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All Journal CRJIM (Clinical and Research Journal in Internal Medicine)
Abshori, Nuril Farid
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Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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Interesting Case of Acute Lung Oedema Complication of Dengue Hemorrhagic Fever-Hypercoagulability: Interesting Case of Acute Lung Oedema Complication of Dengue Hemorrhagic Fever-Hypercoagulability Abshori, Nuril Farid; Kakay, Ferdinandus Stevanus; Ahdi, Iwal Reza
Clinical and Research Journal in Internal Medicine Vol. 6 No. 1 (2025): Volume 6 No 1, May 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.01.11

Abstract

A B S T R A C T Background: Diagnosis and management of dengue hemorrhagic fever (DHF) can be challenging with confounding complications. Important confounding factors are conditions that alter hematologic parameters and prognosis of infection. We report a case of a patient with a positive DHF IgG result and hypercoagulation leading to Acute Lung Oedema (ALO), a serious condition with risk of respiratory failure leading to death. This is the first case to highlight the unique set of diagnostic and therapeutic challenges of DHF in this context. Case Presentation: A twenty-seven-year-old man presented with suspected DHF with thrombocytopenia and hypoalbumin. Pharmacologic and fluid therapy were optimal. However, the patient suddenly developed dyspnea leading to respiratory failure and had to be admitted to the intensive care unit. The patient also had severe infection as evidenced by D-dimer > 5,000 ng/ml and pulmonary edema, one of which was due to pulmonary embolism. This requires appropriate and rapid treatment, considering the patient is in critical condition. Conclusion: This patient faced two diagnostic challenges: the diagnosis of dengue fever with positive DHF IgG but with different clinical manifestations and the diagnosis of hypercoagulation related to pulmonary embolism. There were two therapeutic difficulties: that of balancing the risks and benefits of administering anticoagulants and steroids in a pulmonary embolism patient with DHF. As decisions in such cases are patient-specific, sharing individual experiences will help guide future therapeutic management decisions. Keywords: Acute Lung Oedema (ALO), Dengue Hemorrhagic Fever (DHF), Hypercoagulation
The Effect of Fasting Blood Glucose (FBG) on Troponin I and Clinical Outcomes in Acute Coronary Syndrome (ACS) : A Retrospective Analysis: A Retrospective Observational Study Abshori, Nuril Farid; Ahdi, Iwal Reza; Kakiay, Ferdinandus Stevanus
Clinical and Research Journal in Internal Medicine Vol. 6 No. 2 (2025): Volume 6 No 2, November 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.02.08

Abstract

Background: In the early phase of Acute Coronary Syndrome (ACS), simple parameters such as fasting blood glucose (FBG) and cardiac troponin I (cTnI) may provide prognostic information. However, evidence regarding their relationship remains inconsistent, particularly in the Indonesian population. Objective: To investigate the correlation and association between FBG and cTnI in patients with ACS at Karsa Husada Hospital, Batu, Indonesia. Methods: This retrospective observational study included 75 hospitalized ACS patients. Clinical and laboratory data were collected from medical records. Troponin values were log10-transformed. Statistical analyses included Spearman correlation, stepwise linear regression per 10 mg/dL increase in FBG, categorical FBG classification (<100, 100–125, ≥126 mg/dL), trend testing, and restricted cubic spline modeling. Fully adjusted models incorporated age, sex, diabetes, estimated glomerular filtration rate, systolic blood pressure, and heart rate. Results: The median age was 62 years, and 64% were male. FBG showed a weak, non-significant correlation with cTnI (rₛ = 0.19; p = 0.12). After adjustment, each 10 mg/dL increase in FBG was associated with an 8.6% higher cTnI level (β = 0.036; 95% CI −4.5% to +23.6%; p = 0.20). Compared with normal FBG, hyperglycemia (≥126 mg/dL) was associated with a 50.6% higher cTnI level, although this was not statistically significant (p = 0.60), and no significant linear trend was observed (p-trend = 0.55). Spline analysis revealed no significant non-linearity (p = 0.72), and no interaction by diabetes status (p = 0.67). Conclusion: In this ACS population, higher FBG tended to be associated with higher cTnI levels; however, the relationship attenuated and lost significance after adjustment. FBG may serve as an additional risk marker rather than a primary determinant of myocardial injury in the early phase. Keywords: fasting blood glucose, troponin I, acute coronary syndrome, hyperglycemia
Co-Authors Ahdi, Iwal Reza Kakay, Ferdinandus Stevanus Kakiay, Ferdinandus Stevanus