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All Journal Jurnal Kedokteran Brawijaya Indonesian Journal of Case Reports
Himawan, Indra Widjaja
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Health Professions Medicine & Pharmacology Neuroscience Public Health

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Effects of Vitamin D Supplementation on Pediatric Tuberculosis Clinical, Radiological, and Laboratory Outcomes Khairiyadi, Khairiyadi; Hadi Putra, Nataniel; Marhaeni, Wulandewi; Himawan, Indra Widjaja; Panghiyangani, Roselina
Jurnal Kedokteran Brawijaya Vol. 33 No. 4 (2025)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2025.033.04.4

Abstract

Tuberculosis is a systemic infectious disease caused by Mycobacterium tuberculosis. Pediatric tuberculosis patients often have reduced immunity due to malnutrition. Vitamin D supplementation improves host cell antimicrobial immune response, improving clinical outcomes. A study in Iran found that intramuscular cholecalciferol administration improved tuberculosis patients' outcomes, including weight gain and arm circumference when administered alongside tuberculosis therapy for 6 or 9 months. This study focuses on oral cholecalciferol for pediatric tuberculosis patients, analyzing its effects on clinical improvement, radiological features, laboratory findings, and its impact on weight gain, height, and vitamin D levels. The chi-square test was used to analyze the effect of vitamin D on the improvement of fever (p=0.638), cough (p=1.00), nutritional status (p=0.388), radiological features (p=0.510), decrease in leukocytes (p=1.00), lymphocytes (p=0.262), monocytes (p=0.575), and increase in vitamin D levels (p=0.149). The Mann-Whitney test was used to analyze the effect of vitamin D on the average increase in weight gain (p=0.392), height (p=0.044), vitamin D levels (p=0.770), and the average decrease in leukocytes (p=0.260), lymphocytes (p=0.055), and monocytes (p=0.687). The confidence level is 95%. Most clinical, radiographic, and laboratory outcomes in pediatric TB patients did not significantly change when vitamin D therapy was used. However, it markedly increased the patients' development, indicating possible advantages for these individuals.
Severe Diabetic Ketoacidosis Complicated by RRT-Requiring Acute Kidney Injury in an Adolescent with Newly Diagnosed Type 1 Diabetes Putri, Niarsari Anugrahing; Himawan, Indra Widjaja; Utama, Adelia Anggraini
Indonesian Journal of Case Reports Vol. 3 No. 2 (2025): December 2025
Publisher : Heca Sentra Analitika

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.60084/ijcr.v3i2.367

Abstract

Diabetic ketoacidosis (DKA) is a major and potentially life-threatening acute complication of type 1 diabetes mellitus (T1DM), particularly in children and adolescents. We report a 17-year-old male who presented with severe DKA as the first manifestation of previously undiagnosed T1DM. On admission, he was profoundly acidotic, markedly hyperglycemic, hemodynamically unstable, and anuric, with rising creatinine levels. Despite appropriate resuscitation and standard DKA therapy, renal function deteriorated to stage 3 AKI according to KDIGO, leading to the initiation of renal replacement therapy. During the initial phase of dialysis, the patient experienced several episodes of hypoglycemia, requiring insulin dose adjustment and closer glucose monitoring. Renal function gradually improved and patient was discharged in stable condition. This case highlights that DKA as the initial presentation of type 1 DM in adolescents can progress to severe AKI requiring dialysis, and emphasizes the importance of careful monitoring of renal function and glycemic management during renal replacement therapy in pediatric patients.
Co-Authors Hadi Putra, Nataniel Khairiyadi Khairiyadi Marhaeni, Wulandewi Niarsari Anugrahing Putri Roselina Panghiyangani Utama, Adelia Anggraini