研究者詳細 - 寺井　崇二

論文 - 寺井　崇二

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Endoscopic diverticulectomy for Zenker's diverticulum with heterotopic gastric mucosa. 査読国際誌

Hiroki Sato, Manabu Takeuchi, Shuji Terai

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 32 ( 1 ) 145 - 145 2020年1月

Loss of autophagy impairs physiological steatosis by accumulation of NCoR1. 国際誌

Shun-Saku Takahashi, Yu-Shin Sou, Tetsuya Saito, Akiko Kuma, Takayuki Yabe, Yuki Sugiura, Hyeon-Cheol Lee, Makoto Suematsu, Takehiko Yokomizo, Masato Koike, Shuji Terai, Noboru Mizushima, Satoshi Waguri, Masaaki Komatsu

Life science alliance 3 ( 1 ) 2020年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

Lipid droplets (LDs) are dynamic organelles that store neutral lipids during times of energy excess, such as after a meal. LDs serve as an energy reservoir during fasting and have a buffering capacity that prevents lipotoxicity. Autophagy and the autophagic machinery have been proposed to play a role in LD biogenesis, but the underlying molecular mechanism remains unclear. Here, we show that when nuclear receptor co-repressor 1 (NCoR1), which inhibits the transactivation of nuclear receptors, accumulates because of autophagy suppression, LDs decrease in size and number. Ablation of ATG7, a gene essential for autophagy, suppressed the expression of gene targets of liver X receptor α, a nuclear receptor responsible for fatty acid and triglyceride synthesis in an NCoR1-dependent manner. LD accumulation in response to fasting and after hepatectomy was hampered by the suppression of autophagy. These results suggest that autophagy controls physiological hepatosteatosis by fine-tuning NCoR1 protein levels.

DOI： 10.26508/lsa.201900513

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Therapeutic potential of mesenchymal stem cells and their exosomes in severe novel coronavirus disease 2019 (COVID-19) cases. 査読国際誌

Atsunori Tsuchiya, Suguru Takeuchi, Takahiro Iwasawa, Masaru Kumagai, Takeki Sato, Satoko Motegi, Yui Ishii, Youhei Koseki, Kei Tomiyoshi, Kazuki Natsui, Nobutaka Takeda, Yuki Yoshida, Fusako Yamazaki, Yuichi Kojima, Yusuke Watanabe, Naruhiro Kimura, Kentaro Tominaga, Hiroteru Kamimura, Masaaki Takamura, Shuji Terai

Inflammation and regeneration 40 14 - 14 2020年

記述言語：英語掲載種別：研究論文（学術雑誌）

The novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19) and the ensuing worldwide pandemic. The spread of the virus has had global effects such as activity restriction, economic stagnation, and collapse of healthcare infrastructure. Severe SARS-CoV-2 infection induces a cytokine storm, leading to acute respiratory distress syndrome (ARDS) and multiple organ failure, which are very serious health conditions and must be mitigated or resolved as soon as possible. Mesenchymal stem cells (MSCs) and their exosomes can affect immune cells by inducing anti-inflammatory macrophages, regulatory T and B cells, and regulatory dendritic cells, and can inactivate T cells. Hence, they are potential candidate agents for treatment of severe cases of COVID-19. In this review, we report the background of severe cases of COVID-19, basic aspects and mechanisms of action of MSCs and their exosomes, and discuss basic and clinical studies based on MSCs and exosomes for influenza-induced ARDS. Finally, we report the potential of MSC and exosome therapy in severe cases of COVID-19 in recently initiated or planned clinical trials of MSCs (33 trials) and exosomes (1 trial) registered in 13 countries on ClinicalTrials.gov.

DOI： 10.1186/s41232-020-00121-y

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10年目を迎えた新潟県肝疾患相談センターの現況査読

上村博輝, 高村昌昭, 五十嵐正人, 青栁豊, 菊田玲, 渡辺和仁, 中山均, 田村務, 寺井崇二, 薛徹, 荒生祥尚, 廣川光, 澤栗裕美, 渡邊文子, 小師優子, 坂牧僚, 土屋淳紀

肝臓 61 ( 5 ) 245 - 254 2020年

記述言語：日本語出版者・発行元：一般社団法人日本肝臓学会

<p>平成21年に設立された新潟大学医歯学総合病院肝疾患相談センターは令和元年に10年目を迎え，236万人の新潟県民や医療従事者に対するウイルス性肝炎の情報の提供，啓発活動，助成制度のサポート等を新潟県健康対策課，厚生労働省健康局がん・疾病対策課肝炎対策室，国立国際医療センター肝炎情報センターとともに行ってきた．新潟県内の各種肝炎ウイルスの発生動向の報告，助成対象人数の把握や非受検者に対する啓発活動を各年度で行ってきた．C型肝炎については他県と同じく新規治療者数については減少段階にある．しかし，肝炎ウイルスは世界最大級の感染症であることにかわりなく，A型肝炎のエンデミック，B型肝炎ウイルスに対する耐性ウイルス発生や核酸アナログ製剤の長期利用による諸問題，E型肝炎の報告例の増加などについては今後も監視が必要である．また肝炎検査未受検者も多く，啓発活動を行う肝疾患相談センターの存在意義は今後も重要である．</p>

DOI： 10.2957/kanzo.61.245

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Obesity and accumulation of subcutaneous adipose tissue are poor prognostic factors in patients with alcoholic liver cirrhosis. 国際誌

Akira Sakamaki, Kunihiko Yokoyama, Kyutaro Koyama, Shinichi Morita, Hiroyuki Abe, Kenya Kamimura, Masaaki Takamura, Shuji Terai

PloS one 15 ( 11 ) e0242582 2020年

記述言語：英語掲載種別：研究論文（学術雑誌）

In alcoholic liver cirrhosis (LC) patients, obesity has become a problem that progresses into liver dysfunction. Herein, we investigated the relationship between the prognosis of steatohepatitis and body weight, along with fat accumulation in patients with alcoholic LC. We conducted a single-center retrospective study, enrolled 104 alcoholic LC patients without hepatocellular carcinoma (HCC) based on histological and clinical evidence, and investigated factors related to poor prognosis using multivariate Cox regression and cluster analyses. Cox regression analysis revealed three independent relevant factors: subcutaneous adipose tissue (SAT) index (median 34.8 cm2/m2, P = 0.009, hazard ratio [HR] 1.017, 95% confidence interval [CI] 1.004-1.030), total bilirubin level (median 1.7 mg/dL, P = 0.003, HR 1.129, 95% CI 1.042-1.223), and prothrombin time value (median 64%, P = 0.007, HR 0.967, 95% CI 0.943-0.991). In the cluster analysis, we categorized the patients into three groups: no adipose tissue accumulation (NAT group), SAT prior accumulation (SAT group), and visceral adipose tissue prior accumulation (VAT group). The results of the three groups revealed that the SAT group displayed a significantly poor prognosis of the Kaplan-Meier curve (67.1 vs 21.2 vs 65.3, P<0.001) of a 5-year survival rate. Propensity score matching analysis of the SAT and VAT groups was performed to adjust the patient's background, but no significant differences were found between them; however, the prognosis was poorer (21.2 vs 66.3, P<0.001), and hemostatic factors were still at a lower level in the SAT group. These findings suggest that SAT accumulation type of obesity is a poor prognostic factor in alcoholic LC patients without HCC, and the hemorrhagic tendency might worsen the poor prognosis in such cases.

DOI： 10.1371/journal.pone.0242582

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Nationwide epidemiological survey of autoimmune pancreatitis in Japan in 2016

Masamune, A., Kikuta, K., Hamada, S., Tsuji, I., Takeyama, Y., Shimosegawa, T., Okazaki, K., Kanno, A., Sano, T., Uchida, K., Ikeura, T., Fujimori, N., Nakai, Y., Kamisawa, T., Kubota, K., Motoya, M., Shimizu, K., Ushijima, T., Fukasawa, M., Naitoh, I., Ueno, M., Okuwaki, K., Uza, N., Asada, M., Mukai, T., Kudo, Y., Uetsuki, K., Mitoro, A., Watanabe, H., Terai, S., Hayashi, K., Imamura, Y., Haba, S., Hara, K., Fujisawa, T., Iwasaki, E., Okumura, F., Kawaji, Y., Kitano, M., Nishino, T., Nagahama, M., Hirano, A., Aruga, Y., Yamamoto, S., Inui, K., Kubota, Y., Takahashi, K., Sakagami, J., Kobayashi, T., Miraki, T., Watanabe, T., Sato, H., Takeda, Y., Satoh, M., Kobashigawa, K., Chiba, M., Tamura, T., Sawada, N., Mizukami, K., Sekine, M., Unno, J., Ishizawa, T., Funayama, H., Hatayama, K., Miyakawa, H., Sakai, T., Kuwatani, M., Toki, M., Toyokawa, T., Hashimoto, S., Itoi, T., Iwashita, Y., Sato, A., Kato, H., Takatori, H., Iizawa, Y., Iwashita, T., Kondo, H., Sato, Y., Tanabe, M., Ogura, T., Yamamoto, K., Masaka, T., Setsuda, M., Sano, T., Matsubara, S., Kitamura, K., Iwata, K., Shirahata, N., Hagiwara, H., Yoshida, M., Yokota, T., Shigoka, H., Kaneko, N., Abue, M., Tsuruoka, N.

Journal of Gastroenterology 55 ( 4 ) 2020年

Nationwide epidemiological survey of chronic pancreatitis in Japan: introduction and validation of the new Japanese diagnostic criteria 2019

Masamune, A., Kikuta, K., Kume, K., Hamada, S., Tsuji, I., Takeyama, Y., Shimosegawa, T., Okazaki, K., Miura, S., Takikawa, T., Hongo, S., Nakano, E., Nabeshima, T., Matsumoto, R., Tanaka, Y., Ueno, M., Mukai, T., Matsumoto, M., Kudo, Y., Azuma, S., Okuwaki, K., Yamamoto, S., Inui, K., Kobashigawa, K., Unno, J., Fujimori, N., Kitamura, K., Miyakawa, H., Takahashi, K., Ikeura, T., Takenaka, M., Fukasawa, M., Funayama, H., Mitoro, A., Takagi, T., Sekine, M., Suwa, K., Sakagami, J., Ishida, M., Ohtsuka, M., Kagawa, S., Muraki, T., Watanabe, T., Watanabe, T., Yamamoto, K., Masaka, T., Nagahama, M., Sato, A., Aruga, Y., Nakai, Y., Iwasaki, E., Itoi, T., Kawaji, Y., Kitano, M., Mizukami, K., Iwasaki, S., Mori, M., Kaneko, N., Kodama, Y., Sato, H., Yoshida, N., Hatayama, K., Kobayashi, T., Hirano, A., Kaino, M., Fujisawa, T., Ushijima, T., Chiba, M., Shimizu, K., Ota, H., Toki, M., Nishikawa, T., Yoshida, Y., Tanaka, K., Uetsuki, K., Motoya, D., Muro, S., Watanabe, H., Imamura, Y., Ishizawa, T., Kamisawa, T., Tsuruoka, M., Hayashi, K., Terai, S., Iwatsuka, K., Iwata, K., Yoshida, M., Takagi, T., Goto, M., Oza, N., Takeda, Y., Hagiwara, H., Tadano, T., Sakai, T., Sumimoto, K., Nishimura, N., Irisawa, A., Kuwatani, M., Shirahata, N., Satoh, M., Fujikawa, T., Iizawa, Y., Watanabe, N., Ishiguro, H., Sawada, N., Katada, K., Kondo, H., Sakakihara, I., Nishida, J., Tamura, T., Dairaku, N., Kamezaki, H., Okano, H., Suzuki, S., Okamoto, T., Matsugu, Y., Imamura, M., Honjo, M., Sugiyama, G., Ohta, H., Higashide, S., Ishii, S., Hoshi, T., Takagi, Y., Satoh, A., Yamaji, N., Nishimura, N., Shibasaki, M., Tamura, H., Iwashita, T., Motoya, M., Tanisaka, Y., Ryozawa, S., Takatori, H., Tsuruoka, N., Hashimoto, S., Suzuki, N., Sato, Y., Tamai, H., Hara, K., Ashida, K., Yokota, T., Tsuji, T., Abue, M., Tomaki, H., Fukunishi, M., Koga, H., Takehara, Y., Kawamura, H., Shimokawahara, N., Otsu, N., Kimura, Y., Ishido, K., Kofunato, Y., Shiihara, M., Sakaguchi, T., Masui, T., Eguchi, H., Suzumura, K., Ide, T., Inomata, M., Maemura, K., Iizawa, H., Nakajima, A., Uyama, S., Shiozaki, S., Yokoyama, S., Wakabayashi, T., Furuuchi, T., Gushima, T., Satoh, S., Shioya, T., Nakazawa, K., Takahashi, Y., Fukuba, N., Matsubara, S.

Journal of Gastroenterology 55 ( 11 ) 2020年

Usefulness of endoscopic ultrasound (EUS)-fine needle aspiration (FNA) for local excision of brunner's gland hamartoma with hemorrhage: A case report and literature review,EUS-FNA が術前診断に有用であった十二指腸 Brunner 腺過誤腫出血の <sub>1</sub> 切除例

Arao, Y., Kobayashi, M., Ikemi, M., Shioji, K., Seino, S., Abe, H., Iwaki, T., Taguchi, T., Tani, Y., Terai, S.

Gastroenterological Endoscopy 62 ( 7 ) 2020年

Practical guide on on-line hemodiafiltration for acute liver failure

Inoue, K., Oda, S., Abe, R., Takikawa, Y., Nakayama, N., Kato, N., Fujiwara, K., Yasui, S., Terai, S., Ido, A., Sakaida, I., Genda, T., Shimizu, M., Mochida, S., Takikawa, H.

Kanzo/Acta Hepatologica Japonica 61 ( 2 ) 2020年

Clinical practice of acute pancreatitis in Japan: An analysis of nationwide epidemiological survey in 2016

Masamune, A., Kikuta, K., Hamada, S., Tsuji, I., Takeyama, Y., Shimosegawa, T., Okazaki, K., Matsumoto, R., Kume, K., Miura, S., Takikawa, T., Hongo, S., Tanaka, Y., Sakai, T., Ueno, M., Unno, J., Toki, M., Nishimura, M., Kitamura, K., Kobashigawa, K., Ashida, K., Takahashi, K., Watanabe, T., Sato, Y., Satoh, A., Yoshida, N., Tanaka, K., Kondo, H., Suzuki, N., Sato, H., Mitoro, A., Minami, K., Iwasaki, E., Okuwaki, K., Mukai, T., Kudo, Y., Azuma, S., Takeda, Y., Setsuda, M., Tsuchida, K., Irisawa, A., Motoya, D., Shirahata, N., Iwata, K., Oza, N., Kawaguchi, Y., Hoshino, A., Hirano, A., Sakakihara, I., Watanabe, N., Funayama, H., Nakamura, Y., Yamamoto, T., Uchida, H.H., Iizawa, Y., Imamura, M., Sekine, M., Inui, K., Yamamoto, S., Sato, S., Ishii, S., Yakushijin, T., Yamamoto, K., Masaka, T., Yoshida, M., Arizumi, T., Goto, M., Takenaka, M., Miyakawa, H., Otsuka, Y., Nishi, M., Suwa, K., Sakagami, J., Satoh, M., Koga, H., Takagi, T., Nagahama, M., Hatayama, K., Kaneko, N., Mori, M., Nakai, Y., Iwashita, Y., Iwatsuka, K., Hayashi, K., Terai, S., Kaneto, H., Nishikawa, T., Uchi, M., Honjo, M., Takagi, T., Mizukami, K., Tamura, T., Gushima, T., Sato, A., Shimizu, K., Aruga, Y., Nonogaki, K., Kaino, M., Iwashita, T., Tsuruoka, M., Miura, M., Hasegawa, H., Takai, T., Yokota, H., Fujisawa, T., Uetsuki, K., Kobayashi, T., yamaji, N., Itoi, T., Muraki, T., Watanabe, T., Inatomi, O., Ushijima, T., Takehara, Y., Kawamura, H., Fukasawa, M., Hagiwara, H., Tamura, H., Moriya, T., Kuwatani, M., Kawaji, Y., Kamisawa, T., Abue, M., Fukunishi, M., Onoyama, H., Mochizuki, S., Sumimoto, K., Koyabu, M., Nishio, A., Sakao, M., Imamura, Y., Ohta, H., Nishimura, N., Shiihara, M., Anan, H., Motoya, M., Chiba, M., Deguchi, T., Kofunato, Y., Sawada, N., Katada, K., Matsumoto, S., Higashide, S., Okano, H., Ishida, M., Yamazaki, M., Tamura, N., Muraoka, T., Uza, N., Kodama, Y., Muro, S., Fujimori, N., Ikeda, T., Shimokawahara, N., Otsu, N., Yano, Y., Sugawara, S., Takaura, K., Ogura, Y., Furuuchi, T., Shibasaki, M., Kishimoto, M.

Pancreatology 20 ( 4 ) 2020年

A case of primary hepatic actinomycosis difficult to distinguish from malignant hepatic tumors

Honda, H., Nozawa, Y., Takamura, M., Kamimura, H., Tsuchiya, A., Terai, S.

Kanzo/Acta Hepatologica Japonica 61 ( 3 ) 2020年

Rare Mesenteric Arterial Diseases: Fibromuscular Dysplasia and Segmental Arterial Mediolysis and Literature Review. 査読

Masayoshi Ko, Kenya Kamimura, Akira Sakamaki, Yusuke Niwa, Kentaro Tominaga, Kenichi Mizuno, Shuji Terai

Internal medicine (Tokyo, Japan) 58 ( 23 ) 3393 - 3400 2019年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

Fibromuscular dysplasia (FMD) and segmental arterial mediolysis (SAM) are noninflammatory, nonatherosclerotic arterial diseases that cause aneurysm, occlusion, and thromboses. These diseases are rarely seen in mesenteric arterial lesions; however, as they can be lethal if appropriate management is not provided, the accumulation of clinical information from cases is essential. We herein report the cases of a 57-year-old man diagnosed with FMD and a 63-year-old man diagnosed with SAM. We conclude that an early diagnosis with imaging modalities and clinical information followed by the appropriate treatment improves the prognosis of these arterial diseases.

DOI： 10.2169/internalmedicine.3094-19

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Pulmonary tumor thrombotic microangiopathy of hepatocellular carcinoma: A case report and review of literature. 査読国際誌

Morita S, Kamimura K, Abe H, Watanabe-Mori Y, Oda C, Kobayashi T, Arao Y, Tani Y, Ohashi R, Ajioka Y, Terai S

World journal of gastroenterology 25 ( 48 ) 6949 - 6958 2019年12月

Efficacy of gelatin hydrogels incorporating triamcinolone acetonide for prevention of fibrosis in a mouse model. 査読国際誌

Nao Nakajima, Satoru Hashimoto, Hiroki Sato, Kazuya Takahashi, Takuro Nagoya, Kenya Kamimura, Atsunori Tsuchiya, Junji Yokoyama, Yuichi Sato, Hanako Wakatsuki, Masayuki Miyata, Yusuke Akashi, Ryusuke Tanaka, Ken Matsuda, Yasuhiko Tabata, Shuji Terai

Regenerative therapy 11 41 - 46 2019年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

Introduction: Triamcinolone acetonide (TA), a steroid, is often used clinically to prevent dysfunctions associated with fibrosis. The objective of this study was to examine whether TA can be suspended in a gelatin sheet for tissue engineering using a mouse skin wound model. Methods: TA was suspended in biodegradable gelatin and freeze-dried in a sheet form. The sheet was analyzed for homogeneity and controlled release of TA by high-performance liquid chromatography. We made two skin wounds on the dorsal side of mice. Gelatin sheets with TA (TA sheet) and without TA (control sheet) were attached to each skin wound. To determine the efficacy of the prepared TA sheet on the skin wounds, TA-sheet versus TA-injection experiments were conducted. Hematoxylin and eosin staining was performed to assess the grade of epithelialization and alpha smooth muscle actin (α-SMA) immunohistochemical staining was conducted to evaluate myofibroblast infiltration. Results: In the TA-release test in vitro, 7.7 ± 2.3% of TA was released from the sheet by 24 h. After replacing the initial phosphate-buffered saline (PBS) with collagenase PBS, the amount of released TA increased over time. The wound area/original skin wound area after 15 days with the TA sheet was significantly larger than that with the control sheet (26.9 ± 5.5% vs 10.7 ± 2.6%, p = 0.023). The α-SMA positive area/whole area with the TA sheet was significantly lower than that with the control sheet (4.65 ± 0.66% vs 7.24 ± 0.7%, p = 0.023). Furthermore, the α-SMA positive area/whole area with the TA sheet was significantly lower than that with TA injection (5.32 ± 0.45% vs 7.93 ± 0.75%, p = 0.013). Conclusions: We developed a TA sheet and confirmed both the homogeneity of the suspended TA and controlled-release of the TA in the presence of collagenase in vitro. The TA sheet caused less myofibroblast infiltration into the tissue than the control sheet or TA injection did.

DOI： 10.1016/j.reth.2019.04.001

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Rare case of systemic scleroderma showing full-layer histologic features of an ileal lesion. 査読国際誌

Hiroki Sato, Terasu Honma, Saki Yamada, Takashi Owaki, Shuji Terai

Gastrointestinal endoscopy 90 ( 6 ) 991 - 993 2019年12月

表在型食道癌患者における禁酒後の体組成変化の検討

水澤健, 橋本哲, 上村博輝, 高村昌昭, 寺井崇二

アルコールと医学生物学 38 54 - 54 2019年12月

心窩部痛、肝障害を契機に発見されたcholedochoceleの一例

岩澤貴宏, 五十嵐聡, 林和直, 大脇崇史, 上村博輝, 橋本哲, 寺井崇二

ENDOSCOPIC FORUM for digestive disease 35 ( 2 ) 152 - 152 2019年12月

A case of pancreatic pseudocysts accompanied by infection, pseudoaneurysm ruptures, and pseudocystocolonic fistulae.

Kosuke Sato, Kazuya Takahashi, Yukio Aruga, Fusako Yamazaki, Daisuke Kumaki, Masashi Yamakawa, Masaaki Hirano, Kazuhiro Funakoshi, Shuji Terai

Clinical journal of gastroenterology 12 ( 6 ) 615 - 620 2019年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

Pancreatic pseudocysts (PPs) can be accompanied by infection, pseudoaneurysm ruptures, and fistulae to other organs, which can be fatal without appropriate treatment. Herein, we present the case of an 82-year-old man with PPs accompanied by infection, pseudoaneurysm rupture, and pseudocystocolonic fistula that were managed via multidisciplinary treatment. Computed tomography (CT) revealed two inflamed PPs, one each in the pancreatic head and tail. He was, therefore, diagnosed with infectious PPs. The pancreatic head PP shrunk on endoscopic nasopancreatic drainage (ENPD), but the pancreatic tail PP did not. Endoscopic ultrasound (EUS)-guided transluminal drainage was performed to treat the pancreatic tail PP; his symptoms improved. However, he vomited blood at 14 day post-drainage. Angiography revealed pseudoaneurysm rupture in a left gastric artery branch. After successful angioembolization, he developed hematochezia 2 days later. We suspected re-bleeding of the pseudoaneurysm. The bleeding stopped spontaneously, but CT and radiography revealed the presence of a pseudocystocolonic fistula. Careful follow-up was performed, and he has not had any symptoms at 9 month post-discharge. We managed PP-related complications via ENPD, EUS-guided transluminal drainage, angioembolization, and careful follow-up. Infection, pseudoaneurysm rupture, and pseudocystocolonic fistula are rare, but can occur simultaneously. Therefore, clinicians should consider these complications when treating patients with PPs.

DOI： 10.1007/s12328-019-00986-8

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Gene Therapy for Liver Cancers: Current Status from Basic to Clinics. 査読国際誌

Kamimura K, Yokoo T, Abe H, Terai AS

Cancers 11 ( 12 ) 2019年11月

Methotrexate-related lymphoproliferative disorders in the liver: Case presentation and mini-review. 査読国際誌

Takeshi Mizusawa, Kenya Kamimura, Hiroki Sato, Takeshi Suda, Hiroyuki Fukunari, Go Hasegawa, Osamu Shibata, Shinichi Morita, Akira Sakamaki, Junji Yokoyama, Yu Saito, Yoshihisa Hori, Yuduru Maruyama, Fumitoshi Yoshimine, Takahiro Hoshi, Shinichi Morita, Tsutomu Kanefuji, Masaaki Kobayashi, Shuji Terai

World journal of clinical cases 7 ( 21 ) 3553 - 3561 2019年11月

記述言語：英語

BACKGROUND: Immunosuppression is effective in treating a number of diseases, but adverse effects such as bone marrow suppression, infection, and oncogenesis are of concern. Methotrexate is a key immunosuppressant used to treat rheumatoid arthritis. Although it is effective for many patients, various side effects have been reported, one of the most serious being methotrexate-related lymphoproliferative disorder. While this may occur in various organs, liver involvement is rare. Information on these liver lesions, including clinical characteristics, course, and imaging studies, has not been summarized to date. CASE SUMMARY: We present a case of 70-year-old woman presented with a 2-wk history of fever and abdominal pain. She had had rheumatoid arthritis for 5 years and was being treated with medication including methotrexate. Contrast-enhanced computed tomography revealed multiple low density tumors in the liver and the histological analyses showed significant proliferation of lymphocytes in masses that were positive on immunohistochemical staining for CD3, CD4, CD8, and CD79a but negative for CD20 and CD56. Staining for Epstein-Barr virus-encoded RNA was negative. And based on these findings, the liver tumors were diagnosed as Methotrexate-related lymphoproliferative disorders. A time-dependent disappearance of the liver tumors after stopping methotrexate supported the diagnoses. CONCLUSION: The information obtained from our case and a review of 9 additional cases reported thus far assist physicians who may face the challenge of diagnosing and managing this disorder.

DOI： 10.12998/wjcc.v7.i21.3553

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