*Ryotaro Kato¹, *Hiroki Isono², Koma Hotta³, Tatsunori Shizuku⁴ (1. The director of Itabashi Chuo Medical Center, 2. Department of General Medicine, HITO Medical Center, 3. Department of General Internal Medicine, Rakuwakai Otowa Hospital, 4. Division of Hematology and Rheumatology, Teikyo University Chiba Medical Center)