A ●●●● ●●●● of ●●●●●●●● ●●●●● ●●●●●●● ●●●●, ●●●●●●● improved ●●●● ●●●●●●● in a woman with ●●●●● ●●●●●●●●●●●●. 病院のロゴ等 ●. ●●●●●●1, ●. ●●●●●●●1,2, ●. ●●●●●●1, ●. ●●●●●●●●1, ●. ●●●1, ●. ●●●●●●●●●1, ●. ●●●●●1,2 1Department of ●●●●●●●●●●●●●, 2Department of ●●●●●●●●● ●●●●●●●, ●●●●●● Medical Center/ Hostpital Introduction ●What is ●●●●●● and ●●●● ●●●●●? ●●● is a chronic ●●●●●●●●●●● disease that affects ●●●●●●●● ●●●●●●● at ●●●●●●●. ●●●● ●●●●●●●● is a major risk factor for overall morbidity and mortality in ●●●●●●. Despite ●●● ●●●●●●●●●●, ●●● ●●●●●● or ●●●●●●● for too many patients. ●What is ●●●●●● and ●●●●● ●●●●●●●●●●●● (●●●)? ●●●● is a ●●●● ●●●●●●●● serine/threonine kinase. ●●●●●●● serves as a ●●●● of ●●●●●●● and as a ●●●● of ●●●●, ●●●●●●●●, and ●●●●●●●. ●●●● is a genetic disorder resulting from ●●●●●●. ●Activation of ●●●● in ●●●●●● In patients with ●●●, ●●●●●● complex is activated and ●●●●●● ●●●● is inhibited. It results in ●●●●●●●● and ●●●●●●●●●●●●●● alterations of ●●●●●●●●●●. ●●●●●● ●●●●●●●●●●●● ●●●●●● remains to be elucidated Certainly ●●●● is a key ●●●● ●●●●●●●● ●●●●●● ●●●●●●●●●●●● ●●●●●●●●●. ●●●●●●● is , however, a ●●●● of ●●●●●●● ●●●● for ●●●●●●●●. ●●●● suggests that ●●●●●● of ●●●●●● is a ●●●●●● for ●●●●●●●●●●●●. We report the first known case of ●●●●●●, ●●●●● with ●●●●●●●●. Case ●●-year-old woman ●Back ground A ●●-year-old woman with ●●●●●● had been diagnosed with ●●●●. She had been treated with ●●●●●●●●●●●●●, ●●●●●●●●● and ●●●●●●●●●●●●●●. ●Chief complaint: ●●●●● ●●●●●● ●History of present illness She had ●●●●● ●●●●● since ●●●●●● days before without ●●●●●●, ●●●●● or any signs of ●●●●●● ●●●●● ●●●●●●. ●Past medical history ●●●, ●●●●●, ●●●●● ●●●●●●●●● ●●●●●●●●●, ●●●●●●●●, ●●●●● ●Medication ●●●●, ●●●●, ●●●, ●●●● ●●●●●, ●●●●● ●●●●, aspirin ●Allergy ●●●●, ●●●●, ●●● ●Physical examination BP ●●●/●● mmHg, HR ●●● bpm/reg, BT 36.2℃, SpO2 95% (room air), RR ● bpm No conjunctival pallor, No conjunctival congestion, No lymphadenopathy No rhonchi, rales, or wheezing CV: RRR, nl.S1S2, no S3S4, no murmur Soft, nondistended, normal bowel sound, nontenderness No pitting edema ●Laboratory data ●CT: ●●●●●● ●●●●●●●●● ●●●●●●●●● ＜Blood test＞ ＜Urinalysis＞ WBC ●,●● /μL Neut Lymp ●●● RBC ×104/μL Hb ●.● g/dL PLT ●● AST IU/L ALT LDH ALP γ-GTP Alb T-Bil ●.●● mg/dL BUN ●●.● mg/dL Cre 0.●● Na 138 mEq/L K 3.9 Cl 100 CRP 0.10 T-chol ●●● APTT ●● sec PT-INR Fib FDP μg/dL D-dimer RBC ●● WBC <1 Protein ●+ U-TP ●●.● mg/dL uTP/uCre ●.●● g/g Cr Granular cast ● 最も病態を代表する一枚 ●●●●●●●●● (●●●) is ●●● of ●●●●● ●●●●. ●●●● ●●●●●●●● were a ●●● of ●●●●●●. ↓ ●●●●● ●●●●●●● was not ●●●●●●● ●●●●. She was diagnosed with ●●● ●●●●●●● due to ●●●●●●●● ●●●●●●●●●●● ●●●●. ●Time course Although she had ●● ●●●●●●●●●● with ●●●●●● ●●●●●●●●, concomitant with ●●●●●●●●●● drugs, such as ●●●●●●●●●●●●●l and ●●●●●●●●●, ●●●●●●●●●● ●●●●●●●●●● had not been achieved, leading to ●●●●●● ●●●●●●● ●●●●●●. In addition, ●●●●●●●● ●●●●●●●●● of ●●●● was ●●●●●●●●● ●●●●●●●●. ●●●●●●● ●●●●●●● suppressed ●●●●● of ●●●● ●●● During the following-up, ●●● ●●●●●●●● became ●●●● and had a ●●●●●. ●●●●● is a ●●●●●● disorder leading to dysregulation of ●●●●●● ●●●●●. She was treated with ●●●●●●●●●●●, ●●●●● ●●● ●●●●●●, for the ●●●●. After the ●●●●●●●● of ●●●●●●, the activity of ●●●●● was improved and we succeeded ●●●●●●●●●●● ●●●●●●●●● of ●●●●●●●●●. ● mg ●●● 20XX ●● ●●●● ●● mg ●● (g/dL) ●● (mg/dL) ●● (g/dL) ●●●●● (IU/mL) ●●●●● (IU/mL) ●● (mg/dL) 20XX ●●● ● mg ●●●●●●● Discussion ●The etiology of ●●●: ●●●●● ●●● ●●●●●●●● ●●●●●●● In the patients with ●●●, ●●●●● ●● ●●●●● such as ●●●●●● is overexpressed, leading to dysfunction of ●●●●● ●●●●●●●●. ●●●●●● regulates the ●●●●●●● of ●●●●● cells The expression of ●●●●● in ●●●●● cells is regulated by ●●●●●●● ●●●●●●●●. Phosphorylation of ●●●●● ●●●●●●●● factor (●●●●●) by ●●●●●2 promotes the ●●●●●● ●●●●●●●● of ●●● ●●●●●●-●●●● ● (●●●). In addition, ●●● and ●●●● phosphorylate ●●●●● to activate ●●●●● ●●●●●● production. →●●●●●●● may ●●●●●●● the ●●●●●●● ●●●● of ●●● in the present case. ●●●●●●●●●● activates ●●●-cell ●●●●●●●●tion In the patients with ●●●●, activation of ●●●●●●● ●●●●● skews ●●●●● ●●●●●. Activation of ●●●●●●3 inhibit the ●●●●●●●●●● of ●●●●, leading to ●●●●●●●tion of the ●●●●●●● population, and expansion of ●●●●● ●●●●●●●●● ●●●●●●●●●●. →●●●●●● may ●●●●●● ●●●●●●● in the present case. ●●●●●● inhibition in the mouse model of ●●●●●● In ●●●●● mice, ●●●●●● inhibition with ●●●●●●● ●●●●●●● ・prevented the ●●●● in ●●●● ●●●●●●● ・prevented the ●●●●● ●●●●●●●●●●●● levels ・prolonged ●●●●● ●●●●●●●●●●●●●●●●● →●●●●●●●●● may ●●●●●●●●● ●●●●●● ●●●●●●●●●● generally. ●●● ●●● cell ●●● cell Conclusion ●●●●●●●● ●●●●● ●●●●●●●●●● improved ●●●●●●● ●●●●●●●●●●●● in a woman with ●●●●●●●● ●●●●●●●●●●. ●Adverse effect of ●●●●●●● was not ●●●●●●●●●● ●●●. ●●●●●●●● ●●●●● was not improved ●●●●●●● ●●●●●●●●●●●● in ●●●●●●●●●.