1. 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 ●●●●●●●●●.