BACKGROUND: Acute transverse myelitis (ATM) could be a pathogenetically heterogeneous inflammatory disorder affecting the spinal cord at one or more segments [1]. CASE PRESENTATION: We report a 69-year-old man presented with complaints of weakness of the arms and legs since 3 weeks before hospital admission. On physical and neurological examination was found Tetraparese, lower motor neuron in the superior limb and upper motor neuron in the inferior limb, sensory disturbances at C6-C7 levels, and autonomic impairment retention of urine and bladder dysfunction. On magnetic resonance imaging examination of the whole spine vertebra, a diffuse process was found in the spinal cord along with the cervical 7 to Th12-L1. Differential diagnosis is with transverse myelitis, multiple sclerosis, and no picture of syringomyelia. The patient was treated with steroids. Acute transverse myelitis is an inflammatory disorder of the spinal cord with various causes. CONCLUSION: Clinical examination and investigations are very important to establish the diagnosis and determine the right management so that the expected outcome is obtained.
BACKGROUND: The proportion of HIV patients with hyponatremia was significantly higher in hospital compared to those without hyponatremia. HIV patients with hyponatremia had significantly lower CD4 cell counts, about twice the HIV viral load and an approximately four-fold higher prevalence. Hyponatremia was positively correlated with a decrease in CD4 cell count. AIM: The aim of this study was to determine the correlation between hyponatremia and CD4 cells in response to HAART treatment in patients with HIV cerebral toxoplasmosis. METHODS: The design of this study was correlative analytic with retrospective data collection method with secondary data sources obtained from the medical records of HIV-toxoplasma cerebral patients with hyponatremia at Haji Adam Malik Hospital Medan who met the inclusion and exclusion criteria and were included in this study. The research started from December 2021 to January 2022. RESULT: This study was conducted on 30 samples of medical records consisting of 24 males and six females with a mean (min-max) age of 36.1 (23–53). There were 28 subjects (83.3%) with an effective response to treatment and two subjects (6.6%) with a less effective response to treatment. There was a significant correlation between hyponatremia and CD4 cells in response to HAART treatment (p < 0.005; r = 0.0462). There was a significant correlation between hyponatremia and CD4 cell count before receiving HAART treatment (p < 0.005; r = 0.0526). CONCLUSION: There is a significant correlation between hyponatremia and CD4 cells in response to HAART treatment in patients with HIV cerebral toxoplasmosis.
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