8
|
Kadoya M, Hida A, Hashimoto Maeda M, Taira K, Ikenaga C, Uchio N, Kubota A, Kaida K, Miwa Y, Kurasawa K, Shimada H, Sonoo M, Chiba A, Shiio Y, Uesaka Y, Sakurai Y, Izumi T, Inoue M, Kwak S, Tsuji S, Shimizu J. Cancer association as a risk factor for anti-HMGCR antibody-positive myopathy. Neurol Neuroimmunol Neuroinflamm 2016; 3:e290. [PMID: 27761483 PMCID: PMC5056647 DOI: 10.1212/nxi.0000000000000290] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 08/26/2016] [Indexed: 11/24/2022]
Abstract
Objective: To show cancer association is a risk factor other than statin exposure for anti-3-hydroxy-3-methylglutaryl coenzyme A reductase autoantibody-positive (anti-HMGCR Ab+) myopathy. Methods: We analyzed the clinical features and courses of 33 patients (23 female and 10 male) with anti-HMGCR Ab+ myopathy among 621 consecutive patients with idiopathic inflammatory myopathies. Results: Among the 33 patients, 7 (21%) were statin-exposed and 26 were statin-naive. In relation with cancer, there were 12 patients (statin-exposed, n = 4) with cancers detected within 3 years of myopathy diagnosis (cancer association), 3 patients (all statin-naive) with cancers detected more than 3 years before myopathy diagnosis (cancer history), 10 cancer-free patients followed up for more than 3 years (all statin-naive), and 8 patients without cancer detection but followed up for less than 3 years (statin-exposed, n = 3). Therefore, 12 patients with cancer association (36%) formed a larger group than that of 7 statin-exposed patients (21%). Among 12 patients with cancer association, 92% had cancer detection within 1 year of myopathy diagnosis (after 1.3 years in the remaining patient), 83% had advanced cancers, and 75% died of cancers within 2.7 years. Of interest, 1 patient with cancer history had sustained increase in creatine kinase level over 12 years from cancer removal to the development of weakness. Conclusions: Patients with cancer association formed a large group with poor prognosis in our series of patients with anti-HMGCR Ab+ myopathy. The close synchronous occurrence of cancers and myopathies suggested that cancer association is one of the risk factors for developing anti-HMGCR Ab+ myopathy.
Collapse
Affiliation(s)
- Masato Kadoya
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Ayumi Hida
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Meiko Hashimoto Maeda
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Kenichiro Taira
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Chiseko Ikenaga
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Naohiro Uchio
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Akatsuki Kubota
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Kenichi Kaida
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Yusuke Miwa
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Kazuhiro Kurasawa
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Hiroyuki Shimada
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Masahiro Sonoo
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Atsuro Chiba
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Yasushi Shiio
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Yoshikazu Uesaka
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Yasuhisa Sakurai
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Toru Izumi
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Manami Inoue
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Shin Kwak
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Shoji Tsuji
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| | - Jun Shimizu
- Department of Neurology and Anti-aging Medicine (M.K., K. Kaida), National Defense Medical College, Saitama; Department of Neurology (A.H., K.T., C.I., N.U., A.K., S.K., S.T., J.S.), Graduate School of Medicine, The University of Tokyo; Department of Neurology (M.H.M., Y.U.), Toranomon Hospital; Division of Rheumatology (Y.M.), Department of Internal Medicine, Showa University School of Medicine, Tokyo; Pulmonary Medicine and Clinical Immunology (K. Kurasawa), Dokkyo Medical University, Tochigi; Department of Diagnostic and Interventional Radiology (H.S.), Osaka City University, Graduate School of Medicine; Department of Neurology (M.S.), Teikyo University School of Medicine; Department of Neurology (A.C.), Kyorin University; Department of Neurology (Y. Shiio), Tokyo Teishin Hospital; Division of Neurology (Y. Sakurai), Mitsui Memorial Hospital, Tokyo; Department of Neurology (T.I.), Tsukazaki Memorial Hospital, Hyogo; and AXA Department of Health and Human Security, Graduate School of Medicine (M.I.), The University of Tokyo, Japan
| |
Collapse
|