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All Journal Sumatera Medical Journal Scientific Journal
Wahyudi, Adefri
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Warm Autoimmune Hemolytic Anemia with Chronic Hepatitis B Wahyudi, Adefri; Fadrian; Afriant, Rudy
Sumatera Medical Journal Vol. 7 No. 1 (2024): Sumatera Medical Journal (SUMEJ)
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/sumej.v7i1.11836

Abstract

Background: Warm autoimmune hemolytic anemia (wAIHA) is caused by erithrocytes destruction by IgG or IgG plus C3d-mediated autoantibody. Objective: To present a case of warm autoimmune hemolytic anemia (wAIHA) in a patient with chronic hepatitis B infection. Methods: This is a case report that showed a special case. Results: Man, 64 y.o, hospitalized with diagnosis wAIHA and chronic hepatitis B. Diagnosis of wAIHA is built by: severe normocytic normochromic anemia, reticulocytosis 42.29%, increasing lactate dehydrogenase 397 U/L, direct Coombs test (+4), antibody screening IgG (+4). Anothers laboratorium findings: HbsAg (+), albumin 3.5 g/dL, ALT U/L, rapid HIV (-), anti HCV (-). There is no blast found in peripheral blood and bone marrow smear. Patient also diagnosed chronic hepatitis B inactive phase with negative HbeAg, HBV DNA 547 IU/L, normal liver finding in abdominal USG and moderate fibrosis from fibroscan. Washed red cell transfussion was administered, 2 x 125 mg methilprednisolone iv (3 days) tapering off until to 40 mg/day doses. He did not get antiviral prophylaxis and be planned to reevaluate in next 6 months. Conclusion: Steroid is first line therapy in wAIHA. When wAIHA is diagnosed, determination of chronic hepatitis B status should confirmed.  There is a risk of reactivation of chronic hepatitis B infection so monitoring is needed.
Tinjauan Pustakaa Peranan ACEIs. ARB dan ARNI pada Penyakit Ginjal Kronik Wahyudi, Adefri; Wahyudi
Scientific Journal Vol. 5 No. 2 (2026): SCIENA Volume V No 2, March 2026
Publisher : CV. AKBAR PUTRA MANDIRI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56260/sciena.v5i2.322

Abstract

Latar Belakang: Penyakit ginjal kronik (PGK) dan penyakit kardiovaskular (PKV) merupakan dua kondisi berkaitan dan sering muncul bersamaan. Penggunaan obat yang bekerja di sistem renin angiotensin aldosteron (RAA) eperti golongan ACEIs, ARB, dan ARNI merupakan pilihan utama  pada hipertensi dan bagian pilar utama terapi pada gagal jantung fraksi ejeksi rendah. Efek samping hiperkalemia dan peningkatan kreatinin serum sering menjadi alasan bagi klinisi untuk tidak memberikan ACEIs/ARB pada pasien PGK. Metode: Pendekatan narrative review, sumber literatur dari Pubmed, Google Scholar dan Science Direct dengan kata kunci PGK, PKV, RAAS inhibitor. Kriteria inklusi berupa artikel sesuai tema penelitian, artikel terindeks scopus dan diterbitkan tahun 2016 – 2025. Kriteria eksklusi meliputi artikel yang tidak dapat diakses, tidak menjawab jenis review. Hasil: Penggunaan obat yang bekerja di sistem RAA pada PGK aman dan memberikan outcome yang baik. Penghentian terapi akan meningkatkan risiko progresivitas end stage renal disease (ERSD) 1,29 kali dan insiden PKV 1,38 kali. Kesimpulan: Penggunaan obat yang bekerja di sistem RAA seperti golongan ACEIs, ARB, dan ARNI pada pasien PGK aman, efektif dan memberikan outcome yang lebih baik.
Co-Authors Fadrian, Fadrian Rudy Afriant WAHYUDI