Internal medicine
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Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are highly effective against EGFR-mutant non-small-cell lung carcinoma but can cause serious adverse events, such as interstitial lung disease (ILD). Treatment strategies for osimertinib-induced ILD are not well established. ⋯ We herein report a 67-year-old woman with symptomatic osimertinib-induced ILD who was switched to afatinib and later rechallenged with osimertinib and corticosteroids. Neither treatment resulted in ILD relapse, suggesting that these may be viable treatment options when alternative treatments are limited.
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A 78-year-old woman experienced systemic edema and was diagnosed with nephrotic syndrome and Hashimoto's thyroiditis (HT). A renal biopsy revealed minimal change disease (MCD) and tubulointerstitial nephritis, which resulted in the diagnosis of primary Sjögren's syndrome (PSS). PSS and HT can be complicated with MCD; however, there are no published case reports of MCD presenting with both conditions simultaneously. We aimed to inform nephrologists and rheumatologists about this rare condition through a literature review of renal outcomes in patients with MCD associated with PSS and HT.
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Pseudohypoparathyroidism (PHP) is a rare disorder characterized by resistance to parathyroid hormone (PTH). Albright's hereditary osteodystrophy (AHO) is a characteristic physical condition associated with PHP. ⋯ The patient did not have AHO or other comorbidities but showed digital clubbing during childhood. Although digital clubbing is rarely associated with PHP, it may represent a phenotype of this disorder.
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A 16-year-old girl presented with a high fever that had persisted for more than 4 weeks. Computed tomography (CT) revealed a 4-cm mass in the left adrenal gland. Clinically, there were no obvious symptoms of adrenal hormone excess; however, serum interleukin-6 (IL-6) and C-reactive protein levels were significantly elevated. ⋯ The tumor was pathologically diagnosed as adrenocortical carcinoma (ACC), with a Weiss score of 5/9. The tumor cells were immunoreactive for IL-6. To our knowledge, this is the first case report of symptomatic IL-6-producing ACC that initially presented with a persistent fever.
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Objective The efficacy of anamorelin in pancreatic cancer (PC) patients with a poor performance status (PS) is uncertain, as previous trials have excluded such patients. This study evaluated the efficacy of anamorelin in PC patients with a poor PS (2) compared with those with a good PS (0-1). Methods We retrospectively reviewed consecutive PC patients with cachexia who received anamorelin at our institution. ⋯ A poor PS was associated with early discontinuation of anamorelin. Conclusion The efficacy of anamorelin is extremely limited in PC patients with a poor PS. Patients with PC with a poor PS may not be good candidates for anamorelin compared to those with a good PS.