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All Journal Majalah Anestesia dan Critical Care Bioscientia Medicina : Journal of Biomedicine and Translational Research Indonesian Journal of Anesthesiology and Reanimation (IJAR) Bioscientia Medicina : Journal of Biomedicine and Translational Research Solo Journal of Anesthesi, Pain and Critical Care Majalah Anestesia & Critical Care (MACC) Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute
Manggala, Sidharta Kusuma
Departemen Anestesiologi Dan Terapi Intensif, Fakultas Kedokteran Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo, Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Respiratory Failure and Hypercoagulable State in Creutzfeldt-Jakob Disease: A Rare Case Report Kurniawan, Celine; Manggala, Sidharta Kusuma
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 5, No 1 (2025): April 2025
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v5i1.91846

Abstract

Background:Creutzfeldt-Jakob Disease (CJD) is a rare, rapidly progressive neurodegenerative disorder caused by prion proteins. It is characterized by a variety of neurological symptoms that lead to severe cognitive decline and death. The uniqueness of this case lies in the severe complications of respiratory failure and a hypercoagulable state, which are not commonly highlighted in the literature. Reporting this case underscores the critical need for awareness and management strategies for such complications in CJD patients, which can significantly impact their clinical outcomes and quality of life.Case Illustration:A 69-year-old female presented with progressively worsening neurological symptoms over a short period. Initially, she experienced visual disturbances and hallucinations, followed by a rapid decline in consciousness, the onset of seizures, and myoclonus. Diagnostic investigations, including an electroencephalogram (EEG) and Magnetic Resonance Imaging (MRI), confirmed the diagnosis of Creutzfeldt-Jakob Disease (CJD).As her condition deteriorated, the patient developed pneumonia and septic shock. Excessive salivary secretion, a symptom often overlooked in CJD, led to significant respiratory compromise and failure. She was admitted to the intensive care unit (ICU) and required mechanical ventilation. Due to the prolonged need for ventilation and to manage airway secretions better, a tracheostomy was performed.Management of her respiratory failure involved meticulous care to reduce hypersalivation and prevent micro-aspiration. Regular suctioning of secretions was crucial. Additionally, given her immobility and increased risk of thromboembolism, she received prophylactic heparin to prevent venous thromboembolism. Physiotherapy was initiated to maintain limb mobility, and elastic stockings were used to reduce the risk of deep vein thrombosis.Conclusion:This case report highlights the complex clinical challenges in managing a patient with CJD, particularly the severe respiratory and thromboembolic complications. The comprehensive approach to managing respiratory failure through tracheostomy and proactive measures to prevent thromboembolism was essential in stabilizing the patient. However, the incurable nature of CJD meant that the focus ultimately shifted to palliative care. This case underscores the importance of recognizing and managing secondary complications in CJD to improve patient outcomes and the need for ongoing research into effective treatments for this devastating disease.
Co-Authors Aida Rosita Tantri Alantas, Anas Asri C. Adisasmita Astari Karina Dita Aditianingsih Hafidz, Noor Halim, Ida Juita Ignatia Novianti Tantri Kapuangan, Christopher Khadafi Indrawan Kurniawan, Celine Listyana, Tia Luther Napitupulu Montolalu, Gabriela Perdana, Aries Rahmah, Herlina Ratna Farida Soenarto Riyadh Firdaus Rosdiana, Prita Rudyanto Sedono, Rudyanto Septianto Halim Solly Aryza Sugiarto, Adhrie Tasya Claudia Pardede Wardhani, Yosi Dwi Zahrina, Fadiah