Internal medicine
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A 74-year-old woman developed acute severe colitis after receiving her sixth mRNA vaccine against coronavirus disease 2019 (COVID-19). On the day after vaccination, she experienced bloody diarrhea, abdominal pain, and high-grade fever. Laboratory tests revealed leukocytosis and increased C-reactive protein. ⋯ Her symptoms and laboratory findings improved immediately after the initiation of prednisolone therapy. Pre-discharge total colonoscopy revealed mucosal repair in most of the colon. Clinicians should acknowledge that severe acute colitis can occur after COVID-19 vaccination.
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We herein report an 80-year-old man showing a downsloping TP segment together with an increase in the height of the T wave in the precordial leads on a standard 12-lead electrocardiogram (ECG). Separately, an 87-year-old woman showed only a downsloping TP segment in the precordial leads on a standard 12-lead ECG. ⋯ This downsloping TP segment in the precordial leads on the standard 12-lead ECG is thought to be due to a cardiac impulse-tapping artifact. Differential diagnoses are also discussed.
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A 70-year-old man underwent nephrectomy for renal cell carcinoma followed by 3 cycles of pembrolizumab as adjuvant chemotherapy. Three months later, he complained of appetite loss. He was diagnosed with secondary adrenal insufficiency and pancreatic tumor. ⋯ A histological examination revealed IgG4-related sclerosing pancreatitis. Postoperatively, there was no recurrence of pancreatitis. It is essential to consider the potential development of IgG4-related diseases after the administration of immune checkpoint inhibitors.
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A 69-year-old man was diagnosed with follicular lymphoma (grade 3A). Obinutuzumab combined with bendamustine (OB) therapy was initiated as salvage chemotherapy. ⋯ PAI caused by CMV infection has mainly been reported in patients with acquired immunodeficiency syndrome. In the present case, the PAI triggered by CMV infection led to immunodeficiency after chemotherapy.