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INDONESIA
Indonesian Journal of Rheumatology
ISSN : 20861435     EISSN : 25811142     DOI : -
Core Subject : Health,
Indonesian Journal of Rheumatology is a peer-reviewed open access journal on rheumatic diseases and connective tissue disorders. This is an official journal of Indonesian Rheumatology Associantion (IRA) and published twice a year since 2009. Our mission is to encourage the development of scientific and medical practice in rheumatic diseases and connective tissue disorders. This journal is self-focused on rheumatic disease and connective tissue disorders in the form of original article (extended and/or concise reports), review articles, editorial letters, leaders, lesson from memorable cases, book reviews, and matter arising. Both in clinical and laboratory including animal studies.
Arjuna Subject : -
Articles 204 Documents
CORRELATION BETWEEN ANTI-CCP TITER AND BODY MASS INDEX SCORE IN RHEUMATOID ARTHRITIS PATIENTS IN CIPTO MANGUNKUSUMO HOSPITAL Isbagio, Harry; Fitriah, Khadijah
Indonesian Journal of Rheumatology Vol 10 No 2 (2018): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v10i2.141

Abstract

Background: Rheumatoid Arthritis (RA) is a chronic systemic inflammation that attacks and damages joints of upper and lower extremities. RA causes morbidity and disability, hence, affects the quality of life. Chronic inflammation, as the disease progressing causes lowering of body mass index in RA patients. Titer of anti-CCP is specific for RA which indicates the progressivity and severity of the disease. Study about anti-CCP titer and body mass index has not been done in Indonesia. Therefore, this study done to understand the correlation between anti-CCP titer and body mass index score in rheumatoid arthritis patients in Cipto Mangunkusumo hospital. Method: The design of this study is cross-sectional study with 42 samples. The data included anti-CCP titer, body weight, height, and body mass index are collected from patients? medical records. Results: RA patients in Cipto Mangunkusumo hospital in 2012-2016 with negative and positive anti-CCP titer consecutively are 28.6% and 71.4%. The result of this correlation study is p>0.05; r-0.03. Conclusion: In conclusion, there is no correlation between anti-CCP titer and body mass index score in RA patients in Cipto Mangunkusumo hospital Keywords: Anti-CCP; Body Mass Index; Rheumatoid Arthritis
CORRELATION BETWEEN COGNITIVE FUNCTION WITH DISEASE ACTIVITY OF SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS IN DR. HASAN SADIKIN HOSPITAL BANDUNG: AN ANALYTICAL CROSS-SECTIONAL STUDY Saepudin, Aep; Ong, Paulus Anam; Hidayat, Syarief; Rahmadi, Andri Reza; Hamijoyo, Laniyati
Indonesian Journal of Rheumatology Vol 11 No 1 (2019): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v11i1.142

Abstract

Background: Cognitive dysfunction was found in 55-80% Neuropsychiatry Systemic Lupus Erythematosus (NPSLE) patients. Serious concern from clinicans was needed as its impact to patient?s quality of life. Disease activity is expected to be affecting patient?s cognitive function. Previous studies regarding correlation between disease activity and cognitive dysfunction showed various results. This study aimed to evaluate the correlation between disease activity and cognitive function in SLE patients.Methods: This study is an analytical cross-sectional study. Subjects were SLE patients at the rheumatology clinic of Dr. Hasan Sadikin Hospital Bandung during June-August 2017. Subject?s evaluations included disease activity assessment using SLE disease activity index-2K (SLEDAI-2K) and cognitive function assessment using MoCA-Ina test. Data were analyzed by using Spearman Rank correlation test. Results: Mean age of the subjects was 31 ± 8 years old, most of them were senior high school graduates (65.8 %) and median length of study was 12 years. Subject?s median duration of illness was 44 months. Their MoCA-Ina median score was 25, while SLEDAI-2K median score was 6. Cognitive dysfunctions were found in more than half of subjects (52.63%), which memory domain (78.95%) was most frequently impaired. Most of subjects were patients with active SLE (63.2%). Correlation test showed there was no correlation between SLEDAI-2K score and MoCA-Ina score (rs=0.023, p=0.445).Conclusion: There was no correlation between disease activity (SLEDAI-2K score) and cognitive function (MoCA-Ina score). Keywords: Cognitive dysfunction, MoCA-Ina, Systemic lupus erythematosus, SLEDAI-2K
COMPARISON BETWEEN MYCOPHENOLATE MOFETIL AND AZATHIOPRINE FOR PREVENTING RENAL RELAPSE IN LUPUS NEPHRITIS: AN EVIDENCE-BASED CASE REPORT Setiyohadi, Bambang; Muharrom, Muhammad Aji
Indonesian Journal of Rheumatology Vol 10 No 2 (2018): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v10i2.140

Abstract

Background: Systemic Lupus Erythematosus (SLE) is an autoimmune disease which involved many organs. One of its severe manifestations is lupus nephritis (LN). Treatment of LN consists of two phases, induction and maintenance. Inappropriate treatment approach could increase morbidity and mortality in LN patients. Renal flare is among many bad outcomes of LN that should be mitigated with an appropriate therapeutic approach. Various guidelines stated usage of mycophenolate mofetil (MMF) or azathioprine (AZA) as an appropriate immunosuppresant in the maintenance phase. However, it is not clear which agent acts best in preventing renal flare. This paper presents a case of 21 years old SLE female patient with history of renal flare 1 month prior to admission. This study aimed to give evidence-based recommendation to adjust this patient?s therapy in order to prevent future renal flare episode. Method: Literature search was done on four online databases, namely PubMed, EBSCO, Cohrane Library, and ProQuest. Articles with randomized clinical trial (RCT), systematic review and meta-analysis study design were retrieved and selected based on inclusion and exclusion criterias. Critical appraisal was done using appraisal sheet provided by Oxford Centre of Evidence-based Medicine. Articles were appraised based on its validity, importance, and applicability.Results: There were 144 articles retrieved from literature searching. Further screening and full-text reading yields to 2 RCTs and 2 meta-analysis that were critically appraised. Both meta-analysis were satisfactory on their validity, while none of RCTs found were blinded studies. Both meta-analyses showed pooled risk ratio (RR) of0.70 (0.49 ? 1.00) for renal flare outcome in the use of mycophenolate mofetil compared to azathioprine. Conclusion There are no significant differences between mycophenolate mofetil and azathioprinein prevention of renal flare. Based on applicability, azathioprine is more appropriate to be given in this patient, in accordance to her background.Keywords : Lupus Nephritis, Renal Flare, Mycophenolate Mofetil, Azathioprine, Systemic Lupus Erythematosus
THE CORRELATION VALUE OF DAS28 WITH ANTI-CCP TITER ON RHEUMATOID ARTHRITIS PATIENTS IN CIPTO MANGUNKUSUMO HOSPITAL IN 2012-2016 Isbagio, Harry; Fadillah, Deka Yuli
Indonesian Journal of Rheumatology Vol 10 No 2 (2018): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v10i2.139

Abstract

Background: Rheumatoid Arthritis (RA) is one of the diseases associated with the immune system which causes joint damage and effect to the quality of patient?s life. DAS28 CRP value describes RA disease activity. The anti-CCP titer is a very specific examination which provide an overview prognosis of RA patient?s illness. The research on the correlation of anti-CCP Titers with DAS28 CRP values has never been done in Indonesia. Therefore, this research aims to determine the correlation between anti-CCP Titer and DAS28 CRP value in RA patient in Cipto Mangunkusumo hospital with DAS28 CRP value in RSCM. Method: The research design is cross-sectional with the sample amounted to 34. anti-CCP and DAS28 CRP were obtained through patient?s medical records.Result The result of this correlationstudy is (p = 0,582) and r = 0,086. Conclusion: In conclusion, there is no correlation between anti-CCP and DAS28 in Cipto Mangunkusumo hospital. Keywords: Anti-CCP; DAS28 CRP; Rheumatoid Arthritis
LUPUS LOW DISEASE ACTIVITY STATE ASSOCIATED WITH LOWER FATIGUE : PREELIMINARY STUDY Saputro, Ryan Ardian; Andayani, Santi; Usman, Stefanie Yuliana; Hamijoyo, Laniyati
Indonesian Journal of Rheumatology Vol 11 No 2 (2019): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v11i2.134

Abstract

Background: Systemic Lupus Erythematosus (SLE) is an autoimmune disease with heterogeneous clinical manifestations including fatigue. Previous studies aimed at proving the relationship between fatigue and SLE disease activity showed conflicting results. In 2015, Asia Pacific Lupus Collaboration (APLC) developed low disease activity criteria, named Lupus Low Disease Activity State (LLDAS). Patients who spend more time in LLDAS have significantly lower morbidity. This study aimed to evaluate the association between disease activity based on LLDAS and fatigue.    Methods: This is a analytical cross-sectional study. Subjects were SLE patients at rheumatology clinic in Dr. Hasan Sadikin Hospital, Bandung during June-January 2018. Subjects were evaluated based on LLDAS criteria and divided into 2 groups: LLDAS and non-LLDAS. Fatigue status of the subjects was assessed with Fatigue Severity Scale (FSS). Results: A hundred and thirty-three subjects were included in this study, divided into 63 subjects in LLDAS group and 60 subjects in non-LLDAS group. Nineteen subjects (30.2%) in LLDAS group had fatigue and 39 subjects (65%) in non-LLDAS had fatigue. There was a significant association between LLDAS and fatigue (p< 0.001). Nonetheless, fatigue level in LLDAS group was still high since disease activity was not the only factor related to fatigue. Fatigue may be a distinct clinical manifestation of neuropsychiatric lupus and may be independent of lupus disease activity Conclusions: There was a significant association between LLDAS and fatigue showed by lower fatigue level was found in the LLDAS group than in the non-LLDAS group.   Keywords: Systemic lupus erythematosus, disease activity, Lupus Low Disease Activity State, fatigue
CORRELATION BETWEEN SERUM KREBS VON DEN LUNGEN-6 LEVELS WITH FORCED VITAL CAPACITY AND MODIFIED RODNAN SKIN SCORE OF PATIENTS WITH RESTRICTIVE LUNG DISEASE IN DIFFUSE-TYPE SYSTEMIC SCLEROSIS Yani, Herlina; Dewi, Sumartini; Rahmadi, Andri Reza
Indonesian Journal of Rheumatology Vol 11 No 2 (2019): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v11i2.133

Abstract

Background Pulmonary fibrosis / intersitial lung disease (ILD) in systemic sclerosis (SSc) is a complicated restrictive pulmonary disease and the leading cause of disease-related mortality. Progressive skin fibrosis in diffuse-type SSc (dSSc) is associated with decreased forced vital capacity (FVC). Modified Rodnan Skin Score (mRSS) examination is used as a parameter to assess skin fibrosis, while high-resolution computed tomography (HRCT) and pulmonary function tests (PFTs) are used to assess pulmonary fibrosis. The HRCT test remains as the gold standard in diagnosing ILD. However, it costs a lot and is not available in all healthcare facilities. Krebs Von den Lungen-6 (KL-6) is a biomarker to evaluate pulmonary fibrosis. The aim of this study was to analyze the correlation of serum KL-6 levels with FVC and mRSS value of patients with restrictive lung disease in dSSc. Method This was a cross-sectional study that used primary data from dSSc patients who visited rheumatology outpatient clinic in Hasan Sadikin Hospital Bandung, Indonesia, during the period of June-July 2019. History taking, physical examination, mRSS, spirometry, and serum KL-6 levels were performed. Data were analyzed using the Rank Spearman correlation test.  Result There were 27 subjects with the mean age of 42 ± 12 years. Based on FVC (%) restrictive lung disease criteria, the majority of subjects (74.1%) had severe restrictive lung disease and the rest of all subjects (25.9%) were non severe restrictive lung disease. Serum KL-6 levels ranged from 0.545 to 8.138 ng/ml. The results showed that there was no correlation between serum KL-6 levels and FVC values (r = -0.118, p = 0.279) and mRSS (r = 0.101, p = 0.312 ). Conclusion There is no correlation between serum KL-6 levels with FVC and mRSS value of patient with restritive lung disease in diffuse type systemic sclerosis. Keywords : diffuse type systemic sclerosis, Forced Vital Capacity, KL-6, mRSS, restrictive lung disease.      
PREVALENCE OF CAROTID ARTERY ATHEROSCLEROSIS PLAQUE IN SYSTEMIC LUPUS ERYTHEMATOSUS IN HASAN SADIKIN HOSPITAL BANDUNG IN 2017-2018 Rasyid, Irham; Hidayat, Syarief; Hamijoyo, Laniyati
Indonesian Journal of Rheumatology Vol 11 No 2 (2019): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v11i2.129

Abstract

Background. Systemic Lupus Erythematosus (SLE) is an autoimmune disease involving many organs including the cardiovascular system such as accelerated atherosclerosis or premature atherosclerosis. Atherosclerotic plaque can cause coronary heart disease, ischemic stroke and peripheral arterial disease, which are the main causes of death in the world. The purpose of this study was to determine the prevalence of carotid artery atherosclerosis plaques in patients with SLE. Method. This research is a descriptive study with a cross-sectional design. Carotid artery atherosclerosis plaques in SLE patients were assessed by analysing results of carotid ultrasound examinations that were conducted in 2017-2018. The inclusion criteria of this study were SLE patients who had undergone carotid doppler ultrasound B mode examination on the carotid artery for the period of 2017-2018. The exclusion criteria in this study were SLE patients with a history of stroke, peripheral arterial disease, and significant coronary artery disease. Result. This study involved 88 SLE patients who met the inclusion criteria. Results showed that there were 10 SLE patients (11.4%) who had atherosclerotic plaques. SLE patients with atherosclerosis plaque were mostly in the age range of 35-44 years (16%) and 45-54 years (22.2%). There were 2 patients (15.3%) with atherosclerotic plaque from a total of 11 patients had high triglyceride levels (?150 mg/dL). Chi square analysis of lipid profiles (cholesterol, LDL, HDL, triglycerides) in patients with atheroclerotic plaque revealed not significant (p>0.05). These findings could be caused by several factors, such as the small number of samples in this study and the non-traditional factors in the formation of atherosclerotic plaque as well as other traditional factors Conclusion. The prevalence of carotid artery atherosclerosis plaques in patients with SLE in Dr. Hasan Sadikin General Hospital in 2017-2018 is 11.4%.
CORRELATION BETWEEN CARDIORESPIRATORY FITNESS AND FATIGUE SEVERITY SCALE (FSS) ON SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) PATIENTS AT RSUP DR. HASAN SADIKIN BANDUNG Yovita, Thea; Dewi, Sumartini; Sastradimaja, Sunaryo Barki
Indonesian Journal of Rheumatology Vol 11 No 2 (2019): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v11i2.127

Abstract

Background Systemic Lupus Erythematosus (SLE) is a multifactorial and heterogenous systemic autoimmune disease, involving multisystem organ and marked with the production of autoantibodies. SLE has general constitutional sympton such as fatigue and usually is the main symptom causing limited functional condition on patients. Assessment for cardiorespiratory fitness can be done with various methods, one of them measuring Metabolic Equivalents (METs). The purpose of this study was to examine the correlation between cardiorespiratory fitness and Fatigue Severity Scale (FSS). Method The sampling method used was the total sampling method. Out-patients diagnosed with SLE were screened via medical records according to inclusion and exclusion criteria. SLE patients filled an Indonesian version of the FSS questionnaire sheet and did the six-minute walk test based on standard protocol on a 30-meter track. The total distance patients had crossed was turned into VO2 max with Nury equation, then turned again into cardiorespiratory fitness with METs unit. A correlation analysis between cardiorespiratory fitness and FSS was done next. Results There were 28 patients participating in this research. Correlation analysis resulted in a negative correlation with no statistical meaning between cardiorespiratory fitness and FSS (r = -0,27; p > 0,05). Conclusion There is no correlation between cardiorespiratory fitness and FSS in SLE patients. Keywords Correlation, Cardiorespiratory Fitness, Fatigue Severity Scale, Systemic Lupus Erythematosus
THE DIFFERENCES IN SERUM COMPLEMENTS AND ANTI-DSDNA LEVELS BETWEEN RENAL AND NON-RENAL MANIFESTATIONS IN SYSTEMIC LUPUS ERYTHEMATOSUS Suryana, Bagus Putu Putra; Rosita, Lya; Djais, Nursamsu; Hasanah, Dian
Indonesian Journal of Rheumatology Vol 11 No 1 (2019): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v11i1.121

Abstract

Background. Systemic lupus erythematosus (SLE) has diverse clinical manifestations, including renal and non-renal. Renal manifestation is related to significant morbidity and mortality. SLE is also characterized by serological aberrations, including levels of complement C3, C4 and anti-dsDNA, but the association of them with clinical manifestations including renal and non-renal is unclear. This study investigated the associations of C3, C4 and anti-dsDNA levels with renal and non-renal manifestations in SLE patients. Method. A cross-sectional study was conducted in the Polyclinic of Rheumatology, Dr. Saiful Anwar Hospital Malang. A number of 43 subjects fulfilled the 1997 American College of Rheumatology criteria participated in this study, that consisted of 11 patients with renal manifestation and 32 patients with non-renal manifestations. Serum C3 and C4 levels were measured using immunoturbidimetry, and serum anti-dsDNA levels were measured using enzyme-linked immunosorbent assays (ELISA). The independent T-test was used to compare C3 levels and the Mann-Whitney U test was used to compare C4 and anti-dsDNA levels between groups. Result. SLE with renal manifestation had significant lower levels of serum C3 compare to non-renal manifestations (mean ± SD: 71.27 ± 32.65 mg/dL and 94.47 ± 26.29 mg/dL respectively, p=0.022). SLE with renal manifestation also had significantly lower levels of  serum C4 compare to non-renal manifestations (mean ± SD: 14.55 ± 8.20 mg/dL and 25.50 ± 11.05 mg/dL respectively, p=0.002). Conversely, SLE with renal manifestation had significantly higher levels of serum anti-dsDNA compare to non-renal manifestations (mean ± SD: 249.27 ± 240.34 IU/mL and 109.91 ± 166.11 IU/mL respectively, p=0.014). Conclusion. SLE patients with renal manifestation have significantly lower levels of serum C3 and C4 and a higher level of serum anti-dsDNA than SLE patients with non-renal manifestations.
THE RELATIONSHIP BETWEEN NEUTROPHIL LYMPHOCYTE RATIO WITH DISEASE ACTIVITY IN SYSTEMIC LUPUS ERYTHEMATOSUS Kambayana, Gede; Putra, I Gusti Agung Friskha Surya; Kurniari, Pande Ketut; Putra, Tjokorda Raka
Indonesian Journal of Rheumatology Vol 11 No 1 (2019): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v11i1.126

Abstract

Background. Systemic Lupus Erythematosus (SLE) is an Autoimmune inflammatory disease that is systemic and chronic inflammation with heterogeneous of history, clinical manifestations, and prognosis. The disease activity of SLE has been proven as a predictor of organ damage and death by evidenced of inflammatory markers involved in this disease. Neutrophil to Lymphocyte Ratio (NLR) is useful for estimating the activity of autoimmune disease and inflammation that easily obtained from blood test and low cost and measurable as new biomarker to assess inflammatory response or activity of SLE. This study aimed to determine the relationship between NRL and Disease Activity based on Mex-SLEDAI in patients SLE. Methods. This study is an analytic study with cross sectional design. It started from November 2016 until March 2017. Mex-SLEDAI and blood sampling used in this study. Result. Total sample in this study is 54 patients with median age was 28.5 years, with mostly female (85,2%). Result analysis with positive correlation between NLR with disease activity on SLE (r=0.399  p=0.003  n=54), thus the Scatter plot shows there is a correlation between NRL with Mex-SLEDAI. Conclusion. Positive correlation between NLR and disease activity of the SLE, the higher of the disease activity/Mex-SLEDAI will be followed by the increase of NLR.

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