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All Journal Jurnal Kedokteran Brawijaya Medicinus : Jurnal Kedokteran
Siahaan, Sylvia Sagita
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Medicine & Pharmacology Public Health

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Kadar Prokalsitonin dan Interleukin-6 sebagai Penanda Prognostik pada Pasien Pneumonia dengan Sepsis Siahaan, Sylvia Sagita; Putra, Ngakan Putu; Sugiri, Yani Jane; Rasyid, Harun Al
Jurnal Kedokteran Brawijaya Vol 30, No 4 (2019)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2019.030.04.6

Abstract

Pneumonia merupakan sepuluh besar kasus rawat inap dengan tingkat kematian 7,6%. Pneumonia dengan sepsis membutuhkan terapi suportif dan perawatan intensif karena tingkat kematian tinggi. Untuk memperbaiki kualitas perawatan dan hasil terapi yang lebih baik, perlu pengkajian dini diagnostik maupun prognostik. Prokalsitonin (PCT) dan Interleukin-6 (IL-6) merupakan penanda infeksi berat dan sepsis. Tujuan penelitian ini untuk menganalisa apakah PCT dan IL-6 dapat digunakan bersama-sama untuk menentukan prognosis pasien pneumonia dengan sepsis dalam hubungannya dengan status mortalitas pada hari ke-30. Penelitian kohort dilakukan pada Oktober 2018 dilakukan di Rumah Sakit Saiful Anwar, Malang, melibatkan 40 pasien pneumonia dengan sepsis tanpa diabetes, kanker, HIV dan kehamilan. Sequential Organ Failure Assesment (SOFA) score dihitung dan sampel darah diambil pada hari ke-0 dan ke-5 perawatan untuk mengukur kadar PCT dan IL-6. Status mortalitas pasien dilihat pada hari ke-30 sejak masuk rumah sakit. Dari 40 pasien, 23 pasien hidup (57,5%) dan 17 pasien meninggal (47,5%). Perbandingan antara kelompok hidup dan meninggal menunjukan perbedaan bermakna dan secara signifikan berhubungan dengan mortalitas pada SOFA score hari ke-5 (p<0,001; OR: 78,75, CI 95% (9,948-623,414)), kadar IL-6 hari ke-5 (p<0,05; OR: 9,208, CI 95% (2,146-39,521)) dan kadar PCT hari ke-5 (p<0,05; OR: 4,190, CI 95% (1,104-15,901)). Hasil uji regresi logistik, didapatkan bahwa IL-6 hari ke-5 dan SOFA score hari ke-5 dapat digunakan sebagai faktor prognostik mortalitas pasien pneumonia dengan sepsis hari ke-30, artinya SOFA score diatas 6 dan kadar IL-6 diatas 332pg/mL pada hari ke-5, merupakan faktor penting dari kematian pasien (AUC: 0,935).
Concomitant Chylothorax and Chyloperitoneum with Newly Diagnosed: B-Cell Lymphoma: A Case Report Siahaan, Sylvia Sagita; Prasetya, Ignatius Bima; Pradhana, Cindy Meidy Leony
Medicinus Vol 12, No 3 (2023): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v11i1.7367

Abstract

Chylothorax and Chyloperitoneum are an infrequent condition, characterized by the accumulation of chyle in the pleural and peritoneum cavity. We report an uncommon presentation of concomitant chylothorax and chyloperitoneum caused by diffuse B- cell Lymphoma. A 60-year woman was admitted with progressive shortness of breath, abdominal fullness, cough when lying down on one week duration. She also complains progressive non painful neck lump, night sweats, and weight loss. Chest radiograph showed right pleural effusion. CT scan abdomen with contrast revealed ascites with lobulated mass and multiple lymphadenopathy. Thoracocentesis and paracentesis were performed, revealed exudative with yellow and milky appearance and elevated triglyceride. Histopathologic confirmed diffuse large B-cell lymphoma. Chylothorax concomitant with chylous ascites is rarely encountered. Serous effusion occur often in malignant lymphomas. Management of chylothorax and chyloperitoneum is conservative measures and treat the aetiology. Effusion often becomes a chronic problem that persist although the lymphoma has been treated.
Concomitant Chylothorax and Chyloperitoneum with Newly Diagnosed: B-Cell Lymphoma: A Case Report Siahaan, Sylvia Sagita; Prasetya, Ignatius Bima; Pradhana, Cindy Meidy Leony
Medicinus Vol. 12 No. 3 (2023): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v11i1.7367

Abstract

Chylothorax and Chyloperitoneum are an infrequent condition, characterized by the accumulation of chyle in the pleural and peritoneum cavity. We report an uncommon presentation of concomitant chylothorax and chyloperitoneum caused by diffuse B- cell Lymphoma. A 60-year woman was admitted with progressive shortness of breath, abdominal fullness, cough when lying down on one week duration. She also complains progressive non painful neck lump, night sweats, and weight loss. Chest radiograph showed right pleural effusion. CT scan abdomen with contrast revealed ascites with lobulated mass and multiple lymphadenopathy. Thoracocentesis and paracentesis were performed, revealed exudative with yellow and milky appearance and elevated triglyceride. Histopathologic confirmed diffuse large B-cell lymphoma. Chylothorax concomitant with chylous ascites is rarely encountered. Serous effusion occur often in malignant lymphomas. Management of chylothorax and chyloperitoneum is conservative measures and treat the aetiology. Effusion often becomes a chronic problem that persist although the lymphoma has been treated.
Co-Authors Harun Al Rasyid Ignatius Bima Prasetya, Ignatius Bima Pradhana, Cindy Meidy Leony Putra, Ngakan Putu Sugiri, Yani Jane