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We previously reported three cases of portal hypertension in patients with prolonged anorexia nervosa (AN) with laxative abuse and self-induced vomiting; we now report a fourth, similar case. A 34-year-old woman with anorexia nervosa, binge-eating/purging type (AN-BP), presented to the Kohnodai Hospital National Center for Global Health and Medicine Psychosomatic Medicine Department for treatment of low body weight. We conducted hepatic and renal biopsies and cardiac magnetic resonance imaging (CMR) to evaluate her complicated liver disease, renal failure, and cardiac insufficiency, respectively. Enhanced computed tomography revealed ascites, splenomegaly, and gastroesophageal varices, indicating portal hypertension. The liver and kidney biopsies demonstrated chronic hepatitis without evidence of hepatic cirrhosis and tubulointerstitial nephritis, respectively. CMR demonstrated decreased myocardial mass. We found tubulointerstitial nephritis and decreased myocardial mass in a patient with non-cirrhotic portal hypertension and prolonged AN with laxative abuse and habitual self-induced vomiting. We propose that reciprocal interactions between multiple factors related to AN, including laxative toxicity, dehydration, renal disorder, and cardiac insufficiency, result in portal hypertension. Level of Evidence Level V.

The patient was a 31-year-old man with a chief complaint of cervical mass close to the right submandibular region. At first, we used several antibiotics, which proved to be ineffective.Radiological and laboratory investigations were performed, including chest X-ray and computed tomography of the neck. Purified protein derivative test (PPD test) was positive. Definitive diagnosis of mycobacterial cervical lymphadenitis was made according to the findings of pathological examination and positive mycobacterial culture of the biopsy material.Since the patient had irritation in the stomach at the same time, we examined his abdomen by gastrofiberscope and MRI. As a result, abdominal abscesses were detected with high activity of adenosinedeaminase in the fluid inside. These results suggested that they also were tuberculous abscesses.Four months were required for this patient to recover from mycobacterial cervical lymphadenitis after combined antituberculous pharmacotherapy. After one year, we have also seen improvement in his abdominal abscesses.

1993年の突発性難聴全国疫学調査で突発性難聴として報告された一側例2,790症例のうち急性低音障害型感音難聴がどれくらい含まれているか検討した。 2,790症例中252症例が急性低音障害型感音難聴であった。急性低音障害型感音難聴252症例について性別, 年齢分布, 聴力の変化, 発症から初診までの期間, 予後を検討した。 男女比は1:2, 平均年齢は34.8歳であった。 発症日から初診日までの日数が短いほど予後は良く, 予後の男女差は認めなかった。 急性低音障害型感音難聴は平成12年度急性高度難聴調査研究班の診断基準 (試案) を用いたところ突発性難聴全国疫学調査の登録患者の9%を占めており, 突発性難聴との差が明瞭ではなかったことを示唆していた。