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All Journal Paediatrica Indonesiana Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Indian Journal of Forensic Medicine & Toxicology MEDICINUS
Muhammad Faizi
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Journal : MEDICINUS

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Hyperglycemia in Childhood Acute Lymphoblastic Leukemia during Induction Chemotherapy Nengcy Erlina Tasik Rerung; Cahyadi, Andi; Nur Rochmah; Maria Christina Shanty Larasati; Andarsini, Mia Ratwita; Muhammad Faizi; IDG Ugrasena; Bambang Permono
MEDICINUS Vol. 34 No. 1 (2021): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (76.129 KB) | DOI: 10.56951/medicinus.v34i1.49

Abstract

Introduction: Hyperglycemia is a well-known adverse effect of the corticosteroids and asparaginase given during induction chemotherapy for pediatric acute lymphoblastic leukemia (ALL). ALL is a type of hematologic malignancy with high incidence in the childhood. The aim of this study is to investigate the impact of hyperglycemia during induction chemotherapy in childhood ALL. Methods: This prospective study was done in Dr. Soetomo hospital from January to April 2018. The subject was newly diagnosed as ALL under the age of 18 years, treated with Indonesian childhood ALL 2013 protocol (standard risk (SR) group and high risk (HR) group). Hyperglycemia was defined as at least two separate random plasma glucose levels >200 mg/dL, which was evaluated before and during induction chemotherapy. Statistical analysis using Paired T-test for parametric and Wilcoxon test for nonparametric. Results: Thirty-three children were enrolled, 18/33 boys with mean age 5.8 (SD 3.78) years, compromised as ALL-L1 30/33. They were treated with ALL-HR 19/33 and ALL-SR 14/33. In overall groups, the mean random blood glucose level significantly increased from 108 (SD 21.3) mg/dl to 147 (SD 48.1) mg/dl, (mean difference 38.67 mg/dl; 95% CI 18.08 to 59.26 mg/dl, p=0.008). In SR group, there was a significant increase of mean random blood glucose level from 102 (SD 13.5) mg/dl to 133 (SD 37.3) mg/dl, (mean difference 31.8 mg/dl; 95% CI 8.78 to 54.8 mg/dl; p=0.01). In HR group, the mean random blood glucose level increased from 113 (SD 51.9) mg/dl to 165 (SD 25.4) mg/dl, (mean difference 51.9 mg/dl; 95% CI 18.6 to 85.2 mg/dl, p=0.004). Conclusion: Blood glucose level is significantly increase during induction chemotherapy in both SR and HR Indonesian childhood ALL 2013 protocol.
Delayed Referral of a Neonate with Biliary Atresia Presenting as Jaundice: A Case Report Zubaity Ardhanariswari; Rendi Aji Prihaningtyas; Muji Retnaning Rini; Muhammad Faizi; Bagus Setyoboedi
MEDICINUS Vol. 39 No. 4 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/rmdf9491

Abstract

Delayed diagnosis of cholestasis in infant remains a significant health problem. Cholestatic jaundice is a pathological condition that requires immediate treatment, particularly in cases such as biliary atresia. Biliary atresia is a progressivefibroinflammatory process that causes fibrosis in biliary tract, resulting in liver cirrhosis if left untreated. This case report aims to describe the delayed referral of biliary atresia in an infant. Case: A 3-month-old girl presented to a tertiary hospitalwith a chief complaint of jaundice. Jaundice had been present since the second day of life and persisted despite sun exposure and breastfeeding. The mother also reported abdominal distension, yellow-brown urine resembling tea, and palestools. Physical examination revealed hepatosplenomegaly. Laboratory results showed elevated liver enzymes (aspartate aminotransferase [AST] 237.4 U/l, alanine transaminase [ALT] 139 U/l, gamma-glutamyl transferase [GGT] 864 U/l), and cholestasis (total bilirubin 13.90 mg/dl, direct bilirubin 9.80 mg/dl). A two-phase abdominal ultrasound showed a gallbladder with preprandial size approximately 0.87 x 0.93 x 1.76 cm (length x width x height), with no contractility. Liver histopathologyrevealed extrahepatic cholestasis with extensive fibrosis (F3). The patient was diagnosed with biliary atresia and liver fibrosis and was subsequently referred for liver transplantation. Delayed referral of biliary atresia case is associated withpoor prognosis. Increasing awareness and health education among primary health providers, community health workers, and parents are essential for early detection of cholestasis, which can reduce morbidity, mortality, as well as the need for liver transplantation.
Co-Authors Adwina Nurlita Kusuma Wardhani Anang Endaryanto Andi Cahyadi Ariyanto Harsono Bagus Setyoboedi Bambang Permono Budiono Budiono Garindra Wicaksono IDG Ugrasena Ike Wahyu Triastuti Maria Christina Shanty Larasati Mia Ratwita Andarsini Muji Retnaning Rini Nengcy Erlina Tasik Rerung Nur Rochmah Rendi Aji Prihaningtyas Sidarti Soehita Soetjipto Vinzy Yulina Yuni Hisbiyah Zubaity Ardhanariswari