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All Journal Journal of Food and Pharmaceutical Science Journal of Tropical Life Science : International Journal of Theoretical, Experimental, and Applied Life Sciences Medicina MEDIA MEDIKA INDONESIANA Jurnal Kedokteran Brawijaya Jurnal Keperawatan Jiwa (JKJ): Persatuan Perawat Nasional Indonesia Journal of Biomedicine and Translational Research Journal of Innovation and Applied Technology Research Journal of Life Science The Journal of Pure and Applied Chemistry Research MNJ (Malang Neurology Journal) Majalah Kesehatan FKUB Medical Laboratory Technology Journal Indonesian Journal of Rheumatology Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) International Journal of Community Service Learning YARSI Medical Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Heart Science Journal CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL CRJIM (Clinical and Research Journal in Internal Medicine) Narra J CoMPHI Journal : Community Medicine and Public Health of Indonesia Journal Sciences of Pharmacy Journal of Food and Pharmaceutical Sciences Media Kesehatan Politeknik Kesehatan Makassar Jurnal Info Kesehatan Folia Medica Indonesiana
Kusworini Handono
Department Of Clinical Pathology, Faculty Of Medicine Brawijaya University/Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Computer Science & IT Dentistry Economics, Econometrics & Finance Education Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary Other

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Journal : MEDIA MEDIKA INDONESIANA

 1 
Kadar Autoantibodi dan Manifestasi Klinis pada Pasien Nefritis Lupus Silent dan Nefritis Lupus Overt Kusworini Handono; Atma Gunawan; Rulli Rosandi
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 3 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

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Autoantibodies level and clinical manifestation differences between patients with silent nephritis lupus and overt nephritis lupusBackground: One of the serious clinical manifestations of SLE is the occurrence of lupus nephritis (LN). The pathogenesis of LN is still unclear. Glomerular inflammation has been associated with high levels of autoantibodies. The purpose of this study was to assess the difference of ANA, anti ds-DNA, anti-Sm antibodies and the clinical manifestations between silent lupus nephritis (SLN) and overt lupus nephritis (OLN).Subject and Methods: Subjects were forty SLE patients (diagnosed according to ARA criteria of 1997). Autoantibodies ANA was assayed with IFA, anti-dsDNA and anti-Sm levels were assayed with ELISA. The diagnosis of LN was established using clinical signs, urinary sediments pattern and kidney biopsy, and then patients classified as a silent lupus nephritis (SLN) or overt lupus nephritis (ONL). Classification of NL histopathologic pattern was established according to WHO criteria. Differences in clinical manifestations, presence of ANA, anti-dsDNA and anti-Sm levels in the SLN and OLN and NL classes were analyzed by Chi squaretest and T test. Statistical significance determined when p<0.05.Results: OLN patients showed a edema, hypertension, anemia and autoantibodies more higher than in SLN patients. The mean level of anti-dsDNA was significantly higher in patients with OLN than in SLN (285.75±41.85 vs 179.01±61.81, p<0.000). Renal biopsy on 20 OLN patients showed: 6 patients with NL grade I/II, 9 patients with NL class III/IV and 5 patients with NL class V. Moreover on 11 SLN patients there were 7 patients with NL class I/II, 3 patients with NL class III/IV and 1 patient with NL class V. The NL classIII/IV NL patients showed anti-dsDNA level higher than the class V NL (p<0.05).Conclusion: OLN patients had clinical manifestations more severe than SLN patients. NL patients with class III/IV showed the presence of anti-dsDNA more frequently and with higher levels than the class V NL. Diagnosing NL based solely on clinical signs and laboratory often is inappropriate.Keywords: SLN, OLN, NL class, autoantibodies ABSTRAKLatar belakang: Salah satu manifestasi serius LES adalah terjadinya nefritis lupus (NL). Patogenesis NL hingga saat ini masih belum jelas. Terjadinya inflamasi di glumerulus telah dikaitkan dengan tingginya kadar autoantibodi. Tujuan penelitian ini mengetahui perbedaan ANA, anti ds-DNA dan anti-Sm pada pasien dengan NL tenang (silent lupus nephritis/SLN) dan NL manifes (overt lupus nephritis/OLN).Metode: Sampel penelitian adalah empat puluh penderita LES (didiagnosis berdasarkan kriteria ARA 1997). ANA diperiksa dengan metoda IFA, anti-dsDNA dan anti-Sm menggunakan metoda ELISA. Diagnosis NL didasarkan adanya tanda klinis, sedimen urin dan biopsi ginjal dan dikelompokkan sebagai silent lupus nephritis (SLN) dan overt lupus nephritis (ONL). Klasifikasi histopatologi NL ditegakkan berdasarkan kriteria WHO. Perbedaan manifestasi klinis, adanya ANA, kadar anti-dsDNA dan anti-Sm pada SLN dan OLN serta kelas NL dianalisis dengan uji Chi square dan T tes. Signifikansi statistik ditentukan bila p<0,05.Hasil: Penderita OLN menunjukkan adanya edema, hipertensi, anemia dan autoantibodi yang lebih tinggi daripada penderita SLN. Rerata kadar anti-dsDNA nyata lebih tinggi pada penderita OLN daripada SLN (285.75±179.01 vs 41,85±61,81; p<0,000). Biopsi ginjal 20 penderita OLN menunjukkan 6 penderita dengan NL kelas I/II, 9 penderita dengan NL kelas III/IV dan 5 penderita dengan NL kelas V. Pada 11 penderita SLN terdapat 7 penderita NL kelas I/II, 3 penderita dengan NL kelas III/IV dan 1 penderita NL kelas V. Penderita dengan NL kelas III/IV menunjukkan kadar anti-dsDNA yang lebih tinggi daripada NL kelas V (p<0,05).Simpulan: Penderita OLN mempunyai manifestasi klinis yang lebih berat daripada penderita SLN. Penderita NL kelas III/IV menunjukkan adanya anti-dsDNA yang lebih sering dan dengan kadar yang lebih tinggi daripada NL kelas V. Diagnosis NL hanya berdasarkan tanda klinis dan laboratoris seringkali menimbulkan kesalahan.
Faktor HLA-DRB pada Penderita Tuberkulosis Paru dengan Pengobatan Strategi DOTS Sri Andarini Indreswari; Suharyo Hadisaputro; Marsetyawan HNE Soesatyo; Kusworini Handono
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 1 Year 2011
Publisher : MEDIA MEDIKA INDONESIANA

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ABSTRACTHLA-DRB factor in pulmonal tuberculosis with DOTS strategic treatmentBackground: Tuberculosis remains one of the world’s greatest public health problems, especially in developing countries. In Indonesia the results of DOTS strategic treatment and conversion have not been fruitful results. Many factors play important roles in the success of DOTS strategic treatment, but a little attention was given to the immuno genetics aspects. This study was aimed at theassociation between HLA-DRB factors and clinical output on DOTS strategic treatment (after first 2 months of treatment):conversion of sputum smear positive.Method: A nested case control study was carried out. The exposure variables were alleles of HLA-DRB (result of PCR examination), while the independent variables were sputum smear positive and negative (result of laboratories examination with Ziehl Neelsen staining, Niacin test). Body mass index (BMI) and sex were confounding variables. Odds ratio (OR) was calculated using bivariate and logistic regression for multivariate analysis.Result: A total sample of 73 new patients with active tuberculosis (sputum smear positive) in developing treatment with DOTS strategic treatment, consist of 34 cases and 39 controls. The odds ratio (OR) of HLA-DRB1*1502 and HLA-DRB5*01 were 3.2 (95%CI: 1.103-9.287). The OR of HLA-DRB1*1201 was 0.305 (95% CI: 0.117-0.798), OR of HLA-DRB3*01 was 0.214 (95% CI: 0.077- 0.592). The PAR (population attributable rate) of HLA-DRB1*1502 and HLA-DRB%*01 were 42.64%. While confounding variables were analyzed, only allele HLA-DRB1*1502 was significant, OR 4.9 (95% CI: 1.234-15.617), the probability was 70.57%.Conclusion: HLA-DRB1*1502 is an allele is a risk factor for the conversion of sputum smear positive after 2 months of treatment.Keywords: Tuberculosis, human leukocyte antigen (HLA)ABSTRAKLatar belakang: Di Indonesia hasil pengobatan  tuberkulosis paru belum optimal. Penyebab kekurangberhasilan pengobatan ini belum diketahui, khususnya yang berkaitan dengan faktor imunogenetika. Penelitian bertujuan menjelaskan hubungan faktor HLADRBdengan kesembuhan klinis, dalam hal ini terjadinya konversi BTA pasca 2 bulan pengobatan dengan strategi DOTS.Metoda: Rancangan penelitian adalah nested case control, pada penderita baru tuberkulosis paru dengan pemeriksaan sputum BTA positif yang mendapat pengobatan strategi DOTS selama 2 bulan. Jenis alel (HLA-DRB) yang ditemukan dengan pemeriksaan PCR dinyatakan sebagai variabel paparan, variabel efek adalah hasil pemeriksaan sputum (BTA) dengan pengecatan Ziehl Neelsen yangditeruskan dengan tes Niacin pasca 2 bulan pengobatan. Sebagai variabel perancu ditetapkan BMI dan jenis kelamin. Analisis dilakukan dengan menghitung rasio odds dengan chi-square dan regresi logistik.Hasil: Jumlah sampel 73, diperoleh dari 158 penderita baru berobat jalan yang diikuti selama 2 bulan, terdiri dari 34 kasus (BTA tetap positif pasca 2 bulan pengobatan) dan 39 kontrol (BTA menjadi negatif). Penelitian dilakukan di BP4, 12 puskesmas dan RSUD di Kota Semarang. Hasil penelitian adalah besar risiko (OR) HLA-DRB1*1502 dan HLA-DRB5*01 untuk tidak terjadinya konversi BTA 3,2 (95% CI: 1,103-9,287). Alel HLA-DRB1*1201 dan alel HLA-DRB3*01 merupakan alel yang bersifat protektifdengan OR 0,305 (95% CI: 0,117-0,798), sedangkan HLADRB3*01 dengan OR 0,214 (95% CI: 0,077-0,592). PAR untuk alel HLADRB1* 1502 dan HLA-DRB5*01 sebesar 42,64%. Apabila variabel perancu dimasukkan dalam analisis, maka hanya alel HLA-DRB1*1502 yang secara signifikan merupakan faktor risiko untuk tidak terjadinya konversi BTA pasca 2 bulan awal pengobatan dengan strategi DOTS. OR 4,9 (95% CI:1,234-15,617). Probabilitas untuk HLA-DRB1*1502 adalah sebesar 70,57%.Simpulan: Alel HLA-DRB1*1502 merupakan faktor risikountuk tidak terjadinya konversi BTA pasca 2 bulanpengobatan, dengan probabilitas cukup besar.
Co-Authors Abd. Rasyid Syamsuri Abdurrachman Abdurrachman Achmad Rifa’i, Achmad Achmad Rudijanto Achmad Rudijanto Agustina T Endharti, Agustina T Agustina Tri E Agustina Tri Endharti Ahmad Bayhaqi Nasir Aslam Airlangga, Dimas Ikhsan Albaar, Thoha M. Alfandy, Tommy N. Asih, Sari Wulan Ati Rastini Atma Gunawan Atma Gunawan Atma Gunawan Aulanni'am, Aulanni'am Balindra, Fredlina Rossa Bambang Rahardjo Benny A Pradana, Benny A Bowo Hery Prasetyo, Bowo Hery BP Putra Suryana BP Putra Suryana Cesarius Singgih Wahono Dalhar, Mochamad Daniel Happy Putra Dantara, Tri W.I. Dany Farida Desfryda, Elynca Putri Dessy Setiawati Dessy Wulandari, Dessy desy wulandari Devi, Nabila Sinta Dewi Purnama Sari Dewi, Elvira S. Dhani, Fauzan K. Dhian E. P. Harnandari Dian Ayu Wulansari, Dian Ayu Dian Hasanah Dian Sukma Hanggara Dimas Ikhsan Airlangga Djoko W. Soeatmadji Dona Marisa, Dona Dwinadella, Sephia Eko, Mudjiwijono Handaru Elvira Sari Dewi Ema Pristi Yunita Ema Pristi Yunita, Ema Pristi Engli, Katherina Enny Listyawati Erawati, Dini Rachma Erna Amin Faisal Faisal Farida ** Fatchiyah Fatchiyah Firdaningrum, Nimas Eka Gizta, Aura Bella Handono Kalim Hani Susanti, Hani Hani Susianti Hanik Ruliani Haribowo, A S Hidayat Sujuti HMS Chandra Kusuma I Putu A.S Ibrahim Njoto Ihda Dian Kusuma Indah Jayani Ivan A Hartono, Ivan A Janasti, Laksmitha Kedaton, Rafi’ Andyah Arum Krisni Subandiyah Kurnianingsih, Nia L Enggar Fitri Laksmi Karunia Tanuwijaya Laksmi Karunia Tanuwijaya Lisyani Suromo Loeki Enggar Fitri M Rasjad Indra Machlusil Husna, Machlusil Maghfirah, Halimi Bidaimi Marsetyawan HNE Soesatyo Muhammad Anshory, Muhammad Muhammad Masyhur Nelly Ismayasih Nurdiana Nurdiana Nurhadi, Pradana Perdana Aditya Rahman Poetri, Levrita Nindya Pramadhani, Almira Prasetyo, Dwi A. Pratama, Mirza Z. Pratama, Mirza Zaka Purnomo, Athaya F. Purwanto Adipireno Putri, Choirinnisa Meilia Ayu Putu A. Herliawati R.I R.I Radhitio A Nugroho, Radhitio A Rahmawati, Hanifa Rizky Ria Famuji, Siti Roziah Rifa’i, A Rizky Fachry, Ade Wlidan Rossy Meilani Rulli Rosandi Safrina Dewi Ratnaningrum, Safrina Dewi Sari, Riana Trinovita Sari, Tita Luthfia Satrio Wibowo Singgih Wahono Solly Aryza Sri Andarini Indreswari Sri Poeranto, Sri Subandi Subandi Subandi Subandi Suharyo Hadisaputro Sulistomo, Hikmawan Wahyu Sulistyorini Sulistyorini Sumarno . Sumarta, Norma Hanifah Suryana, Bagus Putu Putra Sutrisno Sutrisno Suwito, Mat Syahrul Chilmi Syahrul Chilmi, Syahrul Tatit Nurseta Tatit Nurseta Torajasa Achamar Tri Yudani Mardining Raras VALENTINA YURINA VALENTINA YURINA Wahono, Caesarius Singgih Wahono, Cesarius S. Wahono, Cesarius Singgih Wardani, Diadjeng Setya Wisnu Barlianto Wisnu Barlianto Wisnu Barlianto Yahya Irwanto Yona One Sidarta, Yona One Yudhanto, Hendy Setyo Yuliana Salman Zaenal Kusuma