Internal Medicine内科学
Internal Medicine(英文缩写 INTERNAL MED),ISSN 0918-2918,eISSN 1349-7235,中文译名:内科学 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-09-27 至 2026-09-27，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 1.282 | Q4 |
| 2022 | 1.200 | Q4 |
| 2023 | 1.000 | Q3 |
| 2024 | 1.100 | Q2 |
| 2025 | 1.000 | Q3 |
Internal Medicine 最新收录文献
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1. Lactic Acidosis and Inferior Epigastric Artery Hemorrhage Complicating Alcohol-Associated Cirrhosis and Pancreatic Diabetes: A Case Report.
PMID:日期:2026-09-22A woman in her 50s with alcohol-associated cirrhosis and pancreatic diabetes presented with disorientation, hypotension, coagulopathy, a plasma glucose level of 1,626 mg/dL, and severe lactic acidosis (lactate ＞30 mmol/L) after alcohol consumption and self-discontinuation of insulin. High-volume fluid resuscitation, vasopressors, continuous insulin infusion, and blood transfusion improved the metabolic derangements; however, she subsequently developed an inferior epigastric artery hemorrhage (IEAH), which required emergency transcatheter arterial embolization. IEAH can be fatal in critically ill patients with coagulopathy, necessitating prompt imaging and immediate life-saving treatment. Multidisciplinary comprehensive care is indispensable to ensure strict alcohol abstinence and thus prevent a relapse.
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2. Prevalence and Impact of a Pathogenic CYP27A1 Variant on the Phenotypes Among Patients with Monogenic Heterozygous Familial Hypercholesterolemia.
PMID:日期:2026-09-22Cerebrotendinous xanthomatosis (CTX) is a rare inherited metabolic disorder caused by pathogenic variants of cytochrome P450 family 27 subfamily A member 1 (CYP27A1). It remains unclear whether such variants modify the clinical manifestations of familial hypercholesterolemia (FH) caused by defects in the low-density lipoprotein (LDL) receptor or other related genes. We aimed to clarify the impact of the pathogenic variants of CYP27A1 on the clinical phenotypes of patients with FH. We analyzed clinical data from 644 patients with a clinical diagnosis of monogenic FH who underwent genotyping for CYP27A1 and phenotypic assessment, including the serum sterol levels. Multivariate linear regression analyses, adjusted for age and sex, were conducted to assess the impact of pathogenic CYP27A1 variants on the serum cholestanol levels. Among these individuals, 22 (3.4%) carried pathogenic CYP27A1 variants. Patients harboring a pathogenic variant showed significantly higher median cholestanol concentrations than non-carriers (3.7 vs. 2.3 μg/mL, p ＜0.001). A single pathogenic CYP27A1 variant was associated with an increase in serum cholestanol of 2.3 μg/mL (95% confidence interval: 1.4-3.2 μg/mL, p ＜0.001) and an Achilles tendon thickness of 0.4 mm (95% confidence interval: 0.1-0.7 mm, p = 0.02). Furthermore, carriers exhibited significantly greater Achilles tendon thickness than non-carriers (9.6 vs. 8.9 mm, p ＜0.001). We identified a substantial number of patients with pathogenic CYP27A1 variants among the patients with monogenic FH, which influenced their Achilles tendon thickness and serum cholestanol levels.
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4. A Case of Acute Lymphoblastic Leukemia Developing After a Diagnosis of Myelodysplastic Syndrome Following Lenalidomide Therapy for Multiple Myeloma.
PMID:日期:2026-09-22Acute lymphoblastic leukemia (ALL) following lenalidomide (LEN) therapy is rare. A 64-year-old man developed myelodysplastic syndrome with excess blasts-2 (MDS-EB-2) six years after LEN maintenance therapy following autologous stem cell transplantation for multiple myeloma, followed by Philadelphia chromosome-negative B-cell acute lymphoblastic leukemia (ALL) 14 months later. A genomic analysis at diagnosis revealed PRPF8, XBP1, and BCORL1 mutations with IKZF1 and PAX5 deletions. No abnormalities were detected in the archived samples from the myeloma or MDS phases. He achieved complete molecular remission after chemotherapy. Although clonal continuity could not be demonstrated, a comprehensive genomic analysis provided insights into the complex clonal architecture of the clinical course.
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5. Aphasic Status Epilepticus as a Stroke Mimic: A Literature Review.
PMID:日期:2026-09-22We reviewed the clinical features of previously reported cases of aphasic status epilepticus. In an analysis of medical information from 87 reported cases (92 attacks), the types of aphasia associated with aphasic status epilepticus were global aphasia in 44 (48%) of 92 attacks, motor aphasia in 29 (32%), and sensory aphasia in 11 (12%) attacks. The findings of diffusion and perfusion imaging, as well as electroencephalography, were often compatible with aphasia, although variations in the distribution and findings were observed in several cases. Furthermore, in 16 (32%) of 67 attacks, it took more than 1 week from the onset of the aphasic status epilepticus to treatment; therefore, the sequelae of aphasia were observed in 18 (20%) of 92 attacks. Aphasic status epilepticus should be considered a stroke mimic and it may cause sequelae due to delayed treatment. Patients suspected of having aphasic status epilepticus should be immediately treated with benzodiazepine without waiting for either electroencephalography or perfusion imaging.
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6. Acute Respiratory Failure Associated with Severe Obstructive Sleep Apnea as an Early Manifestation of Multiple System Atrophy: A Case Report.
PMID:日期:2026-09-22Sleep-related breathing disorders are common in patients with multiple system atrophy (MSA), typically presenting as laryngeal stridor due to vocal cord abductor paralysis; however, severe respiratory impairment in the early stage is rare. We report the case of an 81-year-old woman with MSA who developed acute respiratory failure associated with severe obstructive sleep apnea syndrome (OSAS) preceding stridor. The patient required intubation. Although extubation was successful after six days, nocturnal hypercapnia persisted, necessitating noninvasive ventilation. Polysomnography confirmed the diagnosis of OSAS, while laryngoscopy revealed mild bilateral vocal cord abductor paresis without stridor. This case highlights that life-threatening respiratory failure may precede the development of laryngeal stridor in patients with MSA.
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7. BRCA1/BRCA2 Double Heterozygosity Presenting as Intrahepatic Cholangiocarcinoma.
PMID:日期:2026-09-22We report a case of BRCA1/BRCA2 double heterozygosity-a rare condition with an estimated prevalence of fewer than 1 in 100,000 individuals in unselected populations-identified through tumor genomic profiling in a 50-year-old Japanese woman with intrahepatic cholangiocarcinoma and no prior cancer history. Germline testing confirmed BRCA1 c.2389_2390del and BRCA2 c.5621_5624del. This case demonstrates that intrahepatic cholangiocarcinoma can be a sentinel malignancy of BRCA-related cancer predisposition, thus underscoring the importance of germline testing.
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8. Prevalence of Intestinal Methanogen Overgrowth in Progressive Supranuclear Palsy: A Case-Control Study.
PMID:日期:2026-09-22Objective Progressive supranuclear palsy (PSP) is a rare neurodegenerative disorder frequently accompanied by severe gastrointestinal dysfunction, particularly constipation. Although small intestinal bacterial overgrowth (SIBO) has been reported in several neurological diseases, intestinal microbial phenotypes in patients with PSP have not been systematically evaluated. This study aimed to assess the prevalence of intestinal methanogen overgrowth (IMO) and hydrogen-type SIBO in patients with PSP.Methods We conducted a cross-sectional case-control study to evaluate hydrogen- and methane-based breath test profiles in patients with PSP. Breath testing was performed in accordance with the North American Consensus criteria. The prevalence of hydrogen-type SIBO and IMO was compared between patients with PSP and healthy controls.Results Five patients with PSP and 33 healthy controls were included. IMO was identified more frequently in patients with PSP than in healthy controls (40.0% vs. 3.0%; P = 0.040). In contrast, hydrogen-type SIBO was not observed in either group. The mean Gastrointestinal Symptom Rating Scale (GSRS) score among patients with PSP was 29.4±5.9, and no clear association was observed between IMO positivity and gastrointestinal symptom severity or the presence of constipation.Conclusions Patients with PSP exhibited a distinct intestinal microbial phenotype characterized by methanogen predominance rather than hydrogen-type SIBO. Although limited by the small sample size, this pilot study provides novel insights into the gut microbial characteristics of PSP and suggests that qualitative alterations in the small intestinal microbiota and motility may contribute to PSP-associated gastrointestinal dysfunction.
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9. A Case of Refractory Pouchitis with Postoperative Anal Stenosis after Ileal Pouch-anal Anastomosis Treated with Vedolizumab, a Radial Incision and Cutting.
PMID:日期:2026-09-22A 33-year-old man who had undergone total colectomy for refractory ulcerative colitis (UC) at 22 years of age was referred for severe pouchitis with anal stricture. The remission of pouchitis was achieved with vedolizumab (VDZ) treatment. However, as diarrhea improved, obstructive defecation symptoms became apparent due to the stricture. Repeated anal bougie dilation was unsuccessful. A radial incision and cutting were thus performed, and the defecation symptoms improved without recurrence for 1 year. This is the first case report demonstrating the effectiveness of a radial incision and cutting for the treatment of severe anal stenosis after ileal pouch-anal anastomosis, particularly in a short, fibrotic stricture site refractory to repeated bougie dilatation.
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10. Recurrent Lateral Medullary Infarction with Ipsilateral Motor and Sensory Deficits and a Delayed Worsening of Crossed Hypoalgesia and Thermohypoesthesia: A Case Report.
PMID:日期:2026-09-22The clinical course of early recurrent lateral medullary infarction (LMI) is unclear. We describe the case of an 83-year-old man with severe vertebral artery atherosclerosis who developed early recurrent right LMI. He had ipsilateral Horner's syndrome, bulbar symptoms, and ipsilateral motor-sensory deficits (an Opalski syndrome-like presentation). Imaging revealed caudal extension of the lesion toward the paramedian cervicomedullary junction. A gradual improvement was observed with dual antiplatelet therapy and argatroban hydrate. Contralateral hypoalgesia and thermohypoesthesia were initially minimal, became prominent after 1 week, and later improved spontaneously. Delayed sensory changes during recurrent LMI may complicate the clinical interpretation, warranting careful serial neurological and radiological assessments.