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Perbedaan Rerata Kadar Albumin Pasien Lupus Eritematosus Sistemik berdasarkan Derajat Aktivitas Penyakit di RSUP Dr. M. Djamil Padang Ulti, Zifa Amanda; Elvira, Dwitya; Firdawati; Efrida; Raveinal; Aliska, Gestina
Jurnal Ilmu Kesehatan Indonesia Vol. 6 No. 4 (2025): Desember 2025
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jikesi.v6i4.1478

Latar Belakang: Lupus Eritematosus Sistemik (LES) adalah penyakit autoimun kompleks yang dapat menyerang berbagai pertahanan sistem tubuh. Penyakit ini berhubungan dengan pembentukkan autoantibodi sehingga dapat menyebabkan inflamasi kronis yang berujung pada kerusakkan jaringan tubuh. Aktivitas Penyakit LES diduga dapat mempengaruhi kadar albumin di dalam tubuh. Objektif: Penelitian ini bertujuan untuk mengetahui apakah terdapat perbedaan rerata kadar albumin pasien LES berdasarkan derajat aktivitas penyakit di RS M. Djamil Padang. Metode: Penelitian ini menggunakan metode analitik dengan pendekatan cross-sectional study. Sampel penelitian berjumlah 59 pasien LES rawat jalan dan rawat inap di RS M. Djamil Padang yang dikumpulkan secara consecutive sampling. Analisis data penelitian menggunakan uji one way annova. Hasil: Pada penelitian ini didapatkan mayoritas pasien LES berada di rentang usia 26−35 tahun (44,1%), berjenis kelamin perempuan (100%). Lebih dari setengah pasien LES mengalami hipoalbuminemia (76,3%), sebagian besar pasien memiliki derajat aktivitas penyakit sedang (39%). Rerata kadar albumin terendah ditemukan pada pasien dengan derajat aktivitas penyakit berat sebesar 2,25 g/dL. Kesimpulan: Terdapat perbedaan yang bermakna pada rerata kadar albumin pasien LES. Rerata kadar albumin terendah pasien LES ada pada kelompok derajat aktivitas penyakit berat. Rerata kadar albumin tertinggi pasien LES ada pada kelompok derajat aktivitas penyakit ringan.

Acute Gouty Arthritis with Knee Effusion in a Patient with Chronic Lymphocytic Leukemia: Diagnostic Confirmation and Pre-Chemotherapy Hyperuricemia Management Panji Hadi Permana; Eka Kurniawan; Raveinal; Deka Viotra; Fadrian Fadrian
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 6 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i6.1614

Background: Gout and chronic lymphocytic leukemia (CLL) represent distinct hematologic and rheumatologic pathologies; however, their concurrent presentation presents significant diagnostic and therapeutic challenges. Tumor lysis syndrome and chemotherapy-induced hyperuricemia are recognized complications of hematologic malignancies, yet the manifestation of acute gouty arthritis with crystallographic confirmation in CLL patients remains an underreported clinical scenario requiring careful diagnostic stratification. Case presentation: We present a 69-year-old male farmer with newly diagnosed CLL (stage C, Binet classification) admitted for acute left knee arthritis with effusion, left ankle arthritis, and concurrent community-acquired pneumonia (CAP). Clinical examination revealed articular inflammation characterized by pain, swelling, erythema, warmth, and significant joint effusion with documented flexion limitation and positive bulging sign. Musculoskeletal ultrasound demonstrated double contour sign, synovial hypertrophy, and effusion measuring 5.8 cm in the suprapatellar recess with monosodium urate (MSU) crystal deposition confirmed by polarized light microscopy of synovial fluid (5,350 cells/mm³, 40% polymorphonuclear neutrophils, 60% mononuclear cells, positive MSU crystals). Serum uric acid was elevated at 10.6 mg/dL. The patient was successfully managed with colchicine, methylprednisolone, arthrocentesis, and supportive care while maintaining CLL treatment preparedness. Conclusion: This case illustrates the importance of confirmatory synovial fluid analysis and ultrasound imaging in the diagnosis of acute gout in the context of hematologic malignancy. Optimal management requires careful coordination between rheumatology and hematology-oncology services to prevent therapeutic complications and ensure safe chemotherapy initiation in CLL patients with concurrent acute gouty arthritis and hyperuricemia.

Diagnosis dan Tata Laksana Urtikaria Kronik: Tinjauan Pustaka Retno Eka Sari; Raveinal
Cermin Dunia Kedokteran Vol 53 No 04 (2026): Kedokteran Umum
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i04.1509

Chronic urticaria is an inflammatory skin condition characterized by urticarial skin lesions, angioedema, or both, occurring continuously or sporadically for 6 weeks or more, and may be spontaneous or induced by specific factors. The impact of chronic urticaria significantlyincludes physical discomfort as well as mental health disturbances (particularly anxiety and depression), sexual dysfunction, impaired interpersonal relationships, and limitations in daily activities including work and school. Diagnosis is established based on clinical historyand physical examination, with additional investigations performed in selected cases to exclude secondary causes. Management includes antihistamines as first-line therapy, with treatment escalation based on patient response. This individualized therapeutic approach follows a step-up or step-down principle based on the level of disease control. The treatment target is disease remission, indicated by a sustained urticaria activity score (UAS) of 0, controlled disease with a urticaria control test (UCT) score of 16, and normalization of quality of life. A good understanding of this condition along with proper patient education is essential to help control symptoms and improve overall quality of life.

Acute Gouty Arthritis with Knee Effusion in a Patient with Chronic Lymphocytic Leukemia: Diagnostic Confirmation and Pre-Chemotherapy Hyperuricemia Management Panji Hadi Permana; Eka Kurniawan; Raveinal; Deka Viotra; Fadrian Fadrian
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 6 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i6.1614

Background: Gout and chronic lymphocytic leukemia (CLL) represent distinct hematologic and rheumatologic pathologies; however, their concurrent presentation presents significant diagnostic and therapeutic challenges. Tumor lysis syndrome and chemotherapy-induced hyperuricemia are recognized complications of hematologic malignancies, yet the manifestation of acute gouty arthritis with crystallographic confirmation in CLL patients remains an underreported clinical scenario requiring careful diagnostic stratification. Case presentation: We present a 69-year-old male farmer with newly diagnosed CLL (stage C, Binet classification) admitted for acute left knee arthritis with effusion, left ankle arthritis, and concurrent community-acquired pneumonia (CAP). Clinical examination revealed articular inflammation characterized by pain, swelling, erythema, warmth, and significant joint effusion with documented flexion limitation and positive bulging sign. Musculoskeletal ultrasound demonstrated double contour sign, synovial hypertrophy, and effusion measuring 5.8 cm in the suprapatellar recess with monosodium urate (MSU) crystal deposition confirmed by polarized light microscopy of synovial fluid (5,350 cells/mm³, 40% polymorphonuclear neutrophils, 60% mononuclear cells, positive MSU crystals). Serum uric acid was elevated at 10.6 mg/dL. The patient was successfully managed with colchicine, methylprednisolone, arthrocentesis, and supportive care while maintaining CLL treatment preparedness. Conclusion: This case illustrates the importance of confirmatory synovial fluid analysis and ultrasound imaging in the diagnosis of acute gout in the context of hematologic malignancy. Optimal management requires careful coordination between rheumatology and hematology-oncology services to prevent therapeutic complications and ensure safe chemotherapy initiation in CLL patients with concurrent acute gouty arthritis and hyperuricemia.

Diagnostic Approach and Management of Sjogren's Syndrome Elsy Pramitha Sari; Raveinal
PROFESSIONAL HEALTH JOURNAL Vol. 8 No. 1 (2026)
Publisher : Pusat Penelitian dan Pengabdian Masyarakat (PPPM) STIKES Banyuwangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54832/phj.v8i1.1452

Sjogren’s syndrome (SS) is a chronic autoimmune disorder characterized by sicca symptoms, particularly xerostomia, resulting from salivary gland dysfunction. Accurate assessment of glandular function and systemic disease activity is essential, as subjective complaints often do not correlate with objective clinical measurements. This study aimed to evaluate diagnostic and therapeutic approaches in patients with primary Sjogren’s syndrome based on objective salivary gland function assessment and standardized measurement of systemic disease activity. Methods: This observational study included patients diagnosed with primary Sjogren’s syndrome. Subjective xerostomia was assessed using the Summated Xerostomia Index–Indonesian version (SXI-ID), while objective evaluation was performed using the unstimulated whole salivary flow rate and the Clinical Oral Dryness Score (CODS). Systemic disease activity was measured using the EULAR Sjogren’s Syndrome Disease Activity Index (ESSDAI). All assessments were conducted prior to treatment initiation and periodically during follow-up. Non-autoimmune etiologies were excluded through comprehensive history taking, physical examination, and relevant investigations. A discrepancy was observed between subjective xerostomia complaints and objective salivary function measurements. ESSDAI scoring demonstrated variability in systemic disease activity, categorized as low, moderate, and high. A multidisciplinary approach contributed to accurate diagnosis and evaluation of organ involvement. Therapeutic decision-making in Sjogren’s syndrome should be guided by objective salivary gland function assessment and standardized systemic activity indices such as ESSDAI, rather than relying solely on subjective patient-reported symptoms. The integration of subjective and objective evaluations through periodic monitoring may enhance therapeutic precision and improve long-term disease management outcomes in patients with Sjogren’s syndrome.

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