Pernicious anemia (PA) is an autoimmune disease characterized by atrophic gastritis and deficiency in intrinsic factor leading to impairment of vitamin B12 absorption in the ileum. Anemia is commonly found in rheumatoid arthritis (RA); however, PA is rarely found in RA. There are few reports describing patients with both conditions; none in Korea to date. We report on a case of a 46-year-old female who presented with hypesthesia and general weakness. She was previously diagnosed as seropositive RA with myelodysplastic syndrome. She had severely impaired sensation, especially for vibration and proprioception in all limbs. Subacute combined degeneration was observed on her magnetic resonance imaging and serum vitamin B12 level was very low. Further exam results were consistent with PA and her symptoms improved with cobalamin injection. This case demonstrates that PA should be considered in RA patients presenting with both central nervous system manifestations and anemia.
Absorption ; Anemia ; Anemia, Pernicious* ; Arthritis, Rheumatoid* ; Autoimmune Diseases ; Central Nervous System* ; Extremities ; Female ; Gastritis, Atrophic ; Humans ; Hypesthesia ; Ileum ; Intrinsic Factor ; Korea ; Magnetic Resonance Imaging ; Middle Aged ; Myelodysplastic Syndromes ; Proprioception ; Subacute Combined Degeneration ; Vibration ; Vitamin B 12

Purpose: To determine the effect of axial T2-weighted images (T2WIs) scanning order on the central canal, lateral recess, and related anatomical structures in the lumbar spine. Materials and Methods: After Institutional Review Board approval and informed consent, 45 patients with low back pain (22 males and 23 females, aged between 20–83 years with median age of 60 years) underwent lumbar spine magnetic resonance examination in the supine position on a 1.5 tesla scanner. Axial T2WIs were acquired both before and after the sagittal scans (pre- and post-sagittal axial T2WIs). Two radiologists assessed the grades of the central canal and lateral recess stenosis (CCS and LRS) at the L3/4, L4/5, and L5/S1 levels. The cross-sectional areas of spinal canal (SCCSA), dural sac (DSCSA), free cerebrospinal fluid (FCSA), and ligamentum flavum (LFCSA) were measured twice from a single representative image at each disc level using a threshold-based semiautomated method. The effect of time on the CCS and LRS grades as well as cross-sectional areas was evaluated using a generalized estimating equation. Results: Time had no significant effect on the CCS and LRS grades across the three disc levels (p = 0.178 for CCS, p = 0.383 for right LRS, p = 0.378 for left LRS). However, time significantly affected the DSCSA (p < 0.001), FCSA (p < 0.001), and LFCSA (p = 0.014), but not the SCCSA (p = 0.082). The DSCSA and FCSA were larger and the LFCSA was smaller on post-sagittal axial T2WIs than on pre-sagittal axial T2WIs; estimated differences were 2.9 mm 2 (2.3%) for DSCSA, 3.0 mm 2 (3.7%) for FCSA, and -2.4 mm 2 (-1.7%) for LFCSA. Conclusion The scanning order of axial T2WIs did not affect the CCS or LRS grades.However, the DSCSA, FCSA, and LFCSA in post-sagittal axial T2WIs showed significant differences compared to that of pre-sagittal axial T2WIs, although the relative percentage differences were less than 5%.

No abstract available.
Diabetes Mellitus* ; Humans ; Myositis* ; Renal Dialysis* ; Vasculitis

Background: F-18-fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT) can be used to measure bone mineral density (BMD), cross-sectional muscle area (CSMA), Hounsfield units (HU) of liver and muscle, subcutaneous adipose tissue (SAT), abdominal visceral adipose tissue (VAT), and glucose metabolism. The present study aimed to identify age-related changes in body composition and glucose metabolism in Korean using opportunistic FDG-PET/CT imaging. Methods: We analyzed FDG-PET/CT, clinical history, and laboratory data abstracted from the medical records of patients who underwent health screening at a single institute between 2017 and 2022. Results: In total, 278 patients were included in the analysis (male:female=140:138). Age and body mass index were positively correlated in female, but negatively correlated in male. BMD decreased with age more in female, and CSMA decreased with age more in male. Muscle HU decreased with age for both sexes. In female, SAT and VAT increased with age; and in male, SAT decreased slightly while VAT remained stable. Muscle glucose metabolism showed no association with age in male but increased with age in female. CSMA correlated positively with BMD overall; and positively correlated with VAT and SAT in male only. In female only, both SAT and VAT showed negative correlations with glucose metabolism and correlated positively with muscle glucose metabolism. Liver HU values were inversely correlated with VAT, especially in female; and positively correlated with muscle glucose metabolism in female only. Conclusion FDG-PET/CT demonstrated distinct patterns of age-related changes in body composition and glucose metabolism, with significant differences between sexes.

Background: F-18-fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT) can be used to measure bone mineral density (BMD), cross-sectional muscle area (CSMA), Hounsfield units (HU) of liver and muscle, subcutaneous adipose tissue (SAT), abdominal visceral adipose tissue (VAT), and glucose metabolism. The present study aimed to identify age-related changes in body composition and glucose metabolism in Korean using opportunistic FDG-PET/CT imaging. Methods: We analyzed FDG-PET/CT, clinical history, and laboratory data abstracted from the medical records of patients who underwent health screening at a single institute between 2017 and 2022. Results: In total, 278 patients were included in the analysis (male:female=140:138). Age and body mass index were positively correlated in female, but negatively correlated in male. BMD decreased with age more in female, and CSMA decreased with age more in male. Muscle HU decreased with age for both sexes. In female, SAT and VAT increased with age; and in male, SAT decreased slightly while VAT remained stable. Muscle glucose metabolism showed no association with age in male but increased with age in female. CSMA correlated positively with BMD overall; and positively correlated with VAT and SAT in male only. In female only, both SAT and VAT showed negative correlations with glucose metabolism and correlated positively with muscle glucose metabolism. Liver HU values were inversely correlated with VAT, especially in female; and positively correlated with muscle glucose metabolism in female only. Conclusion FDG-PET/CT demonstrated distinct patterns of age-related changes in body composition and glucose metabolism, with significant differences between sexes.