Flu is burst out.

we were open in o1/01/2019.

in-69 people
flu test-53 people
flu positive-29 people( All type A)


JCR2018Syllabus@Senri life sience center

I went to the lectures in Osaka about Rheumatology.
I gave a present Chocolate for lady doctor 。
During the lecture,I felt the presentations need to be

strong messages,
clear and understandable voices,and
simple and understandable slides.

I also learned

We don't have any date of prevention in Bone necrosis in Steroids.
Tacrolimus and Cyclosporin A were used renal failure patients.
we introduced eye clinic where they have SD-OCT.

Japanese college of Rheumatology in Takamatsu.


Seminar of Rheumatology in Okinawa

I never saw comfortable place like this other than Okinawa.
It’s close to Fukuoka. It’s just like Hawaii.

Today’s seminar, “FUO alacarte “ from Prof. Hagino.

We had 5 FUO.
One is CMV infection, 1 is depression, and 2persons are unknown and cured soon. One is like no sweat syndrome due to sjogren’s syndrome. Let’s make presentation!.
Picture is SYURI-castle in Okinawa.

Pain meeting for Fibramyalgia patients

Today we have meeting for fibromyalgia patients.

American College of Rheumatology -Antinuclear antibodies Mark H. Wener


Novel SLE treatment-pipeline of portential new therapies


Novel SLE treatment-Belimumab

・new phase 3
・Subcutaneous-BLISS -SC
・Long term Safety IV Belimumab
・Lupus Nephritis
・pediatric- Phase 2 PLUTO

Novel SLE treatment-immunosuppressive therapy

summary of evidence
・Effective in inducing renal remission and preventing renal failure.
・Improves survival
・Low dose(Euro-dosing)is as effective and appears to have less toxicity.
・evidence of effectiveness
・Effective as maintenance after both IVCY and MMF induction
・Appears to have less toxicity than IVCY
・as effective as IVCY in menbranous GN
・Significantly higher rate of renal relapse after completion of 1 yr treatment

Novel SLE treatmentーHydroxy chloroquine

Beyond disease activity~Multiethnic longitudinal cohort (n=635)~
reduced damage accrual
decrease in renal damage
decrease in skin-damage
decrease in vascular events.
Anti-malarial toxicity
Rertina-weight based dosing:Toxicity near 1% after 5-7years:Cumulative dose of 1000g :Baseline then annual after 5 yrs.
Muscle-Curvilinear bodies:muscle fiber atrophy:Vacuolar changes
Toxic-Myocardial Disease:47cases median doses 1050g for CQ and 1542g for HCQ Chronic heart failure.
Excreted by kidney
High risk patients-concomitant tamoxifen(increase risk 5-fold)
GFR<50cc/min, dose>5mg/kg
Risk is <2% up to 10 yrs but rises to 20 % after 20 years.
safe rule is 5x5 Screen after 5 yrs use and <5mg/kg real weight
[picture: a sunday on La Grande Jatte]