Griskalia Christine
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Idiopathic Portal Hypertension: A Rare Cause of Recurrent Hematemesis Melena Griskalia Christine; Irsan Hasan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 3, December 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (748.115 KB) | DOI: 10.24871/1232011179-184

Abstract

Idiopathic portal hypertension (IPH) known as non-cirrhotic portal fibrosis (NCPF) is a constellation of liver disorders, in which liver cirrhosis is not present and the main clinical and pathological findings are encountered in the portal venous system. Patients usually come to hospital with esophageal varices and upper gastrointestinal bleeding; however, it is often misdiagnosed as liver cirrhosis. Its etiology is still unknown, but some evidences and epidemiological studies suggest that it is a multifactorial disease with genetic basis. The laboratory evaluation in IPH reveals only mild and subtle abnormalities predominantly related to hypersplenism. The major complications of IPH are esophageal varices and hypersplenism. Endoscopic sclerotherapy or band ligation, shunt surgery, and transjugular intrahepatic portosystemic shunt (TIPS) are modalities to treat the complications of IPH. The case report reported about diagnosis and treatment of a 20-year-old male with idiopathic portal hypertension. Keywords: idiopathic portal hypertension, non-cirrhotic portal fibrosis, diagnosis, treatment
Neutrophil Lymphocyte Ratio as A Predictor of The First Onset Acute Neutropenia After R-CHOP Chemotherapy in Diffuse Large B-cell Lymphoma Patients Christine, Griskalia; Sukrisman, Lugyanti; Sutandyo, Noorwati; Rumende, Cleopas Martin
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 3
Publisher : UI Scholars Hub

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Abstract

Background. Diffuse Large B-cell Lymphoma (DLBCL) is the most common lymphoma in Indonesia. R-CHOP chemotherapy has a moderate risk for neutropenia / febrile neutropenia. Lymphocytes can describe host immunity, while neutrophils and monocytes can describe the inflammatory response. No study has assessed differential count of leukocytes as a predictor of the first onset acute neutropenia after R-CHOP chemotherapy in DLBCL patients. This study aimed to determine the relationship between differential count of leukocytes before chemotherapy as a predictor of the first onset acute neutropenia after R-CHOP chemotherapy in DLBCL patients. Methods. A retrospective cohort study was conducted among 18–60 years old DLBCL patients with ECOG 0–1 and no comorbidity related to chemotherapy 18–60 years old. Subjects were given with the first 3 cycles of R-CHOP chemotherapy without G-CSF prophylaxis. Results. Of the 95 patients, first onset acute neutropenia after chemotherapy occurred in 83 (87.4%) subjects or 83 (55.3%) cycles of 150 chemotherapy cycles. Febrile neutropenia occurs in 50.6% of the onset of neutropenia. Severe neutropenia occurs in 34 (41.0%) cycles of 83 neutropenic episodes. The first onset of acute neutropenia was the most common at 7–15 days after chemotherapy. The AUC of neutrophil lymphocyte ratio was 0.74 (95% CI 0.65–0.82); while absolute lymphocytes, absolute neutrophils, absolute monocytes, and monocyte lymphocyte ratios were 4.1 neutrophil lymphocyte ratio were able to predict the first onset of acute neutropenia after RCHOP chemotherapy in DLBCL patients (sensitivity 71.1%; specificity 64.2%; positive predictive value 71.1%; negative predictive value 64.2%). Conclusion. Neutrophil lymphocyte ratio before chemotherapy > 4.1 is a predictor of the first onset acute neutropenia after R-CHOP chemotherapy in DLBCL patients.
Pendekatan Diagnosis dan Tatalaksana Sindrom Mirizzi Putra, Ario Perbowo; Christine, Griskalia; Amin, Zulkifli; Fauzi, Achmad
Jurnal Penyakit Dalam Indonesia Vol. 2, No. 3
Publisher : UI Scholars Hub

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Abstract

Penyakit batu empedu telah menjadi masalah kesehatan penting di banyak negara. Estimasi prevalensi penyakit batu saluran empedu yang menyertai penyakit batu empedu adalah sekitar 10-15% dan meningkat dengan usia lanjut. Sindrom Mirizzi adalah komplikasi dari penyakit batu empedu yang jarang terjadi. Karakteristik yang khas yaitu adanya impaksi batu empedu di duktus sistikus atau di leher kandung empedu sehingga menghasilkan obstruksi mekanik di duktus hepatikus dan menghasilkan striktur inflamasi di saluran empedu, sehingga menyebabkan ikterus obstruktif berkelanjutan. Kami laporkan sebuah kasus Sindrom Mirizzi pada laki-laki dewasa yang menyebabkan iketerus obstruktif dengan kolelitiasis.