{"created":"2024-07-22T06:14:25.846772+00:00","id":2003136,"links":{},"metadata":{"_buckets":{"deposit":"a0f2b7d0-dbe8-410e-9882-b18d139561fb"},"_deposit":{"created_by":25,"id":"2003136","owner":"25","owners":[25],"pid":{"revision_id":0,"type":"depid","value":"2003136"},"status":"published"},"_oai":{"id":"oai:ycu.repo.nii.ac.jp:02003136","sets":["4:71:1709270345492:1721623799323"]},"author_link":[],"control_number":"2003136","item_10002_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2024-06-01","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicNumberOfPages":"5","bibliographicPageEnd":"53","bibliographicPageStart":"49","bibliographicVolumeNumber":"75","bibliographic_titles":[{"bibliographic_title":"横浜医学","bibliographic_titleLang":"ja"},{"bibliographic_title":"YOKOHAMA MEDICAL JOURNAL","bibliographic_titleLang":"en"}]}]},"item_10002_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"症例は15歳女性．突然発症した意識障害を伴う不随意運動と腹痛のため当院に入院した．不随意運動に対しては頭部CT，脳波，神経伝導速度検査など各種検査を行ったが明らかな原因は特定できず，解離性障害と診断して薬物治療を開始した．また，脂肪肝を認め，非アルコール性脂肪性肝疾患（non-alcoholic fatty liver disease; NAFLD）として外来で栄養指導を行っていたが，蛋白質や脂質の過剰摂取が続いていた．初診から5年が経過し，次第に具体的な食事内容から極端に蛋白質や脂質を好む食癖が明らかとなり，シトリン欠損症が疑われた．遺伝子診断を行い確定診断に至った．解離性障害の症状と診断されていた不随意運動は成人発症Ⅱ型シトルリン血症（adult-onset type 2 citrullinemia; CTLN2）による症状と考えられた．CTLN2による高アンモニア脳症が適切に治療されず，放置されれば脳浮腫をきたし死に至ることもある．NAFLDと異なり低糖質・高蛋白・高脂肪食の食事指導が重要である．飲酒がCTLN2の発症の引き金となることもあり，小児の脂肪肝では，シトリン欠損症も鑑別に挙げ，飲酒機会がある成人に達するまでに診断することが重要である．","subitem_description_language":"ja","subitem_description_type":"Abstract"}]},"item_10002_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"横浜市立大学医学会","subitem_publisher_language":"ja"}]},"item_10002_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0372-7726","subitem_source_identifier_type":"ISSN"}]},"item_access_right":{"attribute_name":"アクセス権","attribute_value_mlt":[{"subitem_access_right":"open access","subitem_access_right_uri":"http://purl.org/coar/access_right/c_abf2"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"米井　萌","creatorNameLang":"ja"},{"creatorName":"ヨネイ　モエ","creatorNameLang":"ja-Kana"}]},{"creatorNames":[{"creatorName":"大河内　慎","creatorNameLang":"ja"},{"creatorName":"オオコウチ　シン","creatorNameLang":"ja-Kana"}]},{"creatorNames":[{"creatorName":"竹部　麻美子","creatorNameLang":"ja"},{"creatorName":"タケベ　マミコ","creatorNameLang":"ja-Kana"}]},{"creatorNames":[{"creatorName":"大谷　春菜","creatorNameLang":"ja"},{"creatorName":"オオタニ　ハルナ","creatorNameLang":"ja-Kana"}]},{"creatorNames":[{"creatorName":"川上　兼堂","creatorNameLang":"ja"},{"creatorName":"カワカミ　ケント","creatorNameLang":"ja-Kana"}]},{"creatorNames":[{"creatorName":"正本　雅斗","creatorNameLang":"ja"},{"creatorName":"マサモト　マサト","creatorNameLang":"ja-Kana"}]},{"creatorNames":[{"creatorName":"齋藤　千穂","creatorNameLang":"ja"},{"creatorName":"サイトウ　チホ","creatorNameLang":"ja-Kana"}]},{"creatorNames":[{"creatorName":"鈴木　徹臣","creatorNameLang":"ja"},{"creatorName":"スズキ　テツオミ","creatorNameLang":"ja-Kana"}]},{"creatorNames":[{"creatorName":"田中　文子","creatorNameLang":"ja"},{"creatorName":"タナカ　フミコ","creatorNameLang":"ja-Kana"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_access","date":[{"dateType":"Available","dateValue":"2024-07-22"}],"displaytype":"detail","fileDate":[{"fileDateType":"Updated","fileDateValue":"2024-07-26"}],"filename":"03_Yonei.pdf","filesize":[{"value":"830 KB"}],"format":"application/pdf","licensetype":"license_5","mimetype":"application/pdf","url":{"label":"症例報告　米井　萌","objectType":"fulltext","url":"https://ycu.repo.nii.ac.jp/record/2003136/files/03_Yonei.pdf"},"version_id":"2b69ba40-65c2-4fd3-ab57-a514c9e7c796"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"シトリン欠損症｜成人発症Ⅱ型シトルリン血症｜ 非アルコール性脂肪性肝疾患｜解離性障害｜特異な食癖","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"Citrin deficiency｜adult-onset type 2 citrullinemia; CTLN2 ｜non-alcoholic fatty liver disease; NAFLD｜dissociative disorders; DD｜characteristic eating habits","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"解離性障害として経過観察中に脂肪肝と特異な食癖を指摘され，シトリン欠損症の診断に至った一例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"解離性障害として経過観察中に脂肪肝と特異な食癖を指摘され，シトリン欠損症の診断に至った一例","subitem_title_language":"ja"},{"subitem_title":"FATTY LIVER AND CHARACTERISTIC EATING HABITS DURING FOLLOW-UP  FOR DISSOCIATIVE DISORDER,  LEADING TO THE DIAGNOSIS OF CITRIN DEFICIENCY: A CASE REPORT","subitem_title_language":"en"}]},"item_type_id":"10002","owner":"25","path":["1721623799323"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2024-07-26"},"publish_date":"2024-07-26","publish_status":"0","recid":"2003136","relation_version_is_last":true,"title":["解離性障害として経過観察中に脂肪肝と特異な食癖を指摘され，シトリン欠損症の診断に至った一例"],"weko_creator_id":"25","weko_shared_id":-1},"updated":"2024-07-25T08:42:19.413042+00:00"}