Internal medicine
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Objective To calculate the prevalence of anemia based on sex and age using large-scale occupational health examination data, confirm the Hb) distribution in the elderly, and examine the standard for screening for anemia in Japan. Methods Using existing large-scale occupational health examination data of patients who underwent health examinations between April 2015 and March 2022, we calculated the prevalence of anemia based on sex and age. Patients We included 416,366 patients aged 20-89 years who underwent health checkups at health checkup facilities in Japan. ⋯ Furthermore, the mean -2SD of Hb in the elderly men (>65 years) was 12.0 g/dL, larger than the current standard (11.0 g/dL). Conclusion It is imperative to consider the possibility of anemia in young women during health examinations and other screening opportunities, regardless of their history of anemia. In addition, elderly men with Hb levels <12 g/dL should be cautioned about the development of anemic symptoms and the progression of Hb decline.
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Mild glucose intolerance (positive urine glucose or mild hyperglycemia) during health checkups in young, lean women may require specialist consultation. We herein report a 31-year-old Japanese woman with mild hyperglycemia detected during a checkup who was diagnosed with overt diabetes in pregnancy and HNF4A-MODY postpartum, without prior follow-up. ⋯ Fetal outcomes vary with MODY subtype. Preconception care is important.
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A 50-year-old man was diagnosed with type 1 autoimmune pancreatitis (AIP) following endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and a histopathological examination. After six months of untreated follow-up, the serum IgG4 level decreased, and the diffuse pancreatic enlargement improved; however, a pancreatic head mass became apparent. ⋯ After pancreatoduodenectomy, AIP did not recur. The development of AIP in this case could be related to paraneoplastic syndrome.
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A 64-year-old man with autosomal dominant polycystic kidney disease (ADPKD) on hemodialysis presented with multiple lung masses. A computed tomography (CT)-guided biopsy revealed non-small-cell lung cancer (NSCLC). A cavitary mass in the right lung indicated primary NSCLC (cT2N1M1a, stage IVA). ⋯ On day 10 post-treatment, he developed acute respiratory failure with diffuse ground-glass opacities on chest CT, indicative of pembrolizumab-induced lung injury. Despite steroid pulse therapy, the patient died on day 13. An autopsy revealed left renal pelvic cancer with lung metastases, highlighting the diagnostic challenges in ADPKD.