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All Journal Medicina journal of internal medicine E-Jurnal Medika Udayana Acta Interna : The Journal of Internal Medicine Indonesian Journal of Rheumatology Jurnal Penyakit Dalam Udayana Callosum Neurology Journal : Jurnal Berkala Neurologi Bali Oceana Biomedicina Journal ISM (Intisari Sains Medis) : Jurnal Kedokteran Cermin Dunia Kedokteran COMSERVA: Jurnal Penelitian dan Pengabdian Masyarakat Oceana Biomedicina Journal MEDICINUS Cermin Dunia Kedokteran
Gede Kambayana
Departemen Ilmu Penyakit Dalam, FK Universitas Udayana/RSUP Sanglah, Denpasar, Bali, Indonesia
Humanities Biochemistry, Genetics & Molecular Biology Dentistry Economics, Econometrics & Finance Education Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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Journal : MEDICINUS

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The Role of Biologic Agent in The Management of Ankylosing Spondylitis : A Case Report Gede Dilajaya Robin; Gede Kambayana; Robin, Gede Dilajaya
MEDICINUS Vol. 38 No. 10 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/7nbqyy62

Abstract

Background: Ankylosing spondylitis (AS) is a chronic immune-related arthritis primarily affecting the spine, sacroiliac joints, and surrounding tissues. The estimated incidence of AS ranges from 1.30–1.56 million in Europe and from 4.63–4.98 million in Asia. However, data on the current prevalence of AS in Indonesia remains limited. Various treatmentmodalities are available, one of them are biological agents that play a significant role in managing disease progression and preventing complications. Case: A 25-year-old male presented with a four-year history of chronic back pain. Laboratoryresults showed an elevated C-reactive protein (CRP) level of 31.20 mg/dl. Pelvic and thoracolumbar X-ray showed kyphotic deformity, bamboo spine, and dagger spine appearance. The patient was diagnosed with high disease activity ankylosingspondylitis (ASDAS-CRP: 2.9). Initial treatment with nonsteroidal anti-inflammatory drug (NSAID) alone did not result in clinical improvement. Due to the severity of disease activity, combination therapy using NSAID and a tumor necrosis factor (TNF) inhibitor was used, and reported to give satisfactory clinical response. Additionally, patient also underwent corrective spinal surgery due to severe deformity. Conclusion: TNF inhibitors are currently considered as the first-line biological therapy in the management of ankylosing spondylitis, due to their superior efficacy and safety in controlling disease progression compared to other biological agents.
Karakteristik Kelainan Hematologi Pasien Systemic Lupus Erythematosus di RSUP Prof. Dr. I.G.N.G. Ngoerah di Poli Rawat Jalan Rematologi Satwika Hadipratama; Gede Kambayana
MEDICINUS Vol. 38 No. 11 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/zh899c89

Abstract

Systemic lupus erithematosus (SLE) is one of the leading causes of death among young women. Hematological abnormalities are common manifestations of SLE, and can affect various types of blood cell, with severity ranging from mild to life-threatening. The main hematological manifestations of SLE include anemia, leucopenia, thrombocytopenia, lymphadenopathy, and/or splenomegaly. This study aims to explore the characteristics of hematological disorders in SLEpatients. Methods: This was a retrospective descriptive study using a cross-sectional data collection method. The subjects were patients diagnosed with SLE who received treatment at RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar, during the period of July–August 2023. Results: A total of 72 subjects participated in this study, with a mean age of 35.9 years (range: 18–72 years). The majority were female (90.3%) and were within the 18–50 year age group (87.5%). Laboratory tests showed the following mean values: hemoglobin 11.8 g/dl, platelets 299.5×10³/μl, white blood cells (WBC) 13.5×10³/μl, lymphocytes 1.7×10³/μl, and erythrocyte sedimentation rate (ESR) 32.6 mm/hour. The mean neutrophil-to-lymphocyte ratio (NLR) was 3.92. The mean values of renal function and metabolic parameters were as follows: blood urea nitrogen (BUN) 13.3 mg/dl,serum creatinine (SC) 1.19 mg/dl, estimated glomerular filtration rate (eGFR) 100 ml/minute/1.73 m², protein-to-creatinineratio (PCR) 1.03, and calcium level 9.2 mg/dl. Bone mineral density measurements revealed that 6.9% of subjects had osteopenia and 9.7% had osteoporosis. Conclusion: This study provides a better understanding of the clinical, laboratory,and comorbidity profile of patients with SLE. These findings offer valuable insights for appropriate clinical management and intervention strategies.
Co-Authors A Halim Achadiono, Dedy Nurwachid Adnyani, Ni Made Dwi Ali Djamhuri Anak Agung Mas Putrawati Triningrat Andisari, Hendrata Erry Andriyasa Andriyasa Andriyasa, Andriyasa Anna Ariane Anwar Santoso Awalia Awalia Ayu Paramaiswari Bagus Rhama Dwi Budi Darmawati Dwijo Anargha Sindhughosa Faisal Parlindungan Gede Dilajaya Robin Gede Putu Arsana Govindha, I Putu Aris Harry Isbagio Hendrata Erry Andisari I Gusti Agung Friskha Surya Putra I Gusti Agung Indra Adi Kusuma I Gusti Ngurah Wien Aryana I K Rina I Ketut Suastika I Nyoman Suarjana I.B. Aditya Nugraha Ida Ayu Sri Indrayani Ida Bagus Aditya Nugraha IGN Eka Imbawan Indrawan, IGNM Budiana Ketut Suega Laniyati Hamijoyo, Laniyati Made Agus Kusumadjaja Made Paramita Wijayanti Manaek, Andi Ni Ketut Donna Prisilia Ni Made Dwi Adnyani Ni Made Dwi Adnyani Ni Putu Dewi Indriyani Nugraha, I.B. Aditya Nyoman Kertia Pande Ketut Kurniari Prisilia, Ni Ketut Donna Putra, T R Putu Imayati Rakhma Yanti Hellmi Rima Febry Lesmana Robin, Gede Dilajaya Rudy Hidayat Satwika Hadipratama T R Putra T R Putra Tejawati, Dewa Ayu Kartika Tjokorda Raka Putra Tonny, Tonny Try Parama Arthika Widhiarta, Putu Raka Wira Gotera Wiwekananda, Ketut Shri Satya Yenny Kandarini Yogiswara, Komang Satvika Yuliandari KK, Cok Istri