Internal medicine
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We herein report a rare case of periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome that occurred in an 18-year-old man. He visited our hospital with recurrent episodes of a fever, pharyngitis and adenitis without suggestive findings of infection. ⋯ This completely prevented the episodes during six months of follow-up. Colchicine may therefore be effective in cases of adult-onset PFAPA syndrome.
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Case Reports
The Evaluation of Benzodiazepine-induced Dysphagia using High-resolution Manometry: A Case Report.
We evaluated the pathophysiology of dysphagia considered to be induced by benzodiazepine using high-resolution manometry (HRM). A 53-year-old man with Parkinson disease had had dysphagia for over 3 months. ⋯ A video-fluoroscopic swallowing study showed improved pharyngeal bolus passage. Benzodiazepine-induced dysphagia may be due to the muscle relaxant effects on the swallowing muscles and attenuation of the barrier function which prevents reflux from the esophagus into the pharynx.
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Objective Calcitonin gene-related peptide (CGRP)-(receptor) monoclonal antibody (mAb) has been reported to reduce the frequency of medication overuse in patients with migraine. The present study investigated whether or not CGRP-mAb treatment shows early effectiveness for medication overuse headache (MOH) in Japan. Methods We retrospectively reviewed 34 patients with MOH who received preventive treatment with CGRP-mAb from June 2021 to October 2022. ⋯ The change in MHD was -5.7 days (22.7%), indicating significant improvement (p<0.05). Conclusion CGRP-mAb has been suggested as a preventive treatment for patients with MOH. Further investigation of the long-term efficacy of CGRP-mAb for MOH is needed.
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Case Reports
Successful Treatment of Steroid-resistant Eosinophilic Gastrointestinal Disease with Mepolizumab: A Case Report.
We experienced a case of treatment-resistant eosinophilic gastrointestinal disease (EGID). The patient, a 46-year-old man, presented with a fever, persistent abdominal pain, and an elevated peripheral eosinophil count. ⋯ However, after mepolizumab (anti-interleukin 5 antibody) was administered, the patient's disease was controlled. Currently, the indications for mepolizumab are limited to bronchial asthma and paraneoplastic eosinophilic polyangiitis, but the experience herein reported suggests its usefulness in the treatment of EGID.
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We herein report a case of anti-gamma aminobutyric acid type A receptor antibody-associated encephalitis (anti-GABAA-RE) with progressive aphasia and generalized tonic-clonic seizures. Cerebral magnetic resonance imaging (MRI) showed cortical brain lesions coupled with hypermetabolism on fluorodeoxyglucose-positron emission tomography. After two courses of methylprednisolone pulse therapy, improvements in neurological symptoms without sequelae and the total disappearance of MRI lesions were observed. Upon encountering patients with refractory status epilepticus, multifocal cerebral MRI lesions, and suspected autoimmune encephalitis, especially in cases with thymoma, it would be prudent to suspect anti-GABAA-RE and consider the evaluation of anti-GABAA receptor antibody and methylprednisolone pulse therapy.