Internal medicine
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Case Reports
Diffuse alveolar hemorrhage associated with proteinase 3-specific anti-neutrophil cytoplasmic antibodies.
A 31-year-old man was referred to our hospital for the management of progressive diffuse alveolar hemorrhage associated with renal dysfunction. Leukocytoclastic vasculitis was shown by skin biopsy and crescentic glomerulonephritis was also detected, in addition to positivity for proteinase 3-specific anti-neutrophil cytoplasmic antibodies (PR3-ANCA). The patient was diagnosed as a rare case of PR3-ANCA-positive pulmonary-renal vasculitic syndrome without granulomatous lesions. There was a good response to combination therapy with steroids and cyclophosphamide.
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Review Case Reports
A diabetic case with hemoglobin J-Meerut and low HbA1C levels.
A diabetic patient with hemoglobin (Hb) J-Meerut and low HbA1C levels is reported. An automatic glycohemoglobin analyzer used for the determination of HbA1C revealed an abnormal peak of the peripheral blood obtained from a Japanese female with diabetes. ⋯ High performance liquid chromatography and isoelectric focusing indicated that her abnormal hemoglobin was Hb J-Meerut [alpha 120(H3)Ala-->Glu] and it accounted for 28.3% of the total hemoglobin. Abnormal hemoglobinemia should be considered when a major discrepancy between the levels of HbA1C and fasting plasma glucose is observed.
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Editorial Comment
Inappropriate hemoglobin A1c level, interference or bonus?
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Disseminated intravascular coagulation (DIC) is a very rare complication of pulmonary tuberculosis. We herein describe a case of cavitary tuberculosis complicated with DIC. Rifampin was considered to deteriorate the clinical course of DIC in this case.
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We evaluated the influence of the Hanshin-Awaji earthquake on the patients in our internal medicine department. After the initial rush of patients with injury, the number of respiratory diseases, largely pneumonia, increased within one month. ⋯ Diabetic control of outpatients became worse after the earthquake. It is important to recognize that various disorders involving physical and psychological problems develop at different stages after a large-scale disaster.