研究者詳細 - 岡　浩介

論文 - 岡　浩介

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Characteristics of Functional Hyperthermia Detected in an Outpatient Clinic for Fever of Unknown Origin. 査読国際誌

Kosuke Oka, Kazuki Tokumasu, Hideharu Hagiya, Fumio Otsuka

Journal of clinical medicine 13 ( 3 ) 2024年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

Background: Functional hyperthermia (FH) is characterized by hyperthermia resulting from sympathetic hyperactivity rather than inflammation, and it is frequently overlooked by medical practitioners due to the absence of abnormalities in a medical examination. Although FH is an important differential diagnosis for fever of unknown origin (FUO), the literature on FUO cases in Japan lacks information on FH. In this study, we aimed to uncover the population of FH patients hidden in FUO cases. Methods: An outpatient clinic for FUO was established at Okayama University Hospital, and 132 patients were examined during the period from May 2019 to February 2022. Results: A diagnosis of FH was made in 31.1% of the FUO cases, and FH predominantly affected individuals in their third and fourth decades of life with a higher incidence in females (68.3%). The frequency of a history of psychiatric illness was higher in patients with FH than in patients with other febrile illnesses. Although the C-reactive protein (CRP) is generally negative in FH cases, some obese patients, with a body mass index ≥ 25 had slightly elevated levels of CRP but were diagnosed with FH. Conclusions: The results showed the importance of identifying FH when encountering patients with FUO without any organic etiology.

DOI： 10.3390/jcm13030889

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不明熱診療にて遭遇した機能性高体温症とその臨床的特徴

岡浩介, 徳増一樹, 萩谷英大, 大塚文男

日本病院総合診療医学会雑誌 19 ( 臨増2 ) 145 - 145 2023年8月

Rhinogenic optic neuropathy with hemianopia caused by ethmoidal sinus mucocele. 査読国際誌

Kosuke Oka, Wataru Ando, Hideharu Hagiya, Takaya Higaki, Fumio Otsuka

Clinical case reports 10 ( 12 ) e6696 2022年12月

Kikuchi-Fujimoto disease manifesting bilateral lymphadenopathy. 国際誌

Akihiro Kawatsuki, Kosuke Oka, Hideharu Hagiya, Fumio Otsuka

Clinical case reports 10 ( 10 ) e6494 2022年10月

中枢性尿崩症と眼瞼黄色腫から診断したErdheim-Chester病の3例査読

山本紘一郎, 高瀬了輔, 大國皓平, 中野靖浩, 岡浩介, 本多寛之, 長谷川功, 花山宜久, 小比賀美香子, 大塚文男

日本内分泌学会雑誌 98 ( 2 ) 569 - 569 2022年10月

Eyelid edema due to Cushing's syndrome. 国際誌

Koichiro Yamamoto, Kosuke Oka, Kou Hasegawa, Fumio Otsuka

Clinical case reports 10 ( 6 ) e05940 2022年6月

Cat scratch disease without a history of cat exposure. 国際誌

Kosuke Oka, Yume Takagi, Hideharu Hagiya, Fumio Otsuka

Clinical case reports 10 ( 4 ) e04816 2022年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

A patient complaining of swelling and tenderness in her left axilla was diagnosed with cat scratch disease despite no apparent history of cat exposure. Zoonosis can occur even in the absence of cat exposure because cat flea Ctenocephalides felis is also the vector of the pathogen through the flea feces.

DOI： 10.1002/ccr3.4816

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Adult Hypogonadism Due to Testicular Adrenal Rest Tumors.

Koichiro Yamamoto, Kosuke Oka, Kou Hasegawa, Fumio Otsuka

Internal medicine (Tokyo, Japan) 60 ( 23 ) 3839 - 3840 2021年12月

Celiac artery dissection in polycystic kidney disease. 国際誌

Koichiro Yamamoto, Kou Hasegawa, Kosuke Oka, Fumio Otsuka

Clinical case reports 9 ( 10 ) e04922 2021年10月

Intravascular lymphoma presenting as spinal cord infarction. 国際誌

Yukichika Yamamoto, Yoshito Nishimura, Misa Okumura, Yuki Otsuka, Kosuke Oka, Kazuhiro Ikeuchi, Hisakazu Nishimori, Kohei Taniguchi, Fumio Otsuka

Postgraduate medical journal 97 ( 1152 ) 672 - 673 2021年10月

Sternoclavicular Joint Hypertrophy Involved in Polymyalgia Rheumatica.

Koichiro Yamamoto, Kosuke Oka, Kou Hasegawa, Fumio Otsuka

Internal medicine (Tokyo, Japan) 60 ( 18 ) 3057 - 3057 2021年9月

An Elderly Male with Primary Sjögren's Syndrome Presenting Pleuritis as the Initial Manifestation.

Yukichika Yamamoto, Yuki Otsuka, Takayuki Katsuyama, Yoshito Nishimura, Kosuke Oka, Kou Hasegawa, Hideharu Hagiya, Fumio Otsuka

Acta medica Okayama 75 ( 4 ) 539 - 542 2021年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

Primary Sjögren's syndrome (SS) is an autoimmune disease that usually affects the exocrine glands in mid-dle-aged women. Fifteen percent of SS patients experience severe systemic extraglandular complications, and pleuritis is one of the rare complications of SS. We report the case of an elderly Japanese man who initially pre-sented with a prolonged fever and chest pain and was finally diagnosed with primary SS-associated pleuritis. Of the nine reported cases of primary SS that initially presented with pleuritis, up to six cases were elderly males. This case highlights the complication of pleuritis among elderly males with primary SS.

DOI： 10.18926/AMO/62409

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Acute Pancreatitis Related to COVID-19 Infection.

Koichiro Yamamoto, Kosuke Oka, Hiroyuki Sakae, Fumio Otsuka

Internal medicine (Tokyo, Japan) 60 ( 13 ) 2159 - 2160 2021年7月

Acute pancreatitis without abdominal pain induced by administration of nivolumab and ipilimumab. 国際誌

Koichiro Yamamoto, Kosuke Oka, Reina Son, Hiroyuki Honda, Hiroyuki Sakae, Kou Hasegawa, Shigeru Horiguchi, Hironari Kato, Osamu Yamasaki, Fumio Otsuka

Modern rheumatology case reports 5 ( 2 ) 425 - 430 2021年7月

記述言語：英語

Immune checkpoint inhibitors (ICIs) such as nivolumab and ipilimumab are emerging agents for the treatment of cancers including melanoma. ICIs are known to cause immune-related adverse events (irAEs), including the development of enterocolitis, dermatitis, and nephritis. However, ICI-induced pancreatitis has seldom been reported, and its pathophysiology and clinical importance remain largely unknown. We describe a 76-year-old man with melanoma who developed acute pancreatitis without abdominal pain after immunotherapy with nivolumab and ipilimumab. The patient was referred due to 2-week-long general fatigue, anorexia, and dermatitis after his second immunotherapy. Laboratory examinations in serum showed high inflammation and renal dysfunction. Plain computed tomography (CT) on admission showed no new lesions including colitis or pancreatitis. On the 4th day of hospitalisation, serum pancreatic enzymes were extremely elevated. Amylase was increased to 683 U/L (normal range: 44-132) and lipase was increased to 1520 U/L (13-55), but he had no abdominal tenderness. Contrast-enhanced CT showed enlarged pancreatic parenchyma and magnetic resonance cholangiopancreatography showed peripancreatic fat stranding, suggesting pancreatitis. Blood culture tests and empirical antibiotic therapy with ceftriaxone indicated no active infectious diseases. We diagnosed ICI-induced pancreatitis and treated him with 0.5 mg/kg/day of prednisolone, which improved his general fatigue, anorexia, dermatitis, and pancreatitis. The potential significance of asymptomatic elevations of pancreatic enzymes has been unclear; however, this case suggested that ICI-induced pancreatitis without abdominal tenderness could be clinically significant. Clinicians should pay attention to the development of latent pancreatitis in patients receiving ICIs, even those without abdominal pain.

DOI： 10.1080/24725625.2021.1899444

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Large-vessel vasculitis induced by granulocyte colony-stimulating factor administration after chemotherapy. 国際誌

Koichiro Yamamoto, Nayu Tamura, Kosuke Oka, Kou Hasegawa, Hideharu Hagiya, Madoka Hokama, Joji Ishida, Fumio Otsuka

Modern rheumatology case reports 5 ( 2 ) 322 - 326 2021年7月

記述言語：英語

Granulocyte colony-stimulating factor (G-CSF) is a relatively new drug that is used for recovery of chemotherapy-associated neutropenia. It is known to cause bone pain, headache and fatigue as side-effects; however, large-vessel vasculitis is extremely rare and its relation with G-CSF remains unknown. We describe a 49-year-old woman in whom arteritis developed after chemotherapy and subsequent G-CSF administration. She had experienced pinealoma 3 months ago and received surgery and chemotherapy, leading to neutropenia. After administration of lenograstim at 100 μg/day for 1 week, high fever and neck pain appeared. White blood cell count and serum levels of C-reactive protein and interleukin-6 were increased to 37,930/μL, 23.71 mg/dL, and 241 pg/mL, respectively. Contrast-enhanced computed tomography revealed thickened walls of large vessels including the bilateral common carotid artery (CCA), right brachiocephalic artery, and ascending aorta. Ultrasonography showed wall thickening of the CCA (maximum of intima media thickness: right, 2.9 mm; left, 3.2 mm). As differential diagnoses, infection, chemotherapy, autoimmune diseases, and cancer were considered other than G-CSF. Blood culture tests, lumbar puncture, β-D-glucan tests, and tests for viral antibodies indicated no active infection, and autoantibodies were negative. Empirical antibiotic therapy was ineffective. The score of Naranjo's algorithm to lenograstim was 6, indicating "probable" causality. Considering the clinical course and test results, we made a diagnosis of G-CSF-associated arteritis and commenced glucocorticoid therapy, which drastically improved the symptoms and inflammation. Clinicians should be aware of this uncommon but significant complication of GCS-F administration, for which glucocorticoid treatment can be a useful therapeutic option.

DOI： 10.1080/24725625.2020.1857022

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Interrelationships Between Serum Levels of Procalcitonin and Inflammatory Markers in Patients Who Visited a General Medicine Department.

Jo Araki, Kosuke Oka, Koichiro Yamamoto, Yoshihisa Hanayama, Kazuki Tokumasu, Hideharu Hagiya, Hiroko Ogawa, Koichi Itoshima, Fumio Otsuka

Acta medica Okayama 75 ( 3 ) 299 - 306 2021年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

Various laboratory markers of inflammation are utilized in general practice, but their clinical diagnostic significance is often ambiguous. In the present study, we determined the clinical significance of the examination of serum levels of procalcitonin (PCT) by comparing the PCT levels with the levels of other inflammatory markers, based on a retrospective review of 332 PCT-positive patients, including cases of bacterial infection (20.5%), non-specific inflammation (20.8%), neoplasm (9.9%), connective tissue diseases (8.4%), and non-bacterial infection (7.2%), were analyzed. The serum PCT level was highest in the bacterial infection group (1.94 ng/ml) followed by the non-specific inflammatory group (0.58 ng/ml) and neoplastic diseases group (0.34 ng/ml). The serum PCT level was positively correlated with serum levels of C-reactive protein (rho=0.62), soluble interleukin-2 receptor (sIL-2R; rho=0.69), and ferritin, the plasma level of D-dimer, and white blood cell count, and negatively correlated with the serum albumin level (rho=-0.52), hemoglobin concentration, and platelet count. The serum PCT level showed a stronger positive correlation with the serum sIL-2R level than the other biomarkers. The results suggest that an increased PCT level may indicate not only an infectious state but also a non-bacterial inflammatory condition in the diagnostic process in general practice.

DOI： 10.18926/AMO/62221

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Isolated adrenocorticotropin deficiency induced by pembrolizumab for hypopharyngeal cancer: A case report. 国際誌

Koichiro Yamamoto, Kazuki Tokumasu, Kosuke Oka, Kou Hasegawa, Fumio Otsuka

Clinical case reports 9 ( 6 ) e04305 2021年6月

Orbital mass and hairy kidney as characteristics of Erdheim-Chester disease. 国際誌

Koichiro Yamamoto, Kosuke Oka, Kou Hasegawa, Fumio Otsuka

Clinical case reports 9 ( 6 ) e04333 2021年6月

Pseudoacromegaly with acromegalic features in radiography. 国際誌

Koichiro Yamamoto, Kosuke Oka, Hiroyuki Honda, Kou Hasegawa, Fumio Otsuka

Clinical case reports 9 ( 5 ) e04095 2021年5月

An adrenal incidentaloma caused by synchronous and isolated metastasis. 国際誌

Koichiro Yamamoto, Kosuke Oka, Hiroyuki Honda, Kou Hasegawa, Yoshihisa Hanayama, Tomofumi Watanabe, Yusuke Tominaga, Atsushi Takamoto, Takayuki Hara, Fumio Otsuka

Clinical case reports 9 ( 4 ) 2494 - 2495 2021年4月

Ulcer-like Projection Accompanied by Giant Cell Arteritis.

Yuki Otsuka, Kosuke Oka, Yoshihisa Hanayama, Fumio Otsuka

Internal medicine (Tokyo, Japan) 60 ( 5 ) 819 - 820 2021年3月

Positron emission tomography for the diagnosis of prosthetic heart valve endocarditis. 国際誌

Yuki Otsuka, Hideharu Hagiya, Kosuke Oka, Fumio Otsuka

BMJ case reports 14 ( 2 ) 2021年2月

複数の基礎疾患を有した超高齢者COVID-19の一例

孫麗那, 藤田茉奈美, 山本紘一郎, 岡浩介, 山根真衣, 大塚勇輝, 高瀬了輔, 中野靖浩, 大村大輔, 榮浩行, 長谷川功, 萩谷英大, 大塚文男

日本病院総合診療医学会雑誌 17 ( 臨増1 ) 149 - 149 2021年2月

Adult-onset Still's disease accompanying noninfective endocarditis.

Kosuke Oka, Yokota Yuya, Miho Yasuda, Fumio Otsuka

Journal of general and family medicine 21 ( 6 ) 268 - 269 2020年11月

Massive pheochromocytoma. 国際誌

Terumitsu Anai, Kosuke Oka, Yuya Yokota, Yoshito Nishimura, Hideharu Hagiya, Fumio Otsuka

Clinical case reports 8 ( 11 ) 2308 - 2309 2020年11月

Disseminated Mycobacterium genavense infection mimicking TAFRO syndrome. 国際誌

Kosuke Oka, Mai Yamane, Yuya Yokota, Miho Yasuda, Kou Hasegawa, Takumi Fujimori, Koji Iio, Hideharu Hagiya, Fumio Otsuka

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 26 ( 10 ) 1095 - 1099 2020年10月

記述言語：英語

TAFRO syndrome is a rare variant of idiopathic multicentric Castleman's disease, for which disseminated non-tuberculous mycobacteria (NTM) infection must be excluded. However, due to the slow and fastidious growth of the organisms, identification of the pathogen is often challenging. We herein describe a case of disseminated Mycobacterium genavence infection, in which manifestations of the patient were confusingly similar to those of TAFRO syndrome. A 69-year-old Japanese man presented with prolonged fever accompanying pain in his back and ribs on the right side. Systemic investigations revealed thrombocytopenia, marked elevation of alkaline phosphatase, anasarca (pleural effusion and ascites), megakaryocytosis in the bone marrow, and hepatomegaly. Magnetic resonance imaging (MRI) showed diffuse, T1-and T2-low-intensity spotted lesions on his vertebral bodies, but biopsy showed inconclusive results. The patient met the diagnostic criteria of TAFRO syndrome and was started on prednisolone, which improved his general condition shortly thereafter. Blood culture after 42 days of incubation revealed the presence of Mycobacterium; however, we considered it a contamination at that time because no organisms grew on conventional agars, and the patient was discharged. Ten weeks after the isolation of Mycobacterium, he developed persistent fever and was readmitted. This time, vertebral bone mallow biopsy demonstrated a large amount of mycobacterium, which was later successfully identified as M. genavense by sequencing analysis. Under a final diagnosis of disseminated M. genavense infection, we treated the patient with clarithromycin, rifampicin, and ethambutol. This case highlighted that disseminated NTM infection may follow a similar clinical course as that of TAFRO syndrome.

DOI： 10.1016/j.jiac.2020.06.020

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Invasive non-typeable Haemophilus influenzae infection due to endometritis associated with adenomyosis. 国際誌

Yoshito Nishimura, Hideharu Hagiya, Kaoru Kawano, Yuya Yokota, Kosuke Oka, Koji Iio, Kou Hasegawa, Mikako Obika, Tomoko Haruma, Sawako Ono, Hisashi Masuyama, Fumio Otsuka

BMC infectious diseases 20 ( 1 ) 521 - 521 2020年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: The widespread administration of the Haemophilus influenzae type b vaccine has led to the predominance of non-typable H. influenzae (NTHi). However, the occurrence of invasive NTHi infection based on gynecologic diseases is still rare. CASE PRESENTATION: A 51-year-old Japanese woman with a history of adenomyoma presented with fever. Blood cultures and a vaginal discharge culture were positive with NTHi. With the high uptake in the uterus with 67Ga scintigraphy, she was diagnosed with invasive NTHi infection. In addition to antibiotic administrations, a total hysterectomy was performed. The pathological analysis found microabscess formations in adenomyosis. CONCLUSIONS: Although NTHi bacteremia consequent to a microabscess in adenomyosis is rare, this case emphasizes the need to consider the uterus as a potential source of infection in patients with underlying gynecological diseases, including an invasive NTHi infection with no known primary focus.

DOI： 10.1186/s12879-020-05193-2

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Osmotic Demyelination Syndrome Triggered by Pituitary Apoplexy.

Yuya Yokota, Kosuke Oka, Miho Yasuda, Fumio Otsuka

Internal medicine (Tokyo, Japan) 59 ( 6 ) 869 - 870 2020年3月

経食道心エコーで疣贅を認めた成人発症スティル病の1例

岡浩介, 横田雄也, 長谷川功, 萩谷英大, 大塚文男

日本病院総合診療医学会雑誌 16 ( 臨増1 ) 98 - 98 2020年2月

TAFRO症候群との鑑別に難渋した播種性Mycobacterium genavense感染症の1例

山根真衣, 横田雄也, 岡浩介, 長谷川功, 萩谷英大, 大塚文男

日本病院総合診療医学会雑誌 16 ( 臨増1 ) 148 - 148 2020年2月

Correlations between Depressive Condition and Gastroesophageal Reflux Symptoms in Patients Visiting a Department of General Medicine.

Yu Suganami, Kosuke Oka, Yoshihisa Hanayama, Hiroyuki Honda, Jun Hamahara, Mikako Obika, Kazuya Kariyama, Masayuki Kishida, Fumio Otsuka

Acta medica Okayama 73 ( 6 ) 479 - 486 2019年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

To clarify the potential relevance of patients' chief complaints at a general medicine department to their self-rating depression scale (SDS) and frequency scale for symptoms of gastroesophageal reflux disease (GERD) (FSSG) scores, we analyzed data of 478 patients who visited our general medicine department. The chief complaints (553 symptoms of 447 patients) were categorized into major symptom-based groups: respiratory (31%), circulatory (3%), gastrointestinal (GI) tract (26%), neurology (8%), orthopedic and skin (10%), and systemic (22%) symptoms. The SDS score tended to be higher in females and younger patients. The FSSG score did not differ by gender but was higher in younger patients. The patients receiving social welfare had higher SDS and FSSG scores. A close inter-relationship between the FSSG (including both degrees of reflux and dysmotility) and SDS was observed in all patients. Although the averages of the SDS and FSSG scores were not significantly different among the symptom-based categories, we observed significantly positive correlations between the FSSG and SDS in each category, suggesting that depressive status may be closely related to GERD-related symptoms regardless of the patients' chief complaints. An initial checkup of patients' psychological condition and/or GERD-like symptoms could help screen for latent disorders in outpatients with uncertain complaints.

DOI： 10.18926/AMO/57711

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A Remarkable Uptake of FDG in Huge Mediastinal Hashimoto's Goiter.

Kosuke Oka, Takeshi Hosoya, Naruto Taira, Fumio Otsuka

Internal medicine (Tokyo, Japan) 58 ( 2 ) 313 - 314 2019年1月

A marked goiter involved in Marine-Lenhart syndrome.

Kosuke Oka, Miho Yasuda, Tadahiko Shien, Fumio Otsuka

Journal of general and family medicine 20 ( 1 ) 37 - 38 2019年1月

Changes in Serum Biochemical Markers in Relation to Chief Complaints and Aging in General Medicine.

Daisuke Omura, Asuka Sato, Kosuke Oka, Yoshihisa Hanayama, Hiroko Ogawa, Mikako Obika, Fumio Otsuka

Acta medica Okayama 72 ( 6 ) 553 - 562 2018年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

To clarify potential relationships between chief complaints of patients and laboratory data with a focus on aging-related changes, we retrospectively analyzed the data of 843 patients who visited a general medicine department for the first time. Their chief complaints were classified into 8 major symptoms: visceral pain, somatic pain, fever, cough, dizziness, fatigue, appetite loss, and edema. We compared the laboratory data obtained from the patients with complaints with the data of symptom-free (control) patients. The serum sodium and potassium levels in the fever group were decreased compared to those in the control group. In the fever group, the serum sodium level was inversely correlated with age. The ratio of serum urea nitrogen to creatinine (UN/Cr) was increased in the appetite-loss group. There were significant age-dependent increases in the UN/Cr ratio in the appetite-loss and edema groups. Of note, serum levels of free thyroxin were lower in the dizziness group compared to the control group. In addition, the free thyroxin level was inversely correlated with age in the dizziness group but not in the asymptomatic control group. Collectively, the results indicated that osmolality-related laboratory data are strongly associated with individual primary symptoms at the first visit regardless of the final diagnosis. The consideration of age-dependent changes of these markers is helpful for diagnosing latent disorders based on various primary symptoms.

DOI： 10.18926/AMO/56372

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Clival Osteomyelitis with Cavernous Sinus Thrombosis Due to Fusobacterium nucleatum and Campylobacter rectus Induced by Tooth Extraction.

Kosuke Oka, Yasuhiro Nakano, Yosuke Sazumi, Tomo Michitani, Shigeru Horiguchi, Kazuki Ocho, Masaya Iwamuro, Fumio Otsuka

Internal medicine (Tokyo, Japan) 57 ( 22 ) 3325 - 3328 2018年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

A 70-year-old woman who had suffered from aseptic meningitis complained of chronic headache after dental treatment including tooth extraction. She developed a fever and respiratory failure. Based on chest computed tomography and head magnetic resonance imaging (MRI), she was diagnosed with osteomyelitis in the clivus accompanying moderate pituitary involvement, cavernous sinus thrombosis and septic pulmonary embolism. Both of the causal bacteria, Fusobacterium nucleatum and Campylobacter rectus, were isolated from her blood. Dual infection leading to clival osteomyelitis and cavernous sinus thrombosis has not been reported. It is important to perform enhanced MRI and blood culture for patients with chronic headache related to dental treatment.

DOI： 10.2169/internalmedicine.1025-18

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Clinical Characteristics of Febrile Outpatients : Possible Involvement of Thyroid Dysfunction in Febrile Tachycardia.

Kosuke Oka, Yoshihisa Hanayama, Asuka Sato, Daisuke Omura, Miho Yasuda, Ko Hasegawa, Mikako Obika, Fumio Otsuka

Acta medica Okayama 72 ( 5 ) 447 - 456 2018年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

We retrospectively analyzed the cases of 148 febrile patients whose body temperature (BT) was ≥ 37.5°C at our hospital. We categorized them into seven groups; those with bacterial and viral infection, nonspecific inflammation, neoplasm, connective tissue disease (CTD), drug-induced disease, and unidentified causes. Our analysis revealed that the patient's BT at the 1st visit (BT-1st visit) and highest BT during the febrile period (BT-max) differed significantly among all categories except neoplasm. The greatest difference between BT-1st visit and BT-max was highest in the CTD group (1.5°C). Positive correlations of heart rate and C-reactive protein (CRP) level with BT-max and a negative correlation between serum sodium level with BT-max were uncovered. The serum thyroid-stimulating hormone (TSH) level and the ratio of TSH/free thyroxine were negatively correlated with BT-max, especially in the viral infection group, suggesting the existence of occult thyrotoxicosis in accord with a febrile condition, possibly leading to febrile tachycardia. A febrile gap between BT-1st visit and BT-max (except in the neoplasm group) was shown, in which BT-max was correlated with thyroid function. Clinicians should recognize the fluctuation of BT when diagnosing febrile patients, and tachycardia in such febrile patients may be, at least in part, associated with subclinical thyroid dysfunction.

DOI： 10.18926/AMO/56242

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Thyroid follicular carcinoma in a teenager: A case report.

Kosuke Oka, Tadahiko Shien, Fumio Otsuka

Journal of general and family medicine 19 ( 5 ) 170 - 172 2018年9月

Manifestation of Central Diabetes Insipidus in a Patient with Thyroid Storm.

Akiko Nakamichi, Kazuki Ocho, Kosuke Oka, Miho Yasuda, Kou Hasegawa, Masaya Iwamuro, Mikako Obika, Kammei Rai, Fumio Otsuka

Internal medicine (Tokyo, Japan) 57 ( 13 ) 1939 - 1942 2018年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

We herein report a case of central diabetes insipidus complicated with thyroid storm. A middle-aged woman who was receiving treatment for Graves' disease suddenly complained of polydipsia, polyuria and general fatigue. Laboratory tests showed hyperthyroidism, hypernatremia, hypoosmolar urine and a decreased plasma vasopressin level. The occurrence of central diabetes insipidus with hyperthyroidism was revealed on the basis of pituitary magnetic resonance imaging, a water deprivation test and a desmopressin test. The clinical co-existence of diabetes insipidus and hyperthyroidism is very rare; however, the complication should be considered when hypernatremia and/or dehydration progress in patients with Graves's disease as a common autoimmune-related etiology.

DOI： 10.2169/internalmedicine.0063-17

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Neck schwannoma mimicking a thyroid tumor.

Kosuke Oka, Masaya Iwamuro, Fumio Otsuka

Journal of general and family medicine 18 ( 6 ) 473 - 474 2017年12月

Hypertrophic Pachymeningitis Accompanying Scleritis.

Kosuke Oka, Kazuki Ocho, Masaya Iwamuro, Fumio Otsuka

Internal medicine (Tokyo, Japan) 56 ( 17 ) 2383 - 2384 2017年9月

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