論文 - 橋口　明典

キャッスルマン病によるネフローゼ症候群にトシリズマブが有効であった一例

児島 大輝, 山口 慎太郎, 安達 京華, 安田 格, 西岡 謙, 吉本 憲史, 内山 清貴, 田島 敬也, 林 香, 長谷川 一宏, 吉野 純, 目黒 周, 橋口 明典, 神田 武志, 伊藤 裕

日本腎臓学会誌 （(一社)日本腎臓学会）  63 （ 6-E ） 703 - 703 2021年09月

共著,  ISSN  0385-2385

IgA沈着型膜性腎症の一例

橋元 奈津子, 川口 隆久, 橋口 明典, 片山 順平, 増井 健太朗, 唐澤 隆明

日本腎臓学会誌 （(一社)日本腎臓学会）  63 （ 6-E ） 674 - 674 2021年09月

共著,  ISSN  0385-2385

抗SS-A抗体陽性の若年膜性腎症の一例

川口 隆久, 橋口 明典, 片山 順平, 増井 健太朗, 唐澤 隆明

日本腎臓学会誌 （(一社)日本腎臓学会）  63 （ 6-E ） 732 - 732 2021年09月

共著,  ISSN  0385-2385

MPO-ANCA、抗GBM抗体共陽性の急速進行性糸球体腎炎に対して選択的血漿交換(SePE)を行った一例

星 健太, 浦井 秀徳, 渡部 統, 中村 彰良, 橋口 明典, 村上 円人

日本急性血液浄化学会雑誌 （(NPO)日本急性血液浄化学会）  12 （ Suppl. ） 114 - 114 2021年09月

共著,  ISSN  2185-1085

A girl with a mutation of the ciliary gene CC2D2A presenting with FSGS and nephronophthisis.

Awazu M, Yamada M, Asada N, Hashiguchi A, Kosaki K, Matsumura K

CEN case reports （CEN case reports）  11 （ 1 ） 116 - 119 2021年08月

研究論文（学術雑誌）, 共著, 査読有り

　概要を見る

Mutations in the ciliary gene TTC21B, NPHP4, and CRB2 cause familial focal and segmental glomerulosclerosis (FSGS). We report a girl with a mutation of the ciliary gene CC2D2A presenting with FSGS and nephronophthisis. The patient had mental retardation, postaxial polydactyly, and ataxic breathing, and was diagnosed as having compound heterozygous CC2D2A missense mutations at age 5. Retrospectively, azotemia at 1 year and proteinuria at 5 years were recorded but not investigated. At age 6, she was referred to the pediatric nephrology service because of hypertension, pretibial pitting edema, heavy proteinuria, and hematuria. eGFR was 66 ml/min/1.73 m2, total protein 5.3 g/dl, albumin 2.4 g/dl, and cholesterol 317 mg/dl. Ultrasonography showed normal-sized kidneys with a cyst in the right. Losartan was started. On renal biopsy, 8 out of 24 glomeruli were globally sclerosed, and three showed segmental sclerosis and/or hyalinosis with no immune deposits. Mild tubular dilatation, tubular atrophy, and interstitial fibrosis were observed. On electron microscopy, glomeruli showed focal foot process effacement with no electron dense deposits. Since losartan did not exert an obvious effect, treatment with prednisolone was tried. Urine protein decreased from 6.6 to 3.7 g/gCr. Prednisolone was discontinued after 10 days, however, because she developed duodenal ulcer perforation that necessitated omentoplasty. Subsequently, she was treated with losartan only. Her renal function deteriorated and peritoneal dialysis was initiated 8 months later. FSGS in this patient could be primary glomerular associated with CC2D2A mutation, rather than the consequences of tubulointerstitial fibrosis.

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Grading of Multifocal Prostate Cancer Cases in which the Largest Volume and the Highest Grade Do Not Coincide within One Lesion

Matsumoto K., Omura M., Takeda T., Kosaka T., Hashiguchi A., Takamatsu K., Yasumizu Y., Tanaka N., Morita S., Mizuno R., Asanuma H., Oya M.

The Journal of urology （The Journal of urology）  206 （ 2 ） 338 - 345 2021年08月

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  0022-5347

　概要を見る

PURPOSE: In general, the index lesion of prostate cancer has the largest tumor volume, the highest Grade Group (GG), and the highest stage (concordant cases). However, these factors sometimes do not coincide within one lesion (discordant cases). In such discordant cases, the largest tumor may not be of biological significance and the secondary tumor may more greatly impact the prognosis. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients who underwent radical prostatectomy, and we identified 580 (85.3%) concordant cases and 100 (14.7%) discordant cases. The end point of this study was biochemical recurrence, and median followup was 4.2 years. RESULTS: Among discordant cases in which GGs of the largest tumor and the highest GG tumor differed, the majority (67 patients) had the largest tumor of GG 2, and we set them as the study cohort. On the other hand, we regarded 212 concordant cases with an index tumor of GG 2 as the control cohort. The study cohort comprised 48 (71.6%) patients with a secondary tumor of GG 3 and 19 (28.4%) with a secondary tumor of GG 4/5. Kaplan-Meier curves revealed that the 5-year biochemical recurrence-free survival rates were 76%, and 67%, respectively. The 5-year biochemical recurrence-free survival rate of the control cohort was 91%, which was significantly better than that of the study cohort (p=0.013 and p=0.014, respectively). CONCLUSIONS: Our study suggests that the prognosis of discordant cases is better determined by the secondary cancer lesion with the highest GG instead of the largest lesion.

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Development of nephropathy in an adult patient after Fontan palliation for cyanotic congenital heart disease

Hayashi K., Hashiguchi A., Ikemiyagi M., Tokuyama H., Wakino S., Itoh H.

CEN case reports （CEN case reports）  10 （ 3 ） 354 - 358 2021年08月

研究論文（学術雑誌）, 共著, 査読有り

　概要を見る

Cyanotic congenital heart disease is occasionally associated with kidney dysfunction, which is known as cyanotic nephropathy or cyanotic glomerulopathy. The clinical presentation of cyanotic nephropathy includes proteinuria, decreased estimated glomerular filtration rate, hyperuricemia, thrombocytopenia, or polycythemia. Although advances in surgical procedures have improved the prognosis of cyanotic congenital heart diseases, adult cases of cyanotic nephropathy are still rare, and there are few reports of kidney biopsy in adults with cyanotic nephropathy. Here, we present the case of a 41-year-old patient with Fontan palliation who developed nephrotic range proteinuria and had a kidney biopsy, which showed glomerular hypertrophy with segmental glomerulosclerosis around vascular poles, suggesting adaptive focal segmental glomerulosclerosis. This case provides further understanding of kidney dysfunction due to cyanotic congenital heart disease and shows the need for attention in the management for prevention of progression to end-stage renal disease and in the selection of renal replacement therapy.

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同時性かつ同一乳房内に全く異なった治療法を必要とする原発性乳癌と乳房内原発悪性リンパ腫を認めた一例

和田 真弘, 橋口 明典

日本乳癌学会総会プログラム抄録集 （(一社)日本乳癌学会）  29回   131 - 131 2021年07月

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C3腎症を基準とした一次性MPGNの再分類:電顕PAMを用いたType 3 Anders-Strife型の鑑別のもとに

本間 志功, 佐藤 直実, 橋口 明典, 上杉 憲子, 中村 保宏, 城 謙輔

日本腎臓学会誌 （(一社)日本腎臓学会）  63 （ 4 ） 436 - 436 2021年06月

共著,  ISSN  0385-2385

DNA修復因子KAT5を介した尿細管糸球体フィードバック制御

菱川 彰人, 林 香, 久保 亜紀子, 宮下 和季, 橋口 明典, 吉本 憲史, 中道 蘭, 杉田 絵里那, 赤塩 理起, 門川 俊明, 末松 誠, 伊藤 裕

日本腎臓学会誌 （(一社)日本腎臓学会）  63 （ 4 ） 488 - 488 2021年06月

共著,  ISSN  0385-2385

Malignancy-associated membranous nephropathy with PLA2R double-positive for glomeruli and carcinoma

Yasuda I., Tokuyama H., Hashiguchi A., Hasegawa K., Uchiyama K., Ryuzaki M., Yasuda M., Mizuno R., Ishidoya S., Wakino S., Itoh H.

CEN case reports （CEN case reports）  10 （ 2 ） 281 - 286 2021年05月

研究論文（学術雑誌）, 共著, 査読有り

　概要を見る

Phospholipase A2 receptor (PLA2R) is the most common primary target antigen of idiopathic membranous nephropathy (MN) although PLA2R antibodies are also reported to be present in malignancy-associated MN. However, a case of PLA2R-positive MN secondary to PLA2R-positive carcinoma has not been reported. A 26-year-old Japanese woman presented with general fatigue, fever, and nonproductive cough. Computed tomography demonstrated a left kidney mass with pathologic diagnosis of Xp11.2 translocation renal cell carcinoma (RCC). After the second time of administration with Sunitinib, the patients exhibited significant proteinuria and hypoalbuminemia. Renal biopsy revealed a diagnosis of diffuse MN secondary to RCC. Immunofluorescence staining showed granular patterns positive for immunoglobulin (Ig) G, IgA, and C3c. PLA2R and IgG1-3 were positive, while IgG4 was negative. For the treatment of severe nephrotic syndrome, we attempted steroid therapy without any clinical improvement. Open nephrectomy was performed and surprisingly, RCC was stained for PLA2R with polarity for the basal side. At outpatient follow-up, 4 months after the operation, urinary protein had still persisted, although serum albumin was slightly increased. We report a case of PLA2R-positive MN secondary to PLA2R-positive RCC.

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デジタル画像解析を用いたIgA腎症糸球体病変定量化

橋口 明典, 石川 雅浩, 城 謙輔, 坂本 直樹, 山内 暁, 大塚 武, 福西 宗憲, 清水 章, 片渕 律子, 川村 哲也

日本病理学会会誌 （(一社)日本病理学会）  110 （ 1 ） 327 - 327 2021年03月

共著,  ISSN  0300-9181

【来たるべくデジタルヘルスケア革命-乗り遅れるな腎臓病学!-】腎臓領域の現在の取り組み　腎生検デジタル病理

橋口 明典

腎と透析 （(株)東京医学社）  90 （ 2 ） 253 - 259 2021年02月

共著,  ISSN  0385-2156

【腎非腫瘍性疾患の病理診断の実践-腎生検病理診断から剖検診断まで-】自己免疫疾患に伴う腎障害　ループス腎炎を中心に

橋口 明典

病理と臨床 （(株)文光堂）  39 （ 2 ） 141 - 147 2021年02月

共著,  ISSN  0287-3745

【来たるべくデジタルヘルスケア革命-乗り遅れるな腎臓病学!-】臨床現場でのAI活用　AIと病理診断

橋口 明典

腎と透析 （(株)東京医学社）  90 （ 2 ） 229 - 235 2021年02月

共著,  ISSN  0385-2156

A cross-sectional study in patients with IgA nephropathy of correlations between clinical data and pathological findings at the time of renal biopsy: a Japanese prospective cohort study

Kamano C., Shimizu A., Joh K., Hashiguchi A., Hisano S., Katafuchi R., Kawamura T.

Clinical and Experimental Nephrology （Clinical and Experimental Nephrology）  25 （ 5 ） 509 - 521 2021年

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  13421751

　概要を見る

Background: The correlations between clinical data and pathological findings at the time of renal biopsy were investigated in IgA nephropathy patients. Methods: 771 patients diagnosed with IgA nephropathy by renal biopsy were enrolled. The correlations between clinical variables including eGFR, daily proteinuria, mean arterial pressure (MAP), serum uric acid (UA) values, and pathological parameters were examined. These patients were further divided into three groups: children (< 19 years old), young adults (19–60 years), and elderly patients (> 60 years). Results: Daily proteinuria was moderately correlated with all pathological parameters (Rs = 0.23–0.49). The mesangial score, the percentage of glomeruli that contained endocapillary hypercellularity, cellular/fibrocellular crescents or tuft necrosis, and segmental glomerulosclerosis (GS) affected daily proteinuria most on multiple linear regression analysis (MLRA). eGFR, MAP, and serum UA levels were mainly correlated with the degree of GS and interstitial lesions. In children, the degree of cellular/fibrocellular crescents or tuft necrosis was correlated with not only daily proteinuria, but also decreased eGFR (Rs = 0.51, − 0.24). Endocapillary hypercellularity was the only independent variable related to daily proteinuria on MLRA. Conclusion: In all age cohorts of IgA nephropathy patients, daily proteinuria was correlated with all histological parameters, including both acute and chronic glomerular lesions, and the mesangial score. Independent variables for daily proteinuria were the meangial score, acute histological lesions, and segmental GS on MLRA, whereas the remaining independent variable in the pediatric group was endocapillary hypercellurality. The clinical pathological correlation at the time of biopsy varied depending on the age group.

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Glomerulonephritis caused by bartonella spp. infective endocarditis: The difficulty and importance of differentiation from anti-neutrophil cytoplasmic antibody-related rapidly progressive glomerulonephritis

Yoshifuji A., Hibino Y., Komatsu M., Yasuda S., Hosoya K., Kobayashi E., Baba Y., Hirose S., Hashiguchi A., Kanno Y., Ryuzaki M.

Internal Medicine （Internal Medicine）  60 （ 12 ） 1899 - 1906 2021年

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  09182918

　概要を見る

A 65-year-old man with valvular disorder presented to his physician because of widespread purpura in both lower extremities. Blood tests showed elevated serum creatinine levels and proteinase 3-anti-neutrophil cytoplasmic antibody (ANCA) with hematuria, suggesting ANCA-related rapidly progressive glomerulonephritis (RPGN). Although multiple blood cultures were negative, transthoracic echocardiography revealed warts in the valves, and a renal biopsy also showed findings of glomerular infiltration by mononuclear leukocytes and C3 deposition in the glomeruli, suggesting infection-related glomerulonephritis. Later, Bartonella antibody turned positive. Antimicrobial treatment improved the purpura and renal function without any recurrence. ANCA-positive RPGN requires the exclusion of infective endocarditis, especially that induced by Bartonella spp.

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Association of glomerular DNA damage and DNA methylation with one-year eGFR decline in IgA nephropathy

Hayashi K., Hishikawa A., Hashiguchi A., Azegami T., Yoshimoto N., Nakamichi R., Tokuyama H., Itoh H.

Scientific Reports （Scientific Reports）  10 （ 1 ） 237 - 237 2020年12月

研究論文（学術雑誌）, 共著, 査読有り

　概要を見る

© 2020, The Author(s). Accumulation of DNA double-strand breaks (DSBs) is linked to aging and age-related diseases. We recently reported the possible association of DNA DSBs with altered DNA methylation in murine models of kidney disease. However, DSBs and DNA methylation in human kidneys was not adequately investigated. This study was a cross-sectional observational study to evaluate the glomerular DNA DSB marker γH2AX and phosphorylated Ataxia Telangiectasia Mutated (pATM), and the DNA methylation marker 5-methyl cytosine (5mC) by immunostaining, and investigated the association with pathological features and clinical parameters in 29 patients with IgA nephropathy. To evaluate podocyte DSBs, quantitative long-distance PCR of the nephrin gene using laser-microdissected glomerular samples and immunofluorescent double-staining with WT1 and γH2AX were performed. Glomerular γH2AX level was associated with glomerular DNA methylation level in IgA nephropathy. Podocytopathic features were associated with increased number of WT1(+)γH2AX(+) cells and reduced amount of PCR product of the nephrin gene, which indicate podocyte DNA DSBs. Glomerular γH2AX and 5mC levels were significantly associated with the slope of eGFR decline over one year in IgA nephropathy patients using multiple regression analysis adjusted for age, baseline eGFR, amount of proteinuria at biopsy and immunosuppressive therapy after biopsy. Glomerular γH2AX level was associated with DNA methylation level, both of which may be a good predictor of renal outcome in IgA nephropathy.

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最大病変が最高Gleason scoreでないmultifocal前立腺癌症例へのGleason scoreの付け方

松本 一宏, 橋口 明典, 武田 利和, 小坂 威雄, 高松 公晴, 安水 洋太, 田中 伸之, 森田 伸也, 水野 隆一, 浅沼 宏, 大家 基嗣

日本癌治療学会学術集会抄録集 （(一社)日本癌治療学会）  58回   P - 353 2020年10月

研究論文（学術雑誌）, 共著, 査読有り

腎臓病理所見からT細胞型悪性リンパ腫と診断し得た一例

押田 卓磨, 徳山 博文, 安田 格, 竜崎 正毅, 大島 洋一, 内山 清貴, 橋口 明典, 脇野 修, 伊藤 裕

日本腎臓学会誌 （(一社)日本腎臓学会）  62 （ 6 ） 567 - 567 2020年09月

共著,  ISSN  0385-2385