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Affiliation |
Faculty of Medicine College Hospital Banking Inspection Department |
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Title |
Assistant Professor |
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Related SDGs |
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KITAMURA Akiko
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Research Areas 【 display / non-display 】
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Life Science / Respiratory medicine
Papers 【 display / non-display 】
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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 International journal
Takeshi Kawaguchi, Akiko Kitamura, Masatoshi Kimura, Yuki Rikitake, Chihiro Iwao, Kosho Iwao, Makoto Sumiyoshi, Yumi Kariya, Motohiro Matsuda, Kunihiko Umekita, Ichiro Takajo, Sayaka Moriguchi-Goto, Atsushi Yamashita, Kana Matsumoto, Taiga Miyazaki
Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 31 ( 1 ) 102534 - 102534 2025.1
Language：English Publishing type：Research paper (scientific journal)
Treating disseminated cryptococcosis in people with human immunodeficiency virus (HIV) is challenging due to the limited availability of effective antifungals. Although isavuconazole has antifungal activity against Cryptococcus neoformans, clinical evidence is sparse because this new drug has not been approved for the treatment of cryptococcosis in the US or Europe. Here, we report a case of HIV-associated cryptococcal meningitis that relapsed during maintenance therapy with fluconazole. A Japanese man in his 20s was diagnosed with HIV-1 infection and cryptococcal meningitis. The patient was intolerant to flucytosine and was treated with liposomal amphotericin B monotherapy for 2 weeks as induction therapy, followed by fluconazole (400 mg/day) for 3 months as consolidation therapy. Four months after starting maintenance therapy with fluconazole (200 mg/day), the patient presented with fever and cough, leading to readmission to our hospital. Biopsies of a nodule in the left lung and a left cervical lymph node led to the diagnosis of disseminated cryptococcosis (pulmonary cryptococcosis and cryptococcal lymphadenitis). Although a combination of fluconazole and liposomal amphotericin B was ineffective, the patient was successfully treated with an induction therapy combining isavuconazole and liposomal amphotericin B, followed by a maintenance therapy with isavuconazole. The patient received isavuconazole orally except for loading doses, achieving stable blood concentration levels. Moreover, we observed that blood levels of amphotericin B increased gradually with repeated administration. Therefore, isavuconazole may have a potential role in the treatment of cryptococcosis, and clinical trials involving larger numbers of cases are needed to confirm its efficacy and safety.
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Postprandial hypoglycemia caused by the combination of clarithromycin and rifampicin in a patient with nontuberculous mycobacterial pulmonary disease. Reviewed International journal
Eriko Mitsutome, Shigehisa Yanagi, Taisuke Uchida, Takanori Horiguchi, Hironobu Tsubouchi, Makoto Sumiyoshi, Akiko Kitamura, Yasuharu Oda, Hiroaki Ueno, Hideki Yamaguchi, Taiga Miyazaki
Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 31 ( 1 ) 102482 - 102482 2025.1
Language：English Publishing type：Research paper (scientific journal)
Most cases of nontuberculous mycobacterial pulmonary disease (NTM-PD) have a progressive clinical course, and initiation of treatment is recommended rather than watchful waiting. The NTM-PD medications are frequently associated with adverse reactions, occasionally serious. Optimization of the methods for monitoring and managing adverse events in NTM-PD treatment is thus an important medical issue. Here we report a first case of postprandial hypoglycemia caused by the combination of clarithromycin (CAM) and rifampicin (RFP) in a patient with NTM-PD. A 73-year-old Japanese woman with NTM-PD was hospitalized for treatment with a combination of oral CAM, RFP, and ethambutol. She took the first doses of antibiotics before breakfast, and 3 h later went into a hypoglycemic state. Postprandial hypoglycemia occurred with high reproducibility and was accompanied by relative insulin excess. Continuous glucose monitoring with or without food and in combination with various patterns of medication revealed that the combination of CAM and RFP specifically induced postprandial hypoglycemia. Shifting the timing of administration of the CAM and RFP combination from morning to before sleep corrected the hypoglycemia and enabled continuation of the antimicrobial treatment. In conclusion, our report suggests the importance of introducing NTM-PD medication under inpatient management in order to closely monitor and early detect postprandial hypoglycemia and other serious adverse events.
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B-Acute Lymphoblastic Leukemia/Lymphoblastic Lymphoma Mimicking Fibrosing Mediastinitis: A Case Report and Diagnostic Insight. Reviewed International journal
Aya Kitamura, Shigehisa Yanagi, Kotaro Shide, Yuichiro Sato, Ayako Kamiunten, Yasuhiro Yamanari, Akiko Kitamura, Makoto Sumiyoshi, Yasuharu Oda, Hironobu Tsubouchi, Kazuya Shimoda, Taiga Miyazaki
The American journal of case reports 25 e945804 2024.12
Language：English Publishing type：Research paper (scientific journal)
BACKGROUND Fibrosing mediastinitis (FM) is a rare, fibroproliferative disorder within the mediastinum. It is extremely rare for hematologic malignancies to develop as FM. CASE REPORT A 32-year-old Japanese man with a 1-month history of headache and 2-week history of facial swelling underwent chest computed tomography (CT); a diffuse mass-like lesion was revealed in the anterior mediastinum with severe stenosis of vital mediastinal organs. After a surgical biopsy, an initial diagnosis of idiopathic FM was made. The FM lesions responded mildly to corticosteroids but recurred repeatedly. Sixteen months after the treatment initiation, blasts appeared in the peripheral blood (PB), and the patient was diagnosed with B-acute lymphoblastic leukemia/lymphoblastic lymphoma (B-ALL/LBL). Chemotherapy led to complete remission of the B-ALL/LBL and almost complete disappearance of FM-like lesions. Immunohistochemistry of the mediastinal biopsy specimen taken before the blasts' appearance in PB demonstrated a CD34/CD7/terminal deoxynucleotidyl transferase-positive population, an identical pattern of expression common to the blasts in the patient's PB and bone marrow. CONCLUSIONS This is the first case report of B-ALL/LBL presenting as FM. This case underscores the importance of considering the possibility of latent hematologic malignancy even in the absence of new symptoms other than those caused by FM lesions for a long period of time. This is the first demonstration that leukemia cells may be present in the FM lesions from the initial stage of disease onset. Even if a diagnosis of idiopathic FM is confirmed, continued suspicion of the presence of hematologic malignancy is vital for improving patient outcomes.
DOI： 10.12659/AJCR.945804
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Malignant mesothelioma with squamous differentiation Reviewed
Tanaka H., Akiyama Y., Kitamura A., Matsumoto N., Tomita M., Kataoka H.
Histopathology 72 ( 7 ) 1216 - 1220 2018.6
Language：English Publishing type：Research paper (scientific journal) Publisher：Histopathology
Aims: We report the autopsy findings of a 58-year-old man with malignant mesothelioma in the left pleural cavity. Methods and results: The patient had a history of asbestos exposure, and the chest computed tomography scan on initial admission demonstrated an extrapleural sign, suggesting a nodular lesion in the chest wall. However, no nodular lesions were detectable in either of his lungs. In spite of chemotherapy, he died 4 months after the initial admission. An autopsy revealed markedly thickened pleura in a large section of the left pleural cavity without visible intrapulmonary primary tumour lesions. Histological examination of a biopsy specimen obtained prior to chemotherapy and that of an autopsy specimen showed that the pleural tumour was composed of a mixture of mesothelioma and tumour cells with squamous differentiation mimicking squamous cell carcinoma. Conclusions: To the best of our knowledge, this is the first case report of mesothelioma with extensive squamous differentiation in the English-language literature. The extensive squamous differentiation reminiscent of squamous cell carcinoma can be a pitfall in the pathological diagnosis of pleural cytology and that of biopsy specimens from patients with mesothelioma. Here, we report autopsy findings of a case of malignant mesothelioma with portions of extensive squamous differentiation, mimicking a squamous cell carcinoma.
DOI： 10.1111/his.13482
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Desquamative interstitial pneumonia complicated by diffuse alveolar haemorrhage Reviewed
Matsuo A., Matsumoto N., Kitamura A., Tsubouchi H., Yanagi S., Nakazato M.
Respirology Case Reports 6 ( 2 ) 2018.2
Publishing type：Research paper (scientific journal) Publisher：Respirology Case Reports
We report a rare case of desquamative interstitial pneumonia (DIP) with diffuse alveolar haemorrhage (DAH). A 56-year-old man diagnosed with DIP by surgical lung biopsy 2 years ago was admitted to our hospital because of severe acute respiratory failure. The DIP had progressed despite smoking cessation. On admission, the patient appeared extremely ill, and physical examination revealed respiratory distress. The patient required mechanical ventilation. High-resolution computed tomography showed diffuse ground glass opacity in both lungs. The bronchoalveolar lavage fluid was bloody, and numerous haemosiderin-laden alveolar macrophages were detected. Pulse steroid therapy followed by oral prednisolone immediately relieved the respiratory failure and improved the long-term control of the DIP. Paired sera tests confirmed the diagnosis of influenza A/H3N2 virus infection, which was the cause of the DAH. Chronically progressive DIP with acute respiratory failure due to DAH was successfully treated by steroid therapy.
DOI： 10.1002/rcr2.291
Presentations 【 display / non-display 】
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放射線治療から約5年後に開頭摘出術を実施した放射線脳壊死の1例
根井健心、北村瑛子、瀬戸口健介、小田康晴、田村充、坪内拡伸、柳重久、宮崎泰可
第349回日本内科学会九州地方会
Event date： 2025.5.25
Presentation type：Oral presentation (general)
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多発性内分泌腫瘍症1型に合併した肺神経内分泌腫瘍の1例
岩下和生、北村瑛子、住吉誠、小田康晴、坪内拡伸、柳重久、都築諒、佐藤勇一郎、宮崎泰可
第349回日本内科学会九州地方会
Event date： 2025.5.25
Presentation type：Oral presentation (general)
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当院における成人Human herpes virus-6（HHV-6）脳炎の臨床的検討
酒井克也、秋月渓一、北村瑛子、塩見一剛
第66回日本神経学会学術大会
Event date： 2025.5.21 - 2025.5.24
Presentation type：Poster presentation
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当院における成人Human herpes virus-6（HHV-6）脳炎の臨床的検討
酒井克也, 秋月渓一, 北村瑛子, 塩見一剛
第66回日本神経学会学術大会
Event date： 2025.5.21 - 2025.5.24
Presentation type：Poster presentation
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血液培養ボトル供給減少が感染症診療に与える影響の検討
髙城一郎、力武雄幹、岩尾千紘、平原康寿、木村賢俊、北村瑛子、住吉誠、川口剛、宮崎泰可
第99回日本感染症学会総会・学術講演会/第73回日本化学療法学会総会 合同学会.
Event date： 2025.5.8 - 2025.5.10
Presentation type：Poster presentation
Grant-in-Aid for Scientific Research 【 display / non-display 】
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自然肺腺癌モデルマウスの1細胞解析で発見した間葉亜集団の発癌への必須性の解明
Grant number：24K11319 2024.04 - 2027.03
独立行政法人日本学術振興会 科学研究費基金 基盤研究(C)
Authorship：Coinvestigator(s)