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All Journal MNJ (Malang Neurology Journal) Health Sciences and Pharmacy Journal
Ghufira, Nanda
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Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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AUTOIMMUNE ENCEPHALITIS: DIAGNOSTIC AND TREATMENT APPROACH Hamdani, Ismi Adhanisa; Agustina, Lydia; Sasongko, Hari Andang; Gaharu, Maula Nuruddin; Rachmatullah, Fahmi; Ghufira, Nanda; Stevany, Nabila; Pawestri, Natasya Rahma Dewi; Fatahuddin, Rahaliya Salsabila; Natasya, Natasya
MNJ (Malang Neurology Journal) Vol. 10 No. 2 (2024): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.02.13

Abstract

Autoimmune encephalitis is a type of brain inflammation induced by an inappropriate immune response to a neuronal antigen, resulting in the generation of autoantibodies. Autoimmunity as important cause of encephalitis in recent years has not been much reported in Indonesia. Increased familiarity with autoimmune encephalitis among physician, not only neurologist, is extremely important for early detection. Prompt diagnosis and early immunotherapy leads to better prognosis in this potentially treatable disease, despite a long disease course. Autoimmune encephalitis is characterized by acute-subacute progressive neuropsychiatric symptoms with associated cognitive dysfunction, encephalopathy, psychiatric disorders, movement disorders and seizures, with anti-N-methyl-D-aspartate (NMDA) receptors encephalitis as the most common type. In addition to clinical features, further diagnostic investigations needed are brain magnetic resonance imaging (MRI), electroencephalography (EEG), cerebrospinal fluid (CSF) analysis, and autoantibody testing. Challenges in establishing diagnosis include wide range of clinical symptoms, absence of abnormalities in brain MRI, unspecified EEG findings, negative antibody testing, and limited availability of antibody testing in Indonesia. This literature review discusses the recognition, diagnosis and principle of treatment of autoimmune encephalitis.
Tatalaksana terkini krisis tiroid: case report Irawan, Budi; Mulyono, Eddy; Suprabowo, Salomo Hizkia; Mulyadi, Ezra Michael; Ghufira, Nanda
Health Sciences and Pharmacy Journal Vol. 8 No. 2 (2024)
Publisher : STIKes Surya Global Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32504/hspj.v8i2.983

Abstract

Krisis tiroid merupakan kegawatdaruratan dalam bidang endokrin yang paling sering dijumpai dengan angka morbiditas dan mortalitas yang sangat tinggi. Tercatat kurang dari 10% insiden krisis tiroid dari total pasien tirotoksitosis yang dirawat di rumah sakit, namun krisis tiroid ini angka mortalitasnya sebesar 20-30%. Penanganan pada kasus ini dengan tujuan membatasi produksi hormon tiroid yang berlebihan dengan cara menekan produksi atau merusak jaringan tiroid. Jenis penelitian ini adalah laporan kasus yang cenderung memperhatikan permasalahan dan gambaran penatalaksanaanya terutama di RSUD R.A.A Soewondo Pati terhadap kasus yang ingin ditemukan. Subjek dalam laporan kasus ini yaitu seorang perempuan berusia 53 tahun datang ke IGD RSUD RAA Soewondo Pati dengan keluhan demam. Alat pemeriksaan berupa pemeriksaan fisik dan alat pemeriksaan laboratorium. Teknik analisis data menggunakan analisis deskriptif dengan menggunakan kriteria Burch dan Wartofsky. Hasil analisis diperoleh skor kriteria Burch dan Wartofsky thermoregulatory dysfunction 37,9C skor +10, cardivascular HR 112x/mnt skor +10, atrial fibrilation skor +10, congestive heart failure Absent skor 0, gastrointestinal-hepatic dysfunction moderate skor +10, central nervous system disturbance skor +10, precipitating event skor 0, didapatkan total skor >45. Pada pemeriksaan EKG didapatkan gambaran atrial fibrilasi. Pada pemeriksaan penunjang darah lengkap didapatkan trombositopenia, leukositosis, hiponatremi, hipokloremia, CKMB 45 (<25), TSH <0,10 (0,25-0,50), total T3 3,51 (0,9-2.33), total T4 195,9 (57,9-150,6), eosinofil 0,10 (2-4%), neutrofil 74,90 (50-70%), limfosit 14,2 (25-40%), monosit 10,70 (2-8%). Pengelolaan secara agresif dilakukan secara intensif dengan pemantauan ketat di intensive care unit (ICU).
Co-Authors Agustina, Lydia Budi Irawan Eddy Mulyono Fatahuddin, Rahaliya Salsabila Gaharu, Maula Nuruddin Hamdani, Ismi Adhanisa Mulyadi, Ezra Michael Natasya Natasya Pawestri, Natasya Rahma Dewi Rachmatullah, Fahmi Sasongko, Hari Andang Stevany, Nabila Suprabowo, Salomo Hizkia