Managing spondylitis tuberculosis in a patient with underlying diabetes and hypothyroidism: A case report

Novita, Bernadette Dian, Muliono, Ari Christy, Wijaya, Sumi, Theodora, Imelda, Tjahjono, Yudy, Supit, Vincentius Diamantino and Willianto, Vincentius Michael (2022) Managing spondylitis tuberculosis in a patient with underlying diabetes and hypothyroidism: A case report. World Journal of Clinical Cases, 10 (21). pp. 7451-7458. ISSN 2307-8960, Jurnal Internasional bereputasi SJR(2021): 0.38, Q3, H-Index: 18

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Abstract

Tuberculosis (TB) remains one of the highest Asia’s health problems. Spondylitis TB in diabetes mellitus (DM) and hypothyroidism patients is a rare case of extrapulmonary tuberculosis. However, there is a lack of therapeutic guidelines to treat spondylitis TB, particularly with type 2 DM (T2DM) and hypothyroidism as comorbidities. Here we present a case of spondylitis TB with T2DM and hypothyroidism in a relatively young patient and its therapeutic procedure. We report the case of a 35-year-old male patient from Surabaya, Indonesia. Based on anamnesis, physical examination, and magnetic resonance imaging, the patient has been categorized in stage II of spondylitis TB with grade 1 paraplegia. Surprisingly, the patient also had a high HbA1c level, high thyroid stimulating hormone, and low free T4 (FT4), which indicated T2DM and hypothyroidism. A granulomatous process was observed in the histopathological section. The antituberculosis drugs isoniazid and rifampicin were given. In addition, insulin, empagliflozin, and linagliptin were given to control hyperglycemia conditions, and also levothyroxine to control hypothyroidism. CONCLUSION The outcome was satisfactory. The patient was able to do daily activities without pain and maintained normal glycemic and thyroid levels. For such cases, we recommend the treatment of spondylitis TB by spinal surgery, together with T2DM and hypothyroidism therapies, to improve the patients’ condition. Prompt early and non-invasive diagnoses and therapy are necessary.

Item Type: Article
Additional Information: Jurnal Internasional bereputasi SJR(2021): 0.38, Q3, H-Index: 18
Uncontrolled Keywords: Spondylitis tuberculosis; Type 2 diabetes mellitus; Hypothyroidism; Case report
Subjects: Medicine
Divisions: Journal Publication
Depositing User: F.X. Hadi
Date Deposited: 09 Aug 2022 06:03
Last Modified: 17 May 2023 02:31
URI: http://repository.ukwms.ac.id/id/eprint/31851

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