A Patient with Non-alcoholic Steatohepatitis Complicated by Multiple Myeloma
A 68-year-old woman with liver dysfunction was diagnosed with nonalcoholic steatohepatitis (NASH) stage 1. Three years later, she showed massive ascites and jaundice. A trans-jugular liver biopsy confirmed advanced cirrhosis, suggesting that her liver fibrosis had progressed rapidly. At the same tim...
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Veröffentlicht in: | Internal Medicine 2018/07/15, Vol.57(14), pp.2013-2018 |
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container_end_page | 2018 |
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container_issue | 14 |
container_start_page | 2013 |
container_title | Internal Medicine |
container_volume | 57 |
creator | Akashi, Momoko Tajiri, Kazuto Wada, Akinori Tsuneyama, Koichi Kawai, Kengo Yasumura, Satoshi Minemura, Masami Takahara, Terumi Sugiyama, Toshiro |
description | A 68-year-old woman with liver dysfunction was diagnosed with nonalcoholic steatohepatitis (NASH) stage 1. Three years later, she showed massive ascites and jaundice. A trans-jugular liver biopsy confirmed advanced cirrhosis, suggesting that her liver fibrosis had progressed rapidly. At the same time, she was diagnosed with multiple myeloma (MM). In this case, the plasma levels of osteopontin (OPN), a proinflammatory cytokine that promotes liver fibrosis progression through the hedgehog pathway and is increased in patients with MM, were increased. This increased OPN expression was accompanied by the upregulation of the hedgehog pathway in this patient, suggesting that the MM-associated increase in OPN had promoted the progression of liver fibrosis through the hedgehog pathway. The progression of liver fibrosis should be monitored in patients with NASH if other diseases, such as MM, are present. |
doi_str_mv | 10.2169/internalmedicine.0092-17 |
format | Article |
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Three years later, she showed massive ascites and jaundice. A trans-jugular liver biopsy confirmed advanced cirrhosis, suggesting that her liver fibrosis had progressed rapidly. At the same time, she was diagnosed with multiple myeloma (MM). In this case, the plasma levels of osteopontin (OPN), a proinflammatory cytokine that promotes liver fibrosis progression through the hedgehog pathway and is increased in patients with MM, were increased. This increased OPN expression was accompanied by the upregulation of the hedgehog pathway in this patient, suggesting that the MM-associated increase in OPN had promoted the progression of liver fibrosis through the hedgehog pathway. The progression of liver fibrosis should be monitored in patients with NASH if other diseases, such as MM, are present.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.0092-17</identifier><identifier>PMID: 29491288</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>Aged ; Ascites ; Asian Continental Ancestry Group ; Bile ; Biopsy ; Case Report ; Cirrhosis ; Female ; Fibrosis ; hedgehog pathway ; Hedgehog Proteins - blood ; Humans ; Inflammation ; Internal medicine ; Jaundice ; Liver ; Liver cirrhosis ; Liver Cirrhosis - diagnostic imaging ; Liver Cirrhosis - physiopathology ; Liver diseases ; Multiple myeloma ; Multiple Myeloma - etiology ; Multiple Myeloma - physiopathology ; Non-alcoholic Fatty Liver Disease - complications ; Non-alcoholic Fatty Liver Disease - physiopathology ; non-alcoholic steatohepatitis ; Osteopontin ; Plasma levels</subject><ispartof>Internal Medicine, 2018/07/15, Vol.57(14), pp.2013-2018</ispartof><rights>2018 by The Japanese Society of Internal Medicine</rights><rights>Copyright Japan Science and Technology Agency 2018</rights><rights>Copyright © 2018 by The Japanese Society of Internal Medicine 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c555t-59255f3d15772b2ea392b97fd336038771ce67af53835471fbe2cbe82e95147d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096013/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096013/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,882,1877,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29491288$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Akashi, Momoko</creatorcontrib><creatorcontrib>Tajiri, Kazuto</creatorcontrib><creatorcontrib>Wada, Akinori</creatorcontrib><creatorcontrib>Tsuneyama, Koichi</creatorcontrib><creatorcontrib>Kawai, Kengo</creatorcontrib><creatorcontrib>Yasumura, Satoshi</creatorcontrib><creatorcontrib>Minemura, Masami</creatorcontrib><creatorcontrib>Takahara, Terumi</creatorcontrib><creatorcontrib>Sugiyama, Toshiro</creatorcontrib><title>A Patient with Non-alcoholic Steatohepatitis Complicated by Multiple Myeloma</title><title>Internal Medicine</title><addtitle>Intern. Med.</addtitle><description>A 68-year-old woman with liver dysfunction was diagnosed with nonalcoholic steatohepatitis (NASH) stage 1. Three years later, she showed massive ascites and jaundice. A trans-jugular liver biopsy confirmed advanced cirrhosis, suggesting that her liver fibrosis had progressed rapidly. At the same time, she was diagnosed with multiple myeloma (MM). In this case, the plasma levels of osteopontin (OPN), a proinflammatory cytokine that promotes liver fibrosis progression through the hedgehog pathway and is increased in patients with MM, were increased. This increased OPN expression was accompanied by the upregulation of the hedgehog pathway in this patient, suggesting that the MM-associated increase in OPN had promoted the progression of liver fibrosis through the hedgehog pathway. The progression of liver fibrosis should be monitored in patients with NASH if other diseases, such as MM, are present.</description><subject>Aged</subject><subject>Ascites</subject><subject>Asian Continental Ancestry Group</subject><subject>Bile</subject><subject>Biopsy</subject><subject>Case Report</subject><subject>Cirrhosis</subject><subject>Female</subject><subject>Fibrosis</subject><subject>hedgehog pathway</subject><subject>Hedgehog Proteins - blood</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Internal medicine</subject><subject>Jaundice</subject><subject>Liver</subject><subject>Liver cirrhosis</subject><subject>Liver Cirrhosis - diagnostic imaging</subject><subject>Liver Cirrhosis - physiopathology</subject><subject>Liver diseases</subject><subject>Multiple myeloma</subject><subject>Multiple Myeloma - etiology</subject><subject>Multiple Myeloma - physiopathology</subject><subject>Non-alcoholic Fatty Liver Disease - complications</subject><subject>Non-alcoholic Fatty Liver Disease - physiopathology</subject><subject>non-alcoholic steatohepatitis</subject><subject>Osteopontin</subject><subject>Plasma levels</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplkV-P1CAUxYnRuOPqVzAkvvjStUAp5cVkM1n_JLOuifpMKL3dMqGlAtXMt5c640TXl0sCv3vu4R6EMCmvKKnlGzslCJN2I3TW2AmuylLSgohHaENYJQtBGX-MNqUkTUFzuUDPYtyXJWuEpE_RBZWVJLRpNmh3jT_rZGFK-KdNA_7kp0I74wfvrMFfEujkB5gzkmzEWz_O-V4n6HB7wLeLS3Z2gG8P4Pyon6MnvXYRXpzOS_Tt3c3X7Ydid_f-4_Z6VxjOeSq4pJz3rCNcCNpS0EzSVoq-Y6xeLQpioBa656xhvBKkb4GaFhoKkpNKdOwSvT3qzkubV2Cy-6CdmoMddTgor63692Wyg7r3P1RdyrokLAu8PgkE_32BmNRoowHn9AR-iYrmffI621vRVw_QvV_W3WeKVrVkoiIiU82RMsHHGKA_myGlWiNTDyNTa2Tqd-vLvz9zbvyTUQbujsA-Jn0PZ0CHZI2D_5W5UKRa62nEmTSDDgom9gtR-LU7</recordid><startdate>20180715</startdate><enddate>20180715</enddate><creator>Akashi, Momoko</creator><creator>Tajiri, Kazuto</creator><creator>Wada, Akinori</creator><creator>Tsuneyama, Koichi</creator><creator>Kawai, Kengo</creator><creator>Yasumura, Satoshi</creator><creator>Minemura, Masami</creator><creator>Takahara, Terumi</creator><creator>Sugiyama, Toshiro</creator><general>The Japanese Society of Internal Medicine</general><general>Japan Science and Technology Agency</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180715</creationdate><title>A Patient with Non-alcoholic Steatohepatitis Complicated by Multiple Myeloma</title><author>Akashi, Momoko ; Tajiri, Kazuto ; Wada, Akinori ; Tsuneyama, Koichi ; Kawai, Kengo ; Yasumura, Satoshi ; Minemura, Masami ; Takahara, Terumi ; Sugiyama, Toshiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c555t-59255f3d15772b2ea392b97fd336038771ce67af53835471fbe2cbe82e95147d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Ascites</topic><topic>Asian Continental Ancestry Group</topic><topic>Bile</topic><topic>Biopsy</topic><topic>Case Report</topic><topic>Cirrhosis</topic><topic>Female</topic><topic>Fibrosis</topic><topic>hedgehog pathway</topic><topic>Hedgehog Proteins - blood</topic><topic>Humans</topic><topic>Inflammation</topic><topic>Internal medicine</topic><topic>Jaundice</topic><topic>Liver</topic><topic>Liver cirrhosis</topic><topic>Liver Cirrhosis - diagnostic imaging</topic><topic>Liver Cirrhosis - physiopathology</topic><topic>Liver diseases</topic><topic>Multiple myeloma</topic><topic>Multiple Myeloma - etiology</topic><topic>Multiple Myeloma - physiopathology</topic><topic>Non-alcoholic Fatty Liver Disease - complications</topic><topic>Non-alcoholic Fatty Liver Disease - physiopathology</topic><topic>non-alcoholic steatohepatitis</topic><topic>Osteopontin</topic><topic>Plasma levels</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Akashi, Momoko</creatorcontrib><creatorcontrib>Tajiri, Kazuto</creatorcontrib><creatorcontrib>Wada, Akinori</creatorcontrib><creatorcontrib>Tsuneyama, Koichi</creatorcontrib><creatorcontrib>Kawai, Kengo</creatorcontrib><creatorcontrib>Yasumura, Satoshi</creatorcontrib><creatorcontrib>Minemura, Masami</creatorcontrib><creatorcontrib>Takahara, Terumi</creatorcontrib><creatorcontrib>Sugiyama, Toshiro</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Internal Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Akashi, Momoko</au><au>Tajiri, Kazuto</au><au>Wada, Akinori</au><au>Tsuneyama, Koichi</au><au>Kawai, Kengo</au><au>Yasumura, Satoshi</au><au>Minemura, Masami</au><au>Takahara, Terumi</au><au>Sugiyama, Toshiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Patient with Non-alcoholic Steatohepatitis Complicated by Multiple Myeloma</atitle><jtitle>Internal Medicine</jtitle><addtitle>Intern. Med.</addtitle><date>2018-07-15</date><risdate>2018</risdate><volume>57</volume><issue>14</issue><spage>2013</spage><epage>2018</epage><pages>2013-2018</pages><issn>0918-2918</issn><eissn>1349-7235</eissn><abstract>A 68-year-old woman with liver dysfunction was diagnosed with nonalcoholic steatohepatitis (NASH) stage 1. Three years later, she showed massive ascites and jaundice. A trans-jugular liver biopsy confirmed advanced cirrhosis, suggesting that her liver fibrosis had progressed rapidly. At the same time, she was diagnosed with multiple myeloma (MM). In this case, the plasma levels of osteopontin (OPN), a proinflammatory cytokine that promotes liver fibrosis progression through the hedgehog pathway and is increased in patients with MM, were increased. This increased OPN expression was accompanied by the upregulation of the hedgehog pathway in this patient, suggesting that the MM-associated increase in OPN had promoted the progression of liver fibrosis through the hedgehog pathway. The progression of liver fibrosis should be monitored in patients with NASH if other diseases, such as MM, are present.</abstract><cop>Japan</cop><pub>The Japanese Society of Internal Medicine</pub><pmid>29491288</pmid><doi>10.2169/internalmedicine.0092-17</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Aged Ascites Asian Continental Ancestry Group Bile Biopsy Case Report Cirrhosis Female Fibrosis hedgehog pathway Hedgehog Proteins - blood Humans Inflammation Internal medicine Jaundice Liver Liver cirrhosis Liver Cirrhosis - diagnostic imaging Liver Cirrhosis - physiopathology Liver diseases Multiple myeloma Multiple Myeloma - etiology Multiple Myeloma - physiopathology Non-alcoholic Fatty Liver Disease - complications Non-alcoholic Fatty Liver Disease - physiopathology non-alcoholic steatohepatitis Osteopontin Plasma levels |
title | A Patient with Non-alcoholic Steatohepatitis Complicated by Multiple Myeloma |
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