{"created":"2023-06-20T15:46:11.752872+00:00","id":784,"links":{},"metadata":{"_buckets":{"deposit":"1f86692c-f679-494a-bc93-ab5f37c52974"},"_deposit":{"created_by":4,"id":"784","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"784"},"status":"published"},"_oai":{"id":"oai:uoeh-u.repo.nii.ac.jp:00000784","sets":["13:23:34"]},"author_link":["2880","2870","2879","2873","2887","2878","2883","2877","2882","2890","2886","2881","2884","2871","2874","2876","2888","2889","2875","2872","2885","2891"],"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2017-12-01","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"4","bibliographicPageEnd":"276","bibliographicPageStart":"271","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":"Case reports of hyperammonemia due to urease-producing bacteria are found occasionally, but most of them are associated with urinary tract infections. We experienced a case of infectious enterocolitis with hyperammonemia in which the causative bacteria was speculated to be urease-producing bacteria.  A Japanese woman in her 70s had been diagnosed with microscopic polyangiitis in a nearby hospital and was transferred to our hospital.  Although the microscopic polyangiitis was relatively under control after treatment with steroids and rituximab, frequent diarrhea with hyperammonemia (324 μg/dl) appeared and she became comatose.  Her blood ammonia decreased to 47 µg/dl and her consciousness recovered to a normal state after antibiotic treatment for infectious enterocolitis and ammonia detoxification therapy.  Liver dysfunction, portosystemic shunt, excessive protein intake and constipation were not observed, and she took no medications that would cause hyperammonemia.  Although culture results could not identify urease-producing bacteria, considering the clinical course, acute hyperammonemia was suspected to be due to urease-producing bacteria infection.  It is necessary to consider the influence of urease-producing bacteria as a cause of acute hyperammonemia not only in urinary tract infections but also in infective enterocolitis.\n","subitem_description_type":"Abstract"},{"subitem_description":"ウレアーゼ産生菌のため高アンモニア血症を来した報告は散見されるが，その多くは尿路感染症であ る．今回我々はウレアーゼ産生菌による感染性腸炎のため高アンモニア血症を来したと考えられた症例を経験し た．症例は70歳代女性．近医で顕微鏡的多発血管炎と診断され当院へ紹介となった．ステロイド療法およびリツ キシマブを開始して顕微鏡的多発血管炎は比較的落ち着いていたが，頻回の下痢および高アンモニア血症（324 μg/ dl）を認め，昏睡状態となった．感染性腸炎および高アンモニア血症に対して，抗菌薬による加療およびアンモニア の解毒療法を開始したところ， 血中アンモニアは47 μg/dlまで低下し意識は清明となった．高アンモニア血症の原因 としては，肝機能障害や門脈体循環シャント，蛋白質過剰摂取，便秘は認めず，薬剤性の高アンモニア血症も否定的で あり，ウレアーゼ産生菌によるアンモニア過剰産生が疑われた．本症例で提出した培養結果からはウレアーゼ産生能をもつ原因菌は特定できなかったが，培養で同定することが出来なかったウレアーゼ産生菌が，高アンモニア血症 を引き起こしていた可能性が高いと考えられた．尿路感染症だけでなく，感染性腸炎においても，高アンモニア血症 の原因としてウレアーゼ産生菌による影響を考慮する必要がある．\n","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/39/4/_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_2017-4j.html","subitem_relation_type_select":"URI"}}]},"item_10001_select_24":{"attribute_name":"記事区分","attribute_value_mlt":[{"subitem_select_item":"Case Report(s)"}]},"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":"尾辻, 健"}],"nameIdentifiers":[{"nameIdentifier":"2870","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"清水, 智子"}],"nameIdentifiers":[{"nameIdentifier":"2871","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"遠藤, 武尊"}],"nameIdentifiers":[{"nameIdentifier":"2872","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"金澤, 綾子"}],"nameIdentifiers":[{"nameIdentifier":"2873","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"荒井, 秀明"}],"nameIdentifiers":[{"nameIdentifier":"2874","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"長田, 圭司"}],"nameIdentifiers":[{"nameIdentifier":"2875","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"原山, 信也"}],"nameIdentifiers":[{"nameIdentifier":"2876","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"二瓶, 俊一"}],"nameIdentifiers":[{"nameIdentifier":"2877","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"相原, 啓二"}],"nameIdentifiers":[{"nameIdentifier":"2878","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"齋藤, 光正"}],"nameIdentifiers":[{"nameIdentifier":"2879","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"蒲地, 正幸"}],"nameIdentifiers":[{"nameIdentifier":"2880","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Otsuji, Ken","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2881","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Simizu, Satoko","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2882","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Endo, Takeru","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2883","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Kanazawa, Ayako","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2884","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Arai, Hideaki","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2885","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Nagata, Keiji","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2886","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Harayama, Nobuya","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2887","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Nihei, Shunichi","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2888","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Aibara, Keiji","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2889","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Saito, Mitsumasa","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2890","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Kamochi, Masayuki","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2891","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":"S00039403.pdf","filesize":[{"value":"983.6 kB"}],"format":"application/pdf","licensetype":"license_11","mimetype":"application/pdf","url":{"label":"S00039403.pdf","url":"https://uoeh-u.repo.nii.ac.jp/record/784/files/S00039403.pdf"},"version_id":"856f08de-3138-4e5f-ae70-3d2da3560f0e"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"高アンモニア血症","subitem_subject_scheme":"Other"},{"subitem_subject":"ウレアーゼ","subitem_subject_scheme":"Other"},{"subitem_subject":"感染性腸炎","subitem_subject_scheme":"Other"},{"subitem_subject":"hyperammonemia","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"urease","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"infectious enterocolitis","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"eng"}]},"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":"高アンモニア血症を伴った感染性腸炎の1例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"高アンモニア血症を伴った感染性腸炎の1例"},{"subitem_title":"A Case of Infectious Enterocolitis with Hyperammonemia","subitem_title_language":"en"}]},"item_type_id":"10001","owner":"4","path":["34"],"pubdate":{"attribute_name":"公開日","attribute_value":"2020-08-03"},"publish_date":"2020-08-03","publish_status":"0","recid":"784","relation_version_is_last":true,"title":["高アンモニア血症を伴った感染性腸炎の1例"],"weko_creator_id":"4","weko_shared_id":-1},"updated":"2023-06-20T15:57:23.909514+00:00"}