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All Journal Collaborative Medical Journal (CMJ) Cermin Dunia Kedokteran
Roswati, Eva
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Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Makroglobulinemia Waldenstrom – Laporan Kasus Roswati, Eva
Cermin Dunia Kedokteran Vol 41, No 4 (2014): Dermatologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (237.737 KB) | DOI: 10.55175/cdk.v41i4.1149

Abstract

Makroglobulinemia Waldenstrom (Waldenstrom macroglobulinemia, WM) adalah varian plasmacytoid lymphocytic lymphoma yang memproduksi Ig M monoklonal dalam jumlah besar, menimbulkan makroglobulinemia yang mengakibatkan hiperviskositas dan volume plasma meningkat. WM merupakan kasus jarang, biasanya ditemukan pada pria umur pertengahan dan lebih tua. Diagnosis ditegakkan bila dijumpai gejala klinik, Ig M serum >1,5 g/dL, sumsum tulang: infiltrasi limfosit, sel plasma dan limfosit plasmasitoid, laju endap darah meningkat, histologi kelenjar getah bening gambaran sel limfoplasmasitoid. Dilaporkan kasus, laki-laki, 43 tahun dengan keluhan muka pucat, mata kabur, nyeri kepala disertai riwayat epistaksis, gusi berdarah dan melena berulang. Pemeriksaan fisik anemis. Pemeriksaan laboratorium didapati pansitopenia, morfologi darah tepi normokrom normositer, LED 115 mm/jam, Ig M serum 9,6 gr/dL. SPE menunjukkan M-spike. Dari BMP dijumpai hiposeluler, limfosit 61,25%, sel plasma (sel limfoplasmasitoid) 6,5% kesan WM. Hasil gastroskopi kesan ulkus akut di korpus dan gastritis erosif di antrum. Pasien didiagnosis WM dan diberi terapi suportif yang menghasilkan perbaikan klinis. Pasien direncanakan mendapat kemoterapi CHOP (siklofosfamid, doksorubisin, vinkristin, prednison).Waldenstrom Macroglobulinemia (WM) is a variant of plasmacytoid lymphocytic lymphoma producing monoclonal Ig M in large quantity, causing macroglobulinemia resulted in hyperviscosity and increased plasma volume. WM is rare, usually found in middle aged men and older. Diagnosis is confirmed with appropriate clinical symptoms, serum Ig M >1.5 g/dL, bone marrow lymphocytes infiltration, plasma cells and plasmacytoid lymphocytes, increased erythrocyte sedimentation rate, lymphoplasmacytoid cells in lymph node. This is a report of a 43 year-old male with complaints of pallor, blurred eyes, headaches accompanied by a history of epistaxis, gum bleeding and recurrent melena. Physical examination reveals anemia. Laboratory tests found pancytopenia, normochromic normocyte, ESR 115 mm/h, serum IgM 9.6 g/dL. SPE showed M-spike. BMP encountered hypocellularity, 61.25% lymphocytes, plasma cells (cells lymphoplasmasitoid) 6.5%. Gastroscopy suggests acute ulcer in the corpus and erosive gastritis in the antrum. Patients diagnosed as WM and given supportive therapy resulting clinical improvement. Patients were scheduled to receive CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine, prednisone).
GOUT ARTHRITIS Roswati, Eva
Collaborative Medical Journal Vol 7 No 2 (2024): Mei 2024
Publisher : LPPM Universitas Abdurrab

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36341/cmj.v7i2.5190

Abstract

A 47-year-old male patient came to the emergency room with complaints of joint pain for 2 days and worsened in the last 1 day. Complaints are felt in all joints, especially in the joints of the hands, knees and feet, the pain appears suddenly at night, and continuously, the pain feels like stabbing. Before the patient experienced this complaint, the patient had eaten meat rendang and coconut milk vegetable katu toge and ate vein meatballs. At the time of the complaint, the patient felt stiffness in the joints making it difficult to walk. The patient also felt that his hands, knees and feet had swollen since the complaints of pain appeared. The patient admits that this is not the first time he has experienced complaints like this. In addition to pain in the joints, the patient also complained of tightness since 1 day, tightness worsens if lying on his back and decreases if the patient is sitting, fever for 2 days with a temperature of 38 0C, chills at night, difficulty sleeping and the whole body feels pain, decreased appetite since the complaint, defecation and urination within normal limits. The patient had experienced a similar thing ± 3 years ago. patients routinely take herbal medicine. The patient works as a self-employed, the patient is an active smoker. On physical examination, it was found that the patient's general condition appeared moderately ill, the patient's nutritional status was level 1 obesity with a BMI of 26.5 kg/m2. The patient was in a febrile condition with a body temperature of 37.9 0C, there was an increase in respiratory rate of 22x / m, oxygen saturation of 95% with free air. Examination of cor and pulmo and abdomen within normal limits. On examination of the extremities, there were signs of rubor, dolor, and caloric inflammation in both hand joints, knee joints and foot joints. There was also tofus on digiti 1 pedis dextra. Therapy was given a low purine renal diet, and medication.
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