD (AKD) is rare with only 105 case reports published. Recently, the efficacy of infliximab (IFX) for patients with refractory KD has been demonstrated. Patient concerns: A previously healthy 24-year-old man was admitted because of a persistent fever, and elevated serum level of AST, ALT, LDH, and CRP. Diagnosis: The patients met the diagnostic criteria for KD based on the findings of persistent fever, polymorphous exanthema, unilateral cervical lymphadenopathy, non-purulent palpebral conjunctivitis and membranous desquamation. Echocardiogram revealed the dilatation at the proximal sites of the right coronary artery (7.9 mm) and left anterior descending artery (5 mm). The patient was treated with high-dose intravenous immunoglobulin (1 g/kg/day for 2 days) and ASA (100 mg daily). However, his fever and arthralgia persisted. Interventions: He was administered single 5 mg/kg doses of IFX. Outcomes: He became afebrile the next day and his arthralgia improved. Lessons: We report the first case of administration of IFX in a patient with AKD refractory to intravenous immunoglobulin (IVIG), and successful reduction of systemic inflammation. However, the effectiveness of IFX in the regression of coronary artery aneurysm remains to be determined.
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多発脳梗塞を来した治療抵抗性巨細胞性動脈炎の1例. Reviewed
力武真央, 梅北邦彦, 楠元規生, 岩尾浩昭, 相澤彩子, 松田基弘, 久保和義, 仮屋裕美, 宮内俊一, 高城一郎, 長友安弘, 岡山昭彦.
九州リウマチ. 37 ( 2 ) 125 - 131 2017.9
Language：Japanese Publishing type：Research paper (scientific journal)
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Infection of defective human T-lymphotropic virus type 1 Reviewed
Hashikura Y., Umeki K., Umekita K., Nomura H., Yamada A., Yamamoto I., Hasegawa H., Yanagihara K., Okayama A.
Human Cell 30 ( 2 ) 117 - 123 2017.4
Language：English Publishing type：Research paper (scientific journal) Publisher：Human Cell
© 2017, Japan Human Cell Society and Springer Japan. In a previous study, we reported that an identical defective provirus had integrated into multiple sites of the genome of a representative human T-lymphotropic virus type 1 (HTLV-1) cell line, MT-2. A possible explanation for this may be the repeated infection of this defective provirus to a cell. Therefore, we attempted to determine whether a defective provirus could transmit during the co-culture of HTLV-1 uninfected human T-cell line, Jurkat, with MT-2 cells treated with mitomycin C. As a result, we established not only a cell line with the integration of one complete provirus, but also a cell line with the integration of one defective provirus. The rearrangement of the T-cell receptor -γ gene of these cell lines showed them to be derived from Jurkat cells. Both HTLV-1 Tax/Rex and HBZ RNA were detected in the cell line, which harbors a complete provirus. On the other hand, HBZ RNA and transcriptional product specific for the defective provirus were detected in the cell line, which harbors a defective HTLV-1 provirus only. These results suggested that a defective HTLV-1 provirus with large depletion of internal sequence could transmit to other cells. Moreover, the defective provirus can be transcriptionally active. This suggested the possibility that the defective HTLV-1 provirus found in the lymphocytes of HTLV-1 carriers and patients with adult T-cell leukemia may transmit to other T-cells in vivo. The results also suggested that defective provirus in HTLV-1 carriers could be functional and may play a role in leukemogenesis.
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関節リウマチ治療中に発症したウエステルマン肺吸虫症.
小村真央, 宮内俊一, 岩尾浩昭, 河野彩子, 松田基弘, 久保和義, 梅北邦彦, 高城一郎, 長友安弘, 岡山昭彦, 丸山治彦.
宮崎県内科医会誌. ( 91 ) 11 - 15 2017.3
Language：Japanese Publishing type：Research paper (scientific journal)
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筋ジストロフィーとの鑑別を要し、経口ステロイドおよびタクロリムス併用療法が奏功した抗SRP抗体陽性ミオパチーの2例. Reviewed
河野彩子, 梅北邦彦, 小村真央, 岩尾浩昭, 松田基弘, 久保和義, 宮内俊一, 高城一郎, 長友安弘, 塩見一剛, 西野一三, 岡山昭彦.
九州リウマチ. 37 ( 1 ) 72 - 79 2017.3
Language：Japanese Publishing type：Research paper (scientific journal)
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Kato H., Yamagishi T., Shimada T., Matsui T., Shimojima M., Saijo M., Oishi K., Abe M., Wada M., Umekita K., Kamekou M., Tanioka D., Sanada I., Kuwai T., Tanaka Y., Shigetou K., Homma Y., Yamamoto C., Yamauchi M., Hayashi S., Watanabe S., Kitao A., Takatsu H., Nakanishi Y., Koguro K., Watanabe M., Uehara N., Kaneko M., Yamanaka A., Murakami Y., Konishi T., Sakamoto A., Harada M., Yamamoto K., Hayashi T., Kondo N., Suemori K., Ogawa T., Nakazawa R., Yamamoto Y., Miyahara M., Senba T., Maruhashi T., Fukushi S., Tani H., Yoshikawa T., Morikawa S.
PLoS ONE 11 ( 10 ) 2016.10
Language：English Publishing type：Research paper (scientific journal) Publisher：PLoS ONE
© 2016 Kato et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Although severe fever with thrombocytopenia syndrome (SFTS) was first reported from Japan in 2013, the precise clinical features and the risk factors for SFTS have not been fully investigated in Japan. Ninety-six cases of severe fever with thrombocytopenia syndrome (SFTS) were notified through the national surveillance system between April 2013 and September 2014 in Japan. All cases were from western Japan, and 82 cases (85%) had an onset between April and August. A retrospective observational study of the notified SFTS cases was conducted to identify the clinical features and laboratory findings during the same period. Of 96 notified cases, 49 (51%) were included in this study. Most case-patients were of advanced age (median age 78 years) and were retired or unemployed, or farmers. These case-patients had a history of outdoor activity within 2 weeks before the onset of illness. The median serum C-reactive protein concentration was slightly elevated at admission. Fungal infections such as invasive aspergilosis were found in 10% of these casepatients. Hemophagocytosis was observed in 15 of the 18 case-patients (83%) whose bone marrow samples were available. Fifteen cases were fatal, giving a case-fatality proportion of 31%. The proportion of neurological abnormalities and serum concentrations of lactate dehydrogenase and aspartate aminotransferase were significantly higher in the fatal cases than in the nonfatal cases during hospitalization. Appearance of neurological abnormality may be useful for predicting the prognosis in SFTS patients.
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Kawaguchi T, Matsuda M, Takajo I, Kawano A, Kariya Y, Kubo K, Miyauchi S, Umekita K, Nagatomo Y, Yano T, Yano K, Okayama A.
Journal of Infection and Chemotherapy. 22 ( 9 ) 633 - 637 2016.9
Language：English Publishing type：Research paper (scientific journal) Publisher：Elsevier.
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The diversity of the structure and genomic integration sites of HTLV-1 provirus in MT-2 cell lines Reviewed
Hashikura Y., Umeki K., Umekita K., Nomura H., Yamamoto I., Hasegawa H., Yanagihara K., Okayama A.
Human Cell 29 ( 3 ) 122 - 129 2016.7
Language：English Publishing type：Research paper (scientific journal) Publisher：Human Cell
© 2016, Japan Human Cell Society and Springer Japan. A human T-lymphotropic virus Type 1 (HTLV-1) positive cell line, MT-2, derived from human cord leukocytes co-culturing with adult T cell leukemia/lymphoma (ATL) cells is commonly used in HTLV-1 research; however, the details of provirus integrated in MT-2 genome have not yet been characterized. In this study, five types of HTLV-1 proviral sequences were detected in 11 different sites of the genome in a reference MT-2 cell line. The five types of HTLV-1 proviral sequences were one complete proviral genome, two types of proviruses with deletion of large internal viral sequences (5.3 and 3.9 kB), one provirus with a large deletion (6.2 kB) from 5′LTR to position 6257, and one provirus of LTR only. The provirus with identical deletion of large internal viral sequence (5.3 kB) was found to be integrated into six different sites (chromosomes). A complete provirus and three of four types of defective provirus were consistently detected in two other MT-2 cell lines cultured in different laboratories. Not only Tax/Rex RNA and HBZ RNA, but also the transcriptional product for a specific defective provirus, were detectable in all three MT-2 cell lines. Because it has been reported that defective provirus is frequently detected in ATL cells, these results may be important in understanding the mechanism of HTLV-1 proviral polymorphism, which may be related to leukemogenesis. In addition, the large variation in integrated HTLV-1 proviruses makes it important for researchers to exercise caution in their assessment and interpretation of results using MT-2 cell lines.
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Possible case of novel spotted fever group rickettsiosis in traveler returning to Japan from India Reviewed
Takajo I., Sekizuka T., Fujita H., Kawano A., Kawaguchi T., Matsuda M., Kubo K., Miyauchi S., Umekita K., Nagatomo Y., Kuroda M., Takasaki T., Okayama A., Ando S.
Emerging Infectious Diseases 22 ( 6 ) 1079 - 1082 2016.6
Language：English Publishing type：Research paper (scientific journal) Publisher：Emerging Infectious Diseases
© 2016, Centers for Disease Control and Prevention (CDC). All rights reserved. A 60-year-old woman experienced fever, headache, rash, and altered vision after returning to Japan from India. Testing detected elevated antibody titers to spotted fever group rickettsia; PCR on blood yielded positive results for the rickettsial outer membrane protein A gene. We isolated a unique rickettsial agent and performed a full-genome analysis.
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Umekita K., Umeki K., Miyauchi S., Ueno S., Kubo K., Kusumoto N., Takajo I., Nagatomo Y., Okayama A.
Modern Rheumatology 25 ( 5 ) 784 - 797 2015.9
Language：English Publishing type：Research paper (scientific journal) Publisher：Modern Rheumatology
© 2013 Japan College of Rheumatology. Anti-tumor necrosis factor (anti-TNF) biologics are effective in the treatment of rheumatoid arthritis (RA); however, it is still not clear whether this treatment promotes the development of malignancies such as lymphoma. Human T-lymphotropic virus type 1 (HTLV-1), which is a causative agent of adult T-cell lymphoma (ATL), is prevalent in Japan. Many HTLV-1-positive patients with RA are assumed to exist; however, there have thus far been no reports on the effect of anti-TNF biologics on HTLV-1-positive patients. We analyzed the response to treatment with anti-TNF biologics and change of HTLV-1 markers in two cases of RA. The two cases showed no response based on the European League Against of Rheumatism response criteria 60-96 weeks after administration of anti-TNF biologics (infliximab and etanercept). No signs of ATL were observed and HTLV-1 markers, such as proviral load and clonality of HTLV-1-infected cells, showed no significant change in either of two cases. Therefore, treatment with anti-TNF biologics did not induce activation of HTLV-1, although the effect on RA was not as effective as in HTLV-1-negative patients in this limited study. Further long-term study with a greater number of patients is necessary to clarify the safety and efficacy of anti-TNF biologics in HTLV-1-positive patients with RA.
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P38-4 炎症性肺疾患におけるマイクロパーティクル発現に関する検討(内科症例8,Posterセッション38,第38回日本呼吸器内視鏡学会学術集会) Reviewed
長友 安弘, 宮内 俊一, 楠元 規生, 梅北 邦彦, 岡山 昭彦
気管支学 37 ( 0 ) 2015
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：特定非営利活動法人 日本呼吸器内視鏡学会
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Miyauchi S., Umekita K., Hidaka T., Umeki K., Aratake Y., Takahashi N., Sawaguchi A., Nakatake A., Morinaga I., Morishita K., Okayama A.
Rheumatology (United Kingdom) 53 ( 11 ) 1966 - 1972 2014.7
Language：English Publishing type：Research paper (scientific journal) Publisher：Rheumatology (United Kingdom)
© The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. Objective. The aim of this study was to clarify the mechanism of leucocytapheresis (LCAP) in patients with RA. Methods. Protein profiles of blood samples from two patients with RA obtained via LCAP column inlet and outlet lines were analysed by two-dimensional fluorescence difference gel electrophoresis and mass spectrometry. The lactoferrin (LTF) levels of peripheral and circulating blood samples from seven patients obtained via the LCAP column blood circuit were then determined by ELISA. Peripheral blood samples from 14 patients with RA were exposed to unwoven polyester fibre filters and the LTF level was determined. In addition, morphological changes in neutrophils after exposure to the filter were examined by optical microscopy, electronic microscopy and LTF immunostaining. Results. LTF levels were increased in both samples from the LCAP column outlet and peripheral blood at the end of LCAP treatment. Furthermore, peripheral blood samples exposed to the filter revealed a decreased number of neutrophils and an increased level of LTF. Morphological analysis of the exposed neutrophils showed vacuolization of the cytoplasm and degranulation of LTF-positive granules. These data suggest that LTF stored in the granules of neutrophils is released from the neutrophils caught in the LCAP column. Conclusion. Because LTF has been reported to have multiple anti-inflammatory properties, increased levels of LTF may contribute to the clinical effect of LCAP in patients with RA.
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Umekita K., Hidaka T., Miyauchi S., Ueno S., Kubo K., Takajo I., Hashiba Y., Kai Y., Nagatomo Y., Okayama A.
Arthritis Care and Research 66 ( 5 ) 788 - 792 2014.5
Language：English Publishing type：Research paper (scientific journal) Publisher：Arthritis Care and Research
Objective To investigate the response to and safety of anti-tumor necrosis factor (anti-TNF) therapy in human T lymphotropic virus type I (HTLV-I)-positive patients with rheumatoid arthritis (RA). Methods Therapeutic response was evaluated in 10 HTLV-I-positive and 20 HTLV-I-negative patients with RA (sex and age matched) at 3 months after the beginning of anti-TNF therapy using the European League Against Rheumatism improvement criteria. As secondary end points, the discontinuation rate of anti-TNF therapy and its safety, especially the development of adult T cell leukemia (ATL), were evaluated over a 2-year period. Results Significantly higher baseline levels of C-reactive protein (CRP) were observed in HTLV-I-positive patients than in HTLV-I-negative patients (P = 0.0003). The response rate to anti-TNF therapy was lower in HTLV-I-positive patients than in HTLV-I-negative patients. The median CRP level, erythrocyte sedimentation rate, and Disease Activity Score in 28 joints at 3 months after anti-TNF treatment in HTLV-I-positive patients were significantly higher than in HTLV-I-negative patients (P = 0.003, P = 0.03, and P = 0.003, respectively). The discontinuation rate due to insufficient response was significantly higher in HTLV-I-positive patients than in HTLV-I-negative patients (P = 0.013). During the 2-year observation period, no patients developed ATL. Conclusion These data suggest that HTLV-I-positive patients with RA had higher inflammation and greater resistance to anti-TNF treatment than HTLV-I-negative patients. Further study is necessary to determine whether HTLV-I infection should be measured when anti-TNF agents are administered to patients with RA, especially in areas were HTLV-I is endemic. © 2014, American College of Rheumatology.
DOI： 10.1002/acr.22205
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宮崎県における関節リウマチに対する生物学的製剤の使用実態調査～第2報～. Reviewed
濱田浩朗, 梅北邦彦, 岡山昭彦, 日高利彦, 甲斐睦章, 上田章, 税所幸一郎, 村井幸一,大平卓, 松山幹太郎, 金井一男, 坂田師通, 佐々木隆, 岡本将幸, 安藤徹, 秋元正樹, 首藤敏秀, 三股恒夫, 田中弦一, 松本英裕, 吉永一春, 谷口博信, 福田健二, 川野啓一郎, 木屋博昭, 市原正彬, 谷畠満, 佐保修二, 宮本義明, 帖佐悦男.
宮崎県医師会医学会誌. 38 ( 1 ) 26 - 33 2014.3
Language：Japanese Publishing type：Research paper (scientific journal)
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関節リウマチ診療における超音波検査の注意点 Reviewed
濱田浩朗, 帖佐悦男, 梅北邦彦, 岡山昭彦
九州リウマチ 33 ( 2 ) 64 - 67 2013.9
Language：Japanese Publishing type：Research paper (scientific journal)
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宮崎県における関節リウマチに対する生物学的製剤の使用実態調査（第１報）. Reviewed
梅北邦彦, 濱田浩朗, 岡山昭彦, 日高利彦, 甲斐睦章, 上田章, 税所幸一郎, 村井幸一,大平卓, 松山幹太郎, 坂田師通, 佐々木隆, 岡本将幸, 安藤徹, 秋元正樹, 首藤敏秀, 黒沢治, 田中弦一, 松本英裕, 吉永一春, 谷口博信, 福田健二, 川野啓一郎, 木屋博昭, 市原正彬, 谷畠満, 佐保修二, 宮本義明, 帖佐悦男.
宮崎県医師会医学会誌 36 ( 2 ) 172 - 180 2012.9
Language：Japanese Publishing type：Research paper (scientific journal)
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トシリズマブ投与中の関節リウマチ患者における関節エコーの意義.
鈴木千代子, 尾方美幸, 河野満子, 日高百合子, 梅木一美, 梅北邦彦, 岡山昭彦.
日本臨床化学会九州支部会誌 22 71 - 75 2012.7
Language：Japanese Publishing type：Research paper (scientific journal)
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Arteriosclerosis of whole aorta in Takayasu arteritis Reviewed
Umekita K., Hashiba Y., Kariya-Kaneko Y., Matsuda M., Okayama A.
Journal of Rheumatology 39 ( 6 ) 1291 2012.6
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Rheumatology
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Ueno S., Umeki K., Takajo I., Nagatomo Y., Kusumoto N., Umekita K., Morishita K., Okayama A.
International Journal of Cancer 130 ( 10 ) 2318 - 2326 2012.5
Language：English Publishing type：Research paper (scientific journal) Publisher：International Journal of Cancer
High human T-lymphotropic virus Type 1 (HTLV-1) proviral DNA load (PVL) has been reported to be one risk factor for the development of adult T-cell leukemia/lymphoma (ATL). ATL is also believed to develop in HTLV-1 carriers who acquire infection perinatally. ATL cells have been reported to frequently harbor defective provirus. In our study, PVLs for three different regions of HTLV-1 provirus (5'LTR-gag, gag and pX) were measured in 309 asymptomatic carriers with different infection routes. PVLs for the pX region in 21 asymptomatic carriers with maternal infection was significantly higher than in 24 carriers with spousal infection. Among 161 carriers with relatively high pX PVLs (equal to or greater than 1 copy per 100 peripheral blood mononuclear cells), 26 carriers (16%) had low gag PVL/pX PVL (less than 0.5) and four (2%) had low 5'LTR-gag PVL/pX PVL (less than 0.5). Low gag PVL/pX PVL ratio, which reflects deficiency and/or polymorphism of HTLV-1 proviral DNA sequences for the gag region, was also associated with maternal infection. These data suggest that HTLV-1 carriers with maternal infection tend to have high PVLs, which may be related to provirus with deficiency and/or the polymorphism of proviral DNA sequences. In addition, there is a possibility that this ratio may be used as a tool to differentiate the infection routes of asymptomatic HTLV-1 carriers, which supports the need for a large scale study. © 2011 UICC.
DOI： 10.1002/ijc.26289
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話題 IL-6 阻害薬と感染症のマスキング Reviewed
梅北邦彦. 日高利彦. 岡山昭彦.
臨床と検査 55 ( 11 ) 1367 - 1370 2011.9
Language：Japanese Publishing type：Research paper (scientific journal)
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Umekita K., Miyauchi S., Ueno S., Takajo I., Kusumoto K., Hasuike S., Umekita Y., Tanaka H., Nagata K., Nagatomo Y., Kataoka H., Shimoda K., Okayama A.
Internal Medicine 50 ( 11 ) 1245 - 1249 2011.6
Language：English Publishing type：Research paper (scientific journal) Publisher：Internal Medicine
We report a case of rheumatoid arthritis (RA) with autoimmune hepatitis (AIH) and Sjogren syndrome (SjS) that was treated with the tumor necrosis factor (TNF) inhibitor, etanercept (ETN). Both RA activity and transaminase levels improved as a result of treatment. Follow-up liver biopsy showed improvement of hepatitis. Although the efficacy of anti-TNF for RA patients with AIH remains controversial, this case suggests that treatment with ETN may result in a favorable clinical course in a certain subset of patients with RA and AIH. © 2011 The Japanese Society of Internal Medicine.
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Defective human T-lymphotropic virus type 1 provirus in asymptomatic carriers Reviewed
Takenouchi H., Umeki K., Sasaki D., Yamamoto I., Nomura H., Takajo I., Ueno S., Umekita K., Kamihira S., Morishita K., Okayama A.
International Journal of Cancer 128 ( 6 ) 1335 - 1343 2011.3
Language：English Publishing type：Research paper (scientific journal) Publisher：International Journal of Cancer
Few studies have specifically examined defective provirus in asymptomatic human T-lymphotropic virus Type 1 (HTLV-1) carriers and its relation to proviral DNA loads (PVLs). To assess the significance of defective provirus in asymptomatic carriers, we examined PVLs in peripheral blood mononuclear cells of 208 asymptomatic HTLV-1 carriers. The mean PVLs determined using primers for the pol region were less than that for the pX region in these carriers. Analysis of seven carriers with high PVLs for the pX region but lower PVLs for the pol region showed that four had single nucleotide polymorphisms of proviral genomes for the pol region and three had HTLV-1-infected cells with defective provirus. Three carriers with defective provirus showed high PVLs at their initial screens, and PVLs increased after a 10- to 12-year interval in two carriers. Southern blot assay showed clonal expansion of HTLV-1-infected cells, and the predominant clones changed during the observation period. These data suggest that although HTLV-1-infected cells with defective provirus may have a growth advantage, the predominant clones of HTLV-1-infected cells do not always survive for many years in asymptomatic carriers. Copyright © 2010 UICC.
DOI： 10.1002/ijc.25450
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A case of intubation granuloma treated with steroid inhalation Reviewed
MIYAUCHI Shun-ichi, NAGATOMO Yasuhiro, KUBO Kazuyoshi, UMEKITA Kunihiko, UENO Shirou, TAKAJOU Ichirou, KAI Yasufumi, OKAYAMA Akihiko
48 ( 7 ) 488 - 491 2010.7
Language：English Publishing type：Research paper (scientific journal)
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A case of intubation granuloma treated with steroid inhalation Reviewed
Miyauchi S., Nagatomo Y., Kubo K., Umekita K., Ueno S., Takajou I., Kai Y., Okayama A.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society 48 ( 7 ) 488 - 491 2010.7
Language：English Publishing type：Research paper (scientific journal) Publisher：Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society
A 36-year-old woman was given a diagnosis of hemophagocytic syndrome associated with systemic lupus erythematosus, and was treated with high-dose methylprednisolone and etoposide. She needed endotracheal intubation for mechanical ventilation because of respiratory failure. She developed hoarseness and stridor 69 days after extubation. A pedunculated mass under her glottis was observed by the laryngoscopy. Development of a laryngeal granuloma due to long-term contact with the endotracheal tube was considered, although she was continuously given oral prednisolone (22.5 mg/day) even after extubation. She was treated with inhalation of fluticasone propionate and her symptoms, e.g. hoarseness, decreased. Disappearance of the polypoid lesion was seen on day 26. A laryngeal granuloma due to intubation developed, even with the systemic administration of steroids; but it was successfully treated with steroid inhalation.
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Overwhelming Postsplenectomy Infection 22 Years After Splenectomy Reviewed
KUSUMOTO Norio, KUROKI Masayuki, UMEKITA Kunihiko, UENO Shiro, TAKAJO Ichiro, KAI Yasufumi, NAGATOMO Yasuhiro, SHIMADA Masami, HIDAKA Tomonori, KUBO Kazuyoshi, MIYAUCHI Syunnichi, OKAYAMA Akihiko
Kansenshogaku Zasshi 83 ( 3 ) 261 - 265 2009.5
Language：English Publishing type：Research paper (scientific journal) Publisher：The Japanese Association for Infectious Diseases
A 25-year-old man undergoing splenectomy at 3 years of age to treat idiopathic thrombocytopenic purpura but no history of <i>Streptococcus pneumonia</i> vaccination, and reporting high fever, nausea, and headache developed purpura, confusion, and hypotension the next day and was admitted. Detailed examination showed disseminated intravascular coagulation and multiple-organ dysfunction. Chest X-ray and computed tomography (CT) showed pneumonia and pleural effusion. Blood culture was positive for <i>S. pneumoniae</i>. Gram staining of sputa yielded numerous white blood cells and gram-negative rods, and sputa culture was positive for <i>Pasteurella multocida</i> and <i>Haemophilus influenzae</i>. The medical history and presence of these organisms yielded a diagnosis of overwhelming postsplenectomy infection (OPSI), and the patient responded to treatment with a combination of benzylpenicillin, cefotaxime, and meropenem. This case suggests that patients with a history of splenectomy may benefit from vaccination for <i>S. pneumoniae</i> and adequate education on OPSI.
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KUSUMOTO Norio, KAI Yasufumi, KUBO Kazuyoshi, MIYAUCHI Syunnichi, UMEKITA Kunihiko, UENO Shiro, TAKAJO Ichiro, NAGATOMO Yasuhiro, OKAYAMA Akihiko, KAMEDA Takuro, SHIMODA Kazuya
Nihon Naika Gakkai Zasshi 98 ( 4 ) 859 - 861 2009.4
Language：English Publishing type：Research paper (scientific journal) Publisher：The Japanese Society of Internal Medicine
DOI： 10.2169/naika.98.859
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Umekita K., Hidaka T., Ueno S., Takajo I., Kai Y., Nagatomo Y., Sawaguchi A., Suganuma T., Okayama A.
Modern Rheumatology 19 ( 3 ) 265 - 272 2009.4
Language：English Publishing type：Research paper (scientific journal) Publisher：Modern Rheumatology
Microparticles (MPs) are believed to play an important role in inflammatory diseases such as rheumatoid arthritis (RA). Leukocytapheresis (LCAP) is one of the options available for the treatment of RA. We analyzed the levels of MPs in RA, by flow cytometry, especially in relation to the effect of LCAP. Twenty female patients with RA were recruited into this study. Six of the 20 patients with RA further received LCAP. Plasma levels of platelet-derived MPs were high in patients with RA and are correlated with disease activity. LCAP significantly improved RA in all six patients. The numbers of platelet-derived MPs significantly decreased after the first session of LCAP, which was probably due to direct removal by LCAP. Mean numbers of platelet-derived MPs after four sessions of LCAP markedly decreased. The numbers of granulocyte-derived MPs, which are suggested to have an anti-inflammatory effect, were markedly increased after the first session of LCAP. These data suggest that removal of platelet-derived MPs and increase of granulocyte-derived MPs are novel mechanisms of LCAP as effective treatment in RA. © Japan College of Rheumatology 2009.
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UENO Shiro, MIYAUCHI Shunichi, UMEKITA Kunihiko, KUSUMOTO Norio, TAKAJO Ichiro, KUROKI Masayuki, KAI Yasufumi, NAGATOMO Yasuhiro, OKAYAMA Akihiko
82 ( 6 ) 644 - 649 2008.11
Language：English Publishing type：Research paper (scientific journal)
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UENO Shiro, MIYAUCHI Shunichi, UMEKITA Kunihiko, KUSUMOTO Norio, TAKAJO Ichiro, KUROKI Masayuki, KAI Yasufumi, NAGATOMO Yasuhiro, OKAYAMA Akihiko
Kansenshogaku Zasshi 82 ( 6 ) 644 - 649 2008.11
Language：English Publishing type：Research paper (scientific journal) Publisher：The Japanese Association for Infectious Diseases
A 74-year-old woman with hepatitis due to hepatitis C virus followed up using oral predonisolone (3mg/day) for two years because of hypergammaglobulinemia-associated purpura reported fever and lumbago in February 2005. Upon admission in June, she was found in chest-computed tomography to have atelectasia in the right middle lung lobe and a nodule with a cavity in the right lower lobe. She tested positive for tuberculous glycolipid antibody. Gallium scintigraphy showed an abnormal accumulation in the lower lumbar vertebra. Magnetic resonance imaging showed abnormal enhancement at L4, L5, and their intervertebral disc. <I>Mycobacterium intracellulare</I> (<I>M. intracellulare</I>) was detected in blood culture, bronchoalveolar lavage, and a biopsy specimen from the intervertebral disc, yielding a diagnosis of disseminated nontuberculous mycobacteriosis (NTM) due to <I>M. intracellulare</I>. She was treated with clarithromycin (CAM), ethambutol (EB), and rifampicin (RFP), but EB and RFP were discontinued due to of the fever they induced. She was then treated with a combination of CAM, levofloxacin, and streptomycin and followed up as an out patient. Based on case reports of disseminated NTM infection in Japan, the prognosis is poor and a protocol must be established for its treatment.
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12.白血球除去療法(LCAP)が長期間有効であった慢性C型肝炎合併関節リウマチの1例(一般論文,日本アフェレシス学会第14回九州地方会抄録) Reviewed
梅北 邦彦, 荻野 展永, 楠元 規生, 上野 史朗, 高城 一郎, 甲斐 泰文, 黒木 昌幸, 長友 安弘, 岡山 昭彦
日本アフェレシス学会雑誌 27 ( 3 ) 250 - 251 2008
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：日本アフェレシス学会
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Umekita K., Takajo I., Miyauchi S., Tsurumura K., Ueno S., Kusumoto N., Kai Y., Kuroki M., Sasaki T., Okayama A.
Modern Rheumatology 16 ( 4 ) 243 - 247 2006.8
Language：English Publishing type：Research paper (scientific journal) Publisher：Modern Rheumatology
Takayasu's arteritis (TA) is a rare disease that can be difficult to diagnose in its early stage. A young woman with a fever and neck pain was thought to have TA, although computed tomographic angiography did not show any specific changes of the arteries. [18F]fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) was performed to detect the source of the inflammation. Specific accumulation of [18F]FDG-6-phosphate in the thoracic aorta and its direct branches was observed, leading to a diagnosis of TA. [18F]FDG-PET is therefore considered to be useful for the diagnosis of early-stage TA. © Japan College of Rheumatology 2006.