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

作　　者：Bernadette Dian Novita Ari Christy Muliono Sumi Wijaya Imelda Theodora Yudy Tjahjono Vincentius Diamantino Supit Vincentius Michael Willianto 

机构地区：[1]Department of Pharmacology and Therapy,Faculty of Medicine,Widya Mandala Surabaya Catholic University,Surabaya 60113,East Java,Indonesia [2]Department of Internal Medicine,Faculty of Medicine,Widya Mandala Surabaya Catholic University,Surabaya 60113,Indonesia [3]Department of Internal Medicine,Premier Surabaya Hospital,Surabaya 60111,Indonesia [4]Department of Internal Medicine,Gotong Royong Surabaya Hospital,Surabaya 60110,Indonesia [5]Faculty of Pharmacy,Widya Mandala Surabaya Catholic University,Surabaya 60113,Indonesia [6]Department of Pathology Anatomy,Faculty of Medicine,Widya Mandala Surabaya Catholic University,Surabaya 60113,Indonesia [7]Department of Emergency Medicine,Gotong Royong Surabaya Hospital,Surabaya 60110,Indonesia [8]Department of General Medicine,Faculty of Medicine,Widya Mandala Surabaya Catholic University,Surabaya 60113,Indonesia

出　　处：《World Journal of Clinical Cases》2022年第21期7451-7458,共8页世界临床病例杂志

摘　　要：BACKGROUND 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.CASE SUMMARY 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 T_(4)(FT_(4)),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.

关 键 词：Spondylitis tuberculosis Type 2 diabetes mellitus HYPOTHYROIDISM Case report 

分 类 号：R529.2[医药卫生—内科学]