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All Journal MNJ (Malang Neurology Journal) Indonesian Journal of Kidney and Hypertension
Gracia, Felicita
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Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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SUDDEN PROGRESSIVE LOWER LIMB WEAKNESS CAUSED BY TRANSVERSE MYELITIS, MENINGITIS, AND COMMUNICANS HYDROCEPHALUS DUE TO TUBERCULOSIS: A RARE CASE REPORT Simanjuntak, Arya Marganda; Candra, Riky; Gracia, Felicita; Maryanti, Yossi; Sucipto; Sukiandra, Riki; Juananda, Desby
MNJ (Malang Neurology Journal) Vol. 12 No. 1 (2026): January
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.2025.012.01.17

Abstract

Background: This report presents a rare case of TB myelitis with concurrent TBM, emphasizing the importance of early detection and intervention due to its atypical symptoms and high risk of neurological disability. Objective: To report a rare case of tuberculous myelitis occurring concurrently with TBM and to highlight the importance of early recognition, appropriate imaging, and timely therapeutic intervention to improve neurological outcomes. Methods: A clinical case review was conducted involving a 32-year-old male presenting with progressive neurological deficits. Clinical evaluation, neuroimaging, cerebrospinal fluid (CSF) analysis, and treatment response were assessed. Management consisted of anti-tuberculosis therapy, corticosteroids, and intensive rehabilitation, with neurosurgical intervention deferred due to medical instability. Result: he patient initially developed chronic headache, fever, and cough, followed by worsening lower limb weakness, numbness, and urinary retention. Neurological examination revealed paraplegia with sensory level at T4. Imaging demonstrated hydrocephalus and pulmonary tuberculosis, while CSF analysis confirmed TBM. A diagnosis of TB myelitis with concurrent meningitis was established. Following initiation of anti-tuberculosis therapy (2RHZE/10RH), corticosteroids, and rehabilitation, the patient showed gradual neurological improvement despite the postponement of neurosurgical procedures. However, there are still few standardized protocols for diagnosing and treating TB myelitis, which calls for more research. Conclusion: Rapid diagnosis of TB myelitis, a treatable complication of CNS tuberculosis, can significantly improve patient outcomes, necessitating further research and development of new therapeutic approaches.
Finerenone in Diabetic-Kidney Disease, Renal and Cardiovascular Outcome: A Meta-Analysis of Independent Trial Registries Gracia, Felicita; Simanjuntak, Arya Marganda; Amanda, Samira; Mustika, Linda Ida; Juwanto, Juwanto; Sembiring, Ligat Pribadi; Karimi, Jazil; Harahap, Sari; Rosmaliana, Rosmaliana
Indonesian Journal of Kidney and Hypertension Vol 2 No 3 (2025): Volume 2 No. 3, December 2025
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v2i3.224

Abstract

Background: Diabetic kidney disease (DKD) remains a frequent complication of type 2 diabetes, which significantly increases cardiovascular risk. Despite existing treatments, a substantial risk of disease progression still remains, leading to further exploration in Finerenone, a selective nonsteroidal mineralocorticoid receptor antagonist. Objective: This meta-analysis evaluates finerenone’s effects on the improvement of cardiorenal outcomes in DKD. Methods: A Systematic Review and Meta-Analysis (PROSPERO CRD420251122382) followed PRISMA guidelines. PubMed, ScienceDirect, and Epistemonikos utilized and used keywords “Finerenone AND Diabetes AND Chronic Kidney Disease AND Outcomes.” RCTs comparing finerenone to placebo in DKD, reporting renal or cardiovascular outcomes, were included. Data extraction covered study characteristics and outcomes. RevMan 5.4 analyzed data using a random-effects model. Risk of bias (RoB2) and certainty of evidence (GRADE-PRO) were assessed. Results: Three RCTs (19,027 participants) were included for renal outcomes, and two RCTs (13,026 participants) for cardiovascular outcomes. Finerenone significantly reduced the odds of sustained eGFR decline ≥40% (OR 0.83, p=0.0003) and≥57% (OR 0.86, p=0.0001), as well as the major composite kidney outcome (OR 0.76, p<0.0001). ESKD odds reduction (21%) was not statistically significant. For cardiovascular outcomes, finerenone significantly reduced hospitalization for heart failure (OR 0.78, p=0.0001). Trends towards reduced cardiovascular death (OR 0.88, p=0.09) were noted. Studies had low bias risk, and most outcomes showed moderate evidence certainty. Conclusions: Finerenone is associated with significant renoprotection and significantly reduces heart failure hospitalizations in DKD. Finerenone as an effective nonsteroidal mineralocorticoid receptor antagonist for comprehensive management, improving cardiorenal outcomes in this high-risk group.
Co-Authors Amanda, Samira Candra, Riky Desby Juananda, Desby Harahap, Sari Jazil Karimi Juwanto Juwanto Ligat Pribadi Sembiring Maryanti, Yossi Mustika, Linda Ida Riki Sukiandra Rosmaliana, Rosmaliana Simanjuntak, Arya Marganda Sucipto