Agnes Rengga Indrati
Departemen Patologi Klinik Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung

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Profil Manifestasi Klinis dan Laboratoris Pasien Dengue Bayi yang Menjalani Rawat Inap di RSUP. DR. Hasan Sadikin Bandung Indri Handayani; Agnes Rengga Indrati; Anggraini Alam
Sari Pediatri Vol 19, No 3 (2017)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp19.3.2017.119-26

Abstract

Latar belakang. Dibanding pada anak dan dewasa, kejadian infeksi virus dengue pada bayi meningkat tiap tahun dengan derajat keparahan yang cepat. Jumlah penelitian mengenai manifestasi klinis maupun laboratoris pada pasien infeksi dengue bayi masih kurang terpublikasi.Tujuan. Untuk menggambarkan manifestasi klinis dan laboratoris pasien infeksi dengue bayi di RSUP DR.Hasan Sadikin tahun 2011-2016.Metode. Penelitian dengan desain observasional deskriptif kuantitatif. Mengambil data manifestasi klinis dan laboratoris selama rawat inap. Hasil. Sampel 62 bayi, termuda berusia 2 bulan. Manifestasi terbanyak adalah ptekie, feses cair, hepatomegali, batuk pilek, muntah efusi pleura dan pendarahan intra abdomen. Dua pasien tidak mengalami demam. Saat nadir, trombositopenia terjadi pada 98,3% pasien. Rerata terendah hemoglobin 9,12 g/dL, hematokrit 26,7%, dan leukosit 8898 /mm3. Terjadi gangguan fungsi hati dari data peningkatan SGPT pada 62,9% pasien dan SGOT pada 88,8% pasien.Kesimpulan. Usia terbanyak adalah rentang umur 4-6 bulan dengan manifestasi paling sering adalah demam, beberapa pasien langsung mengalami manifestasi pendarahan tanpa mengalami demam. Pada EDS manifestasi paling sering yaitu kejang dan penurunan kesadaran. Mayoritas pasien memiliki kadar Hb rendah, trombositopenia dan abnormalitas fungsi hati.
Validitas Pemeriksaan Antigen P24 HIV Metode Rapid Immunochromatography Terhadap Viral Load RNA HIV Metode PCR Yanti Yanti; Ida Parwati; Agnes Rengga Indrati; Anggraini Alam
Sari Pediatri Vol 16, No 5 (2015)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp16.5.2015.347-50

Abstract

Latar belakang. Bayi yang dilahirkan oleh ibu pengidap HIV/AIDS akan mengandung antibodi HIV ibudalam darahnya, terdeteksi sampai usia 18 bulan. Pemeriksaan virologi (RNA/DNA HIV dan antigen p24HIV) sesuai standar WHO adalah pemeriksaan HIV pada bayi dan anak <18 bulan terlahir dari ibu HIV/AIDS.Tujuan. Mengetahui validitas pemeriksaan antigen p24 HIV metode rapid immunochromatogrpahy terhadapviral load RNA HIV metode PCR pada bayi dan anak <18 bulan dengan ibu HIV/AIDS.Metode. Penelitian dilakukan di RSUP dr. Hasan Sadikin Bandung dan RSK Dharmais Jakarta, periodeApril-September 2013. Subjek penelitian adalah 72 bayi dan anak berusia <18 bulan yang lahir dari ibuHIV/AIDS.Hasil. Sembilan (12,5%) dari 72 subjek penelitian terdeteksi HIV pada pemeriksaan viral load RNA HIV, 2(22,2%) di antaranya positif pada pemeriksaan antigen p24 HIV. Didapatkan sensitivitas 22,2%, spesifisitas100%, dan akurasi 90,3%.Kesimpulan. Pemeriksaan antigen p24 HIV metode rapid immunochromatography memiliki spesifisitastinggi, sensitivitas rendah sehingga pemeriksaan antigen p24 HIV metode rapid immunohromatographyini dapat digunakan sebagai alat diagnostik.
Perbandingan Kadar C-Reactive Protein Kuantitatif dengan Hasil Deteksi Antigen Cryptococcus neoformans pada Penderita Human Immunodeficiency Virus Maenaka Smaratungga Hendrajaya; Agnes Rengga Indrati; Ahmad Rizal Ganiem
Global Medical & Health Communication (GMHC) Vol 1, No 2 (2013)
Publisher : Universitas Islam Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1611.082 KB) | DOI: 10.29313/gmhc.v1i2.1517

Abstract

Infeksi Cryptococcus neoformans merupakan salah satu infeksi oportunistik pada penderita HIV yang dapat menyebabkan meningitis kriptokokus dan dapat dideteksi secara dini melalui antigen yang terdapat pada kapsul polisakarida. Ketersediaan pemeriksaan antigen ini sangat terbatas sehingga dibutuhkan parameter lain untuk mendeteksi secara dini kemungkinan terjadi meningitis kriptokokus. Parameter tersebut adalah C-reactive protein (CRP). Penelitian ini bertujuan untuk membandingkan kadar CRP kuantitatif dengan hasil deteksi antigen C. neoformans pada penderita infeksi HIV. Serum diambil dari penderita HIV di Klinik Teratai RSUP Dr. Hasan Sadikin Bandung yang baru pertama kali terdeteksi, CD4+ <100 sel/mm3, belum diterapi, serta tidak didiagnosis meningitis kriptokokus. Dilakukan deteksi antigen menggunakan Cryptococcal antigen latex agglutination system (Meridian Diagnostics), dan pemeriksaan CRP kuantitatif. Desain penelitian analitik komparatif dengan analisis statistik menggunakan statistical product and service solutions (SPSS ver.13), uji Mann-Whitney, dan dilakukan perhitungan sensitivitas dan spesifisitas serta penentuan cut-off CRP kuantitatif dengan kurva ROC. Hasil penelitian menunjukkan perbedaan bermakna kadar CRP kuantitatif pada hasil CALAS positif dan negatif. Kadar CRP pada CALAS positif lebih tinggi dibandingkan dengan dengan negatif (p<0,05). Dari kurva ROC didapatkan sensitivitas 84,3% dan spesifisitas 42,4%, serta cut-off CRP >5,8197 mg/dL. Dari 14 sampel dengan CALAS positif, 12 (85,7%) dengan CRP > 5.8197 mg/dL dan 2 (14,3%) dengan CRP ≤5,8197 mg/dL. Simpulan, CRP kuantitatif dapat dipertimbangkan sebagai salah satu parameter untuk mendeteksi secara dini kemungkinan terjadi meningitis kriptokokus pada pasien HIV, dengan menyingkirkan kemungkinan lain yang dapat mengakibatkan peningkatan CRP COMPARISON OF QUANTITATIVE C-REACTIVE PROTEIN CONCENTRATION AND CRYPTOCOCCUS NEOFORMANS ANTIGENS DETECTION RESULTS IN HUMAN IMMUNODEFICIENCY VIRUS PATIENTSCryptococcus neoformans infection is one of the opportunistic infections in HIV patients, it caused cryptococcal meningitis, which can be detected earlier using the antigen contained in the polysacharide capsule. The availability of this antigen test is very limited that other parameter are needed for early detection of cryptococcal meningitis. That parameter is C-reactive protein (CRP). The aim of this study was to compare the levels of quantitative CRP with the C. neoformans antigen detection in HIV patients. This was a comparative analytical study design using serum taken from HIV patients who came to the Teratai Clinic RSUP Dr. Hasan Sadikin Bandung. The inclusion criteria was subject on their first detection, having CD4 + <100 cells/mm3, have never been treated before, and was not diagnosed with cryptococcal meningitis. Cryptococcal antigen detection using antigen latex agglutination system (Meridian Diagnostics) and quantitative CRP examination was performed. Data analysis used statistical product and service solutions (SPSS) ver. 13 to calculate sensitivity and specificity and the determination of CRP cut-off by ROC curve. Results showed that there was significant differences in the levels of quantitative CRP from positive and negative CALAS results. CRP levels in CALAS positive results was higher than negative result (p<0.05). From ROC curve, the CRP had 84.3% sensitivity and 42.4% specificity, and the cut-off was >5.8197 mg/dL. Of 14 samples with positive CALAS result, 12 (85,7%) having CRP >5.8197 mg/dL and 2 (14,3%) with CRP ≤5.8197 mg/dL. In conclusion, quantitative CRP could be considered as a parameter for early detection of cryptococcal meningitis in HIV patients, by eliminating the possibilities that can lead to increased level of CRP.
EKSPRESI KORESEPTOR HUMAN IMMUNODEFICIENCY VIRUS CCR5 DAN CXCR4 PADA SUBSET SEL LIMFOSIT T SERTA MONOSIT Agnes Rengga Indrati; Hinta Meijerink; Herry Garna; Bachti Alisjahbana; Ida Parwati; Reinout van Crevel; Andre van der Venn
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 18, No 2 (2012)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v18i2.1012

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Chemokine receptors CCR5 and CXCR4 which lied on lymphocyte cell surface play important role in HIV infection and pathogenesis.The expression of these chemokine receptors will affect progressively the disease. The objectives of the study are to find the distributionof lymphocyte T cell subset and monocyte among the peripheral blood mononuclear cells and to know the determination of CCR5 andCXCR4 co receptors expression on T lymphocyte cells subset and monocyte. This study is a preliminary study to explore the distributionof co receptors CCR5 and CXCR4 expression in healthy people. The sample taken is peripheral blood mononuclear cells (PBMC) fromhealthy subjects. The identification of T lymphocyte cells subsets and monocyte, and the expression of CCR5 and CXCR4 co receptorswere determined using flowcytometry. The memory T cell (CD4+CD45RO) is found to be the largest proportion among T lymphocyte cell(66.2%), whereas the other T lymphocyte cell subset, regulatory T cell, which identified by CD25+ high expression was found between2.0-5.3% from the whole T lymphocyte cell. The proportion of CXCR4 co receptors was found higher compare to CCR5 co receptorson all T lymphocyte subsets and monocyte. Only small proportion of monocyte expresses both co receptors (2.85%), but most of the Tlymphocyte cell expressed both CCR5 and CXCR4. The expression of the CXCR4 on regulatory T cell (18.18%) is the lowest compared toother cells, but the fluorescence intensity of both co receptors was very high (CCR5 53.53 and CXCR4 49.33). The different distributionof CCR5 and CXCR4 co receptors among T lymphocyte cell subsets and monocyte will influence the vulnerability and the pathogenicityof HIV infection.
COMPARATIVE RATIO OF BCR-ABL GENES WITH PCR METHOD USING THE CODIFICATION OF G6PD AND ABL GENES IN CHRONIC MYELOID LEUKEMIA PATIENTS (Perbandingan Angka Banding Gen BCR-ABL Metode PCR Menggunakan Baku Gen Glucosa-6-Phosphate Dehidrogenase dan Gen Abelson Kinase di Pasien Chronic Myeloid Leukemia) Tonggo Gerdina Panjaitan; Delita Prihatni; Agnes Rengga Indrati; Amaylia Oehadian
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 23, No 1 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v23i1.1186

Abstract

Chronic Myeloid Leukemia (CML) adalah keganasan hematopoetik pertama yang dihubungkan dengan jejas genetik. Chronic MyeloidLeukemia digolongkan sebagai penyakit mieloproliferatif kronis disebabkan translokasi resiprokal kromosom 9 dan 22 yang disebutkromosom Philadelphia (Ph). Kromosom Ph membentuk gen yang disebut BCR-ABL. Pemeriksaan molekuler CML bertujuan untukmengetahui aktivitas transkripsi mRNA gen BCR-ABL, yang berguna untuk menetapkan diagnosis dan pemantauan pengobatan pasienCML. Saat ini, WHO mempublikasikan ada sembilan (9) gen baku yang digunakan secara luas. Tujuan penelitian ini adalah untukmengetahui angka banding gen BCR-ABL/G6PD dan BCR-ABL/ABL di pasien CML dengan kromosom Ph (+) secara membandingkan.Penelitian ini menggunakan 79 bahan biologis tersimpan (BBT) mRNA Ph (+) dari leukosit pasien CML yang datang ke RSUPDr. Hasan Sadikin Bandung selama masa waktu antara bulan April 2012−April 2014. Pemeriksaan angka banding gen BCR-ABL/G6PDdengan metode Real-time Quantification PCR menggunakan alat LightCycler® Roche. Angka banding gen BCR-ABL/ABL diperiksamenggunakan alat Bioneer®. Gen baku G6PD dapat mendeteksi tipe b2a2, b3a2 dan e1a2. Gen baku ABL hanya dapat mendeteksi tipeb2a2 dan b3a2, tetapi lebih stabil bila dibandingkan dengan gen baku G6PD. Bentuk penelitian adalah perbandingan analitik denganrancangan kajian potong lintang. Analisis statistik menggunakan uji nonparametrik Wilcoxon. Hasil angka banding mRNA gen BCRABL/G6PD dan gen BCR-ABL/ABL [1,93% (0,0–59,7 fg) vs 15,37% (0,04–35,7 kopi), p<0,001]. Gen BCR-ABL tidak terdeteksi di 3 BBTdengan menggunakan gen baku ABL. Berdasarkan telitian ini, dapat disimpulkan, bahwa terdapat perbedaan bermakna antara angkabanding gen BCR-ABL/G6PD dan yang terkait BCR-ABL/ABL. Gen baku yang sama diperlukan untuk mendiagnosis dan memantaurespons pengobatan.
T-CD4+ DAN PROFIL LIPID DI HIV (T-CD4+ and Lipid Profile in HIV) Yulia Hayatul Aini; Coriejati Rita; Agnes Rengga Indrati; Rudi Wisaksana
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 1 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i1.1259

Abstract

Human Immunodeficiency Virus (HIV) infection patients are often reported to be associated with changes of lipid metabolism.A previous study suspected that there was a correlation between low CD4+ T-lymphocyte counts with the lipid profile in HIV-infectedpatients. The objective of this study was to know the assessment of the lipid profile (total cholesterol, HDL, LDL and triglyceride) inpatients with HIV infection and their correlation with CD4+ T-Lymphocyte count. This study was conducted at the Hasan Sadikin Hospital,Bandung using retrospective data, and analysis method as the study design. The study was performed on 402 HIV-infected patients.A significant difference was found in all lipid parameters between patients with and without ART (p<0.05). Weak correlations werefound between CD4+ T-Lymphocyte with total cholesterol and HDL levels (r<0.04), and a very weak correlation as well with the LDLlevel (r<0.2). There was no correlation with the triglyceride levels (p=0.751). The lipid profile showed a weak correlation with CD4+T-Lymphocyte, therefore, it can not be used as a parameter to know the severity of disease relating to the HIV infection. However, it canbe useful for monitoring the metabolic effect of the given therapy, because there was a significant difference between those patients withand without ART.
CORRELATION BETWEEN PRESEPSIN AND SEQUENTIAL [SEPSIS-RELATED] ORGAN FAILURE ASSESSMENT (SOFA) SCORE AS AN ORGAN DYSFUNCTION MARKER IN SEPSIS Stevi Dwiyani; Agnes Rengga Indrati; Leni Lismayanti; Adhi Kristianto S
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 1 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i1.1490

Abstract

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. The latest consensus in 2016 (Sepsis-3) identified organ dysfunction as an acute change in total SOFA score ≥2 points. An ideal laboratory examination is expected to detect sepsis in an early stage and correlated with the degree of infection. Presepsin or Soluble Cluster of Differentiation 14 Sub Type (sCD14-ST) is a proteolysis product of CD14 that is produced in 1-2 hour after innate immune activation during infections. The aim of this study was to determine the correlation of presepsin and SOFA score as an organ dysfunction marker in sepsis. This research was an observational, analytical cross-sectional study conducted in the Dr. Hasan Sadikin Hospital (RSHS) Bandung from September 2016 until July 2017. The subjects were 42 patients from the Emergency Department diagnosed as sepsis by clinicians using criteria of SOFA score ≥2 points. The serum sample was collected and measured for presepsin concentration. A correlation test was analyzed with Spearman analysis. This study showed the increasing of presepsin concentration associated with SOFA score (p=0.000; r=0.660). There was a positive correlation between presepsin and SOFA score as an organ dysfunction marker
Aspartate Aminotransferase to Platelet Ratio Index Score in Correlation with Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio to Predict Hepatic Cirrhosis in Hepatitis C Patients Jane Haryanto; Agnes Rengga Indrati; Tiene Rostini
Althea Medical Journal Vol 9, No 2 (2022)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v9n2.2553

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Background: Tissue biopsy examination which is an invasive procedure has become the mainstay for hepatic cirrhosis identification in patients with hepatitis. Alternatively, noninvasive method using the aspartate aminotransferase (AST) to platelet ratio index (APRI) score has been developed to predict hepatic cirrhosis. Furthermore, the neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) have been used to predict the severity of hepatitis C. This study aimed to analyze the relationship between APRI scores and NLR and PLR in chronic hepatitis C patients.Methods: This correlative cross-sectional observational study used secondary data of complete blood counts such as neutrophil, lymphocyte, and platelet values, as well as AST values of patients with hepatitis C in the outpatient and inpatient installation of Dr. Hasan Sadikin General Hospital during 2019. The inclusion criteria were patients aged ≥18 years, male and female, who were diagnosed as hepatitis C patients, patients who had AST examination data, leukocytes, count type, and platelets. Data were analyzed using the Spearman rank correlation test.Results: The 123 subjects were dominantly male with an age range of 46–55 years. There was no correlation between the APRI and NLR scores (p=0.229). However, there was a moderate and significant negative correlation between APRI and PLR scores with a correlation coefficient of -0.468 (p=0.000).Conclusion: There is a significant negative correlation between APRI and PLR scores to predict the occurrence of hepatic cirrhosis in patients with Hepatitis C.
Correlation Between P-Selectin Level and Platelet Aggregation in Cerebral Venous Sinus Thrombosis Patients Nurmin, Rahmawati; Lismayanti, Leni; Rostini, Tiene; Indrati, Agnes Rengga; Amalia, Lisda
Majalah Kedokteran Bandung Vol 55, No 3 (2023)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v55n3.2777

Abstract

One of the causes of cerebral venous sinus thrombosis (CVST) is platelet hyperactivity. Adhesion and secretion are the beginning of platelet activation, which is indicated by a change in the Platelet-selectin (P-selectin) level. The end result of platelet activation is platelet aggregation. However, it is unknown whether the beginning of platelet activation ends with platelet aggregation. This study aimed to discover the correlation between P-selectin level and platelet aggregation in CVST. This study used a cross-sectional escriptive observational correlative approach. Subjects were the CVST outpatients visiting the Neurology Department of Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, from July to September 2021. A total of 49 subjects met the inclusion and exclusion criteria. This study used citrate plasma samples for platelet aggregation and serum for P-selectin assessment. Platelet aggregation were assessed using the light transmission platelet aggregation method while P-selectin was assessed using Enzyme-linked immunosorbent assay (ELISA). Platelet aggregation median was 10.6% (range 0.2–82.4%), which reflected normoaggregation. Platelet hyperaggregation were seen in 9 samples (8.4%). Median of P-selectin was 2.4 ng/mL (range 0.1–10.1 ng/mL) which were normal. High P-selectin level was observed in 16 (32.7%) with 4/16 (25%) experiencing platelet hyperaggregation. Statistical analysis showed a weak negative correlation between P-selectin and platelet aggregation (r=-0.012; p=0.467). In conclusion, no correlation is seen between P-selectin and platelet aggregation, which may be due to the fact that platelets are influenced by many factors that are not examined in this study.