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All Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
Prabawa, I Putu Yuda
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Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience

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Hydatidiform Mole Pregnancy with Hyperthyroidism: A Case Report Dewi, Ni Made Ratih Purnama; Gotera, Wira; Lestari, Anak Agung Wiradewi; Herawati, Sianny; Wande, I Nyoman; Mulyantari, Ni Kadek; Sudana, I Nyoman Gde; Prabawa, I Putu Yuda
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 3 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i3.2243

Abstract

Hyperthyroidism is a condition with excess biosynthesis and hormone secretion by the thyroid gland. One of the secondary causes of hyperthyroidism is hydatidiform mole pregnancy, which is included in Gestational Trophoblastic Disease (GTD). Hyperthyroidism in hydatidiform mole pregnancies occurs due to increased beta-Human Chorionic Gonadotropin (beta-hCG).  Increasing beta-hCG level affects stimulation of the thyroid gland, increasing thyroid hormone levels in the serum, which causes thyrotoxicosis. This case is such a rare case. A 22-years-old female, G1P0A0, came complaining of amenorrhea accompanied by vaginal bleeding with abdominal pain, nausea, vomiting and palpitations.accompanied by vaginal bleeding with abdominal pain, nausea, vomiting and palpitations. Physical examination showed tachycardia with a pulse rate of 120 beats per minute. Ultrasound examination of the abdomen showed an anteflexed uterus with a honeycomb appearance. Based on a series of tests, the patient has a hydatidiform mole pregnancy with a risk of impending thyroid storm, indicated by TSH suppression with increased fT4. Beta-hCG can cause hyperthyroidism through cross-reaction with TSH receptors. In patients with hyperthyroidism due to GTD, it is not characterized by the characteristic features often found in Graves' disease. Evacuation with curettage and medication was performed to reduce thyroid hormone and serum beta-hCG levels. Hyperthyroidism is an abnormality that can be found in hydatidiform mole pregnancies. It is important to carry out early detection by examining thyroid function in GTD, proper management, and regular monitoring of thyroid function and beta-hCG in pregnant female to provide comprehensive management and prevent complications that can be caused by hyperthyroidism.      
The Concordance of Platelet Counts on Hematology Analyzer with Thrombocytopenia Sample with Platelet Clump Prabawa, I Putu Yuda; Lestari, Anak Agung Wiradewi; Wande, I Nyoman; Mahartini, Ni Nyoman; Herawati, Sianny; Cong, Tzeto Han
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2437

Abstract

Pseudo-thrombocytopenia is a pre-analytical issue commonly observed in clinical laboratory settings due to platelet aggregation or clumps. In cases of thrombocytopenia, it is essential to conduct a platelet count via Peripheral Blood Smear (PBS) to identify clumping and subsequently re-evaluate the platelet count. The examination of platelets can now be carried out through different methodologies offered by Hematology Analyzers, such as PLT-I, PLT-O, and PLT-F. The primary objective of this research was to evaluate the correlation and agreement of platelet count findings (PLT-I, PLT-O, and PLT-F) in samples displaying flagged platelet clumps between a Hematology Analyzer and PBS at Prof. dr. I.G.N.G. Ngoerah General Hospital, Bali. An analytical cross-sectional observational study was conducted on 71 samples of thrombocytopenia with platelet clump flagging on the Sysmex® XN-1000 Series Hematology Analyzer at Prof. dr. I. G. N. G. Ngoerah Hospital. SPSS version 26.0 and MedCalc were used to conduct statistical analysis. There was a significant difference in the PLT clump Fluorescence index (p = 0.001) between the sample groups with and without the clump, and there was a strong positive correlation of the PLT count results between the Hematology Analyzer (p <0.001) and PBS in the sample groups with and without the clump. The Bland-Altman mean bias was lowest in the sample group without clumps against PLT-I (0.39x103/ml; 95% LOA: -57.05-57.83) and highest in the sample group with a clump to PLT-F (105.38x103/ml; 95% LOA: -14.7-225.46). There is a strong positive correlation and concordance of platelet count results between the Hematology Analyzer and PBS. However, there is no concordance between the platelet count results from the Hematology Analyzer and PBS in the clump group.
The Correlation between HbA1c and MCP-1 Levels in Diabetic Retinopathy Patients Lestari, Anak Agung Wiradewi; Nabu, Ekarini Katharina Yunarti; Triningrat, Anak Agung Mas Putrawati; Wande, I Nyoman; Wirawati, Ida Ayu Putri; Mahartini, Ni Nyoman; Cong, Tzeto Han; Prabawa, I Putu Yuda
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2678

Abstract

Diabetic Retinopathy (DR) is a common microvascular complication of diabetes mellitus and a leading cause of vision loss. Persistent hyperglycemia plays a central role in the pathogenesis of DR by promoting chronic inflammation. Monocyte Chemoattractant Protein-1 (MCP-1), a key pro-inflammatory chemokine, is believed to mediate this process. This study aimed to investigate the correlation between glycemic control, as reflected by glycated hemoglobin (HbA1c) levels, and serum MCP-1 concentrations in patients with DR. A cross-sectional analysis was conducted involving 45 DR patients at Prof. dr. I. G. N. G. Ngoerah General Hospital. HbA1c levels were assessed enzymatically and reported in NGSP units, while serum MCP-1 concentrations were measured through ELISA and expressed in pg/mL. The correlation between the two parameters was evaluated using Spearman's rank correlation test, with significance determined at p <0.05.The participants consisted of 64.4% males and 35.6% females, with a mean age of 55.0±6.6 years. The median HbA1c was 9.5% (range: 5.9–12.3%), and the median MCP-1 level was 320.57 pg/mL (range: 32.34–605.41 pg/mL). A moderate positive correlation was identified between HbA1c and MCP-1 levels r = 0.45; p = 0.007). These findings indicate that increased blood glucose levels may coincide with elevated MCP-1, suggesting an ongoing inflammatory response contributing to DR progression. This study demonstrates a significant moderate positive correlation between HbA1c and serum MCP-1 in DR patients, suggesting that elevated blood glucose levels may contribute to increased MCP-1 expression. These findings support the potential role of MCP-1 as a biomarker of both poor glycemic regulation and inflammation in the progression of diabetic retinopathy.
Co-Authors Anak Agung Wiradewi Lestari Cong, Tzeto Han Dewi, Ni Made Ratih Purnama I Nyoman Wande Mahartini, Ni Nyoman Nabu, Ekarini Katharina Yunarti Ni Kadek Mulyantari Sianny Herawati Sudana, I Nyoman Gde Triningrat, Anak Agung Mas Putrawati Wira Gotera Wirawati, Ida Ayu Putri