{"created":"2023-06-20T15:46:10.748873+00:00","id":766,"links":{},"metadata":{"_buckets":{"deposit":"827f3054-6112-4a61-9030-460a51c19458"},"_deposit":{"created_by":4,"id":"766","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"766"},"status":"published"},"_oai":{"id":"oai:uoeh-u.repo.nii.ac.jp:00000766","sets":["13:23:37"]},"author_link":["2666","2676","2667","2674","2669","2671","2675","2673","2670","2668","2677","2672"],"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2017-03-01","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"61","bibliographicPageStart":"55","bibliographicVolumeNumber":"39","bibliographic_titles":[{"bibliographic_title":"産業医科大学雑誌"},{"bibliographic_title":"Journal of UOEH","bibliographic_titleLang":"en"}]}]},"item_10001_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"症例は慢性副鼻腔炎と関節リウマチの既往がある50歳女性．緑膿菌による下気道感染症を繰り返し当科を受診した．胸部CT ではびまん性汎細気管支炎様の肺病変が認められ，血清human T-lymphotrophic virus type 1（HTLV-1）抗体が陽性であった．関節リウマチに対しては生物学的製剤使用後であり，消炎鎮痛剤の内服のみで疾患制御は良好であった．肺病変に対してマクロライド少量長期療法を4年間施行したが，徐々に喀痰培養から検出される緑膿菌は多剤耐性化が進行し，下気道感染症は制御困難となり，さらにadult T cell leukemia（ATL）急性型を発症した．併存する耐性緑膿菌による下気道感染症が制御困難となり呼吸不全を伴うようになったためATL に対する積極的な全身化学療法は施行できず死亡した．剖検所見では，肺を含む多臓器に異型リンパ球の浸潤が認められ，HTLV-1感染によるATL の進行が本症例の病勢に大きく関与していた．びまん性汎細気管支炎類似の臨床背景を呈した関節リウマチとHTLV-1感染を合併した症例は検索範囲内ではなく，これらは類似した臨床像や画像所見を示すため，病態の鑑別が困難である．また，現在，肺病変合併症例に対するATL の全身化学療法の治療時期についての明確な基準はなく，今後の検討を要する．","subitem_description_type":"Abstract"},{"subitem_description":"A 50-year-old female with a history of chronic sinusitis and rheumatoid arthritis visited our department with repetitive lower respiratory tract infections of Pseudomonas aeruginosa. Her chest CT showed diffuse panbronchiolitis-like pulmonary lesions, her blood examination revealed atypical lymphocytes, and she was serologically positive for anti-human T-lymphotrophic virus type 1 (HTLV-1) antibody. Her rheumatoid arthritis had been well-controlled after biological agent treatment followed by anti-inflammatory analgesic treatment. She received long-term lowdose macrolide therapy for four years. The Pseudomonas aeruginosa gradually became multi-antibiotic-resistant. Her lower respiratory infection gradually became uncontrollable, and her adult T cell leukemia (ATL) developed to the acute phase. Due to repetitive lower respiratory tract infections and respiratory failure, however, she could not receive any treatment for ATL, and she eventually died due to the progression of the disease. An autopsy revealed an invasion of abnormal lymphocytes in multiple organs, including the lungs, which indicated that the HTLV-1 infection and the progression of ATL were the dominant factors in this patient’s clinical course. There have been no diffuse panbronchiolitis-like cases accompanied by rheumatoid arthritis and HTLV-1 infection so far. Because these diseases show similar clinical features, it is difficult to discriminate between them. There are presently no appropriate criteria for the proper time of treatment of patients with pulmonary lesion-associated ATL, but further research is expected to elucidate this matter.","subitem_description_type":"Abstract"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"産業医科大学（産業医科大学学会）"}]},"item_10001_relation_17":{"attribute_name":"関連サイト","attribute_value_mlt":[{"subitem_relation_name":[{"subitem_relation_name_text":"Journal of UOEH"}],"subitem_relation_type_id":{"subitem_relation_type_id_text":"https://www.jstage.jst.go.jp/browse/juoeh/39/1/_contents/-char/ja","subitem_relation_type_select":"URI"}},{"subitem_relation_name":[{"subitem_relation_name_text":"産業医科大学雑誌"}],"subitem_relation_type_id":{"subitem_relation_type_id_text":"https://www.uoeh-u.ac.jp/kouza/journal/i_2017-1j.html","subitem_relation_type_select":"URI"}}]},"item_10001_select_24":{"attribute_name":"記事区分","attribute_value_mlt":[{"subitem_select_item":"症例報告"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"ISSN 0387-821X(PRINT), ISSN 2187-2864(ONLINE)","subitem_source_identifier_type":"ISSN"}]},"item_10001_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"白石, 朝子"}],"nameIdentifiers":[{"nameIdentifier":"2666","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"石本, 裕士"}],"nameIdentifiers":[{"nameIdentifier":"2667","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"赤田, 憲太朗"}],"nameIdentifiers":[{"nameIdentifier":"2668","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"川波, 敏則"}],"nameIdentifiers":[{"nameIdentifier":"2669","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"矢寺, 和博"}],"nameIdentifiers":[{"nameIdentifier":"2670","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"迎, 寛"}],"nameIdentifiers":[{"nameIdentifier":"2671","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Shiraishi, Tomoko","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2672","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Ishimoto, Hiroshi","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2673","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Akata, Kentaro","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2674","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Kawanami, Toshinori","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2675","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Yatera, Kazuhiro","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2676","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Mukae, Hiroshi","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2677","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2020-03-18"}],"displaytype":"detail","filename":"S00039106.pdf","filesize":[{"value":"4.2 MB"}],"format":"application/pdf","licensetype":"license_11","mimetype":"application/pdf","url":{"label":"S00039106.pdf","url":"https://uoeh-u.repo.nii.ac.jp/record/766/files/S00039106.pdf"},"version_id":"30903c14-e3af-4d60-928c-375e38205254"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"HTLV-1","subitem_subject_scheme":"Other"},{"subitem_subject":"びまん性汎細気管支炎","subitem_subject_scheme":"Other"},{"subitem_subject":"成人T細胞性白血病","subitem_subject_scheme":"Other"},{"subitem_subject":"関節リウマチ","subitem_subject_scheme":"Other"},{"subitem_subject":"human T-lymphotrophic virus type 1","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"diffuse panbronchiolitis","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"adult T cell leukemia","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"rheumatoid arthritis","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"関節リウマチを合併し，びまん性汎細気管支炎類似の病像を呈した成人T細胞性白血病の１剖検例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"関節リウマチを合併し，びまん性汎細気管支炎類似の病像を呈した成人T細胞性白血病の１剖検例"},{"subitem_title":"An Autopsy Case Report of Adult T-cell Leukemia Accompanied by Rheumatoid Arthritis Mimicking Diffuse Panbronchiolitis","subitem_title_language":"en"}]},"item_type_id":"10001","owner":"4","path":["37"],"pubdate":{"attribute_name":"公開日","attribute_value":"2020-08-03"},"publish_date":"2020-08-03","publish_status":"0","recid":"766","relation_version_is_last":true,"title":["関節リウマチを合併し，びまん性汎細気管支炎類似の病像を呈した成人T細胞性白血病の１剖検例"],"weko_creator_id":"4","weko_shared_id":-1},"updated":"2023-06-20T15:58:23.165826+00:00"}