Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 64, Issue 5
Displaying 1-2 of 2 articles from this issue
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Case Reports
  • A case of elderly-onset erythropoietic protoporphyria diagnosed at autopsy
    Kazuki Kurosaka, Kosuke Tanaka, Miya Takai, Shigehiro Nagasawa, Yusuke ...
    2023 Volume 64 Issue 5 Pages 235-242
    Published: May 01, 2023
    Released on J-STAGE: May 12, 2023
    DOIhttps://doi.org/10.2957/kanzo.64.235
    JOURNAL FREE ACCESS
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    The patient was a 71-year-old man. He was diagnosed with autoimmune hepatitis based on the presence of antinuclear antibodies, high immunoglobulin G levels, and a liver biopsy. Prednisolone therapy was ineffective, and the immunosuppressive drugs, such as azathioprine and cyclosporine, were also ineffective. Eventually, on day 93, he succumbed to liver failure. Erythropoietic protoporphyria with protoporphyrin accumulation in the liver tissue was discovered following a pathological autopsy. We report a case of liver failure in which the patient was identified with autoimmune hepatitis before his death, but in which autopsy showed a diagnosis of elderly-onset erythropoietic protoporphyria.

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  • A case of Guillain-Barré Syndrome after atezolizumab and bevacizumab combination therapy for multiple lung metastases from hepatocellular carcinoma
    Miyu Takahashi, Satoshi Tanaka, Shigen Kasakura, Wagu Watanabe, Satosh ...
    2023 Volume 64 Issue 5 Pages 243-252
    Published: May 01, 2023
    Released on J-STAGE: May 12, 2023
    DOIhttps://doi.org/10.2957/kanzo.64.243
    JOURNAL FREE ACCESS
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    A 60-year-old woman experienced peripheral limb paresthesia and limb weakness 14 days after starting atezolizumab-bevacizumab combination treatment for multiple lung metastases of hepatocellular carcinoma. Examination of the cerebrospinal fluid revealed increased protein and cell counts, and blood tests were positive for GalNAc-GD1a IgG and Gal-C IgG antibodies in serum. Nerve conduction velocity studies showed demyelinating peripheral neuropathy, and a diagnosis of atezolizumab-related drug-induced Guillain-Barré syndrome was confirmed. Muscle weakness resolved with high-dose immunoglobulin therapy. We describe a case of Guillain-Barré syndrome brought on by an immune-related adverse reaction to an immune checkpoint inhibitor used to treat hepatocellular cancer. The early intervention led to clinical improvement in this patient.

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