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All Journal Buletin Udayana Mengabdi E-Jurnal Medika Udayana Health Science Journal of Indonesia E-Jurnal Udayana Medica The Indonesian Biomedical Journal Paediatrica Indonesiana Indonesian Journal of Cardiology ISM (Intisari Sains Medis) : Jurnal Kedokteran Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Archives of The Medicine and Case Reports Journal of Global Pharma Technology
Anak Agung Wiradewi Lestari
Departemen Patologi Klinik, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia
Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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Mapping of Donor Blood Antigens and Development of Panel Cell Reagents in Bali Province Mulyantari, Ni Kadek; Lestari, Anak Agung Wiradewi; Herawati, Sianny
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 3 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i3.2351

Abstract

Examination of other blood groups' antigens, such as Rhesus (d, C, c, E, e), Kell, Duffy, Kidd, and others, is not routinely carried out in blood services. This study aimed to determine the type of blood group antigen and the composition of the antigens of panel cell reagents for antibody screening and identification in Bali. The subjects were 120 voluntary donors who regularly donate blood. Blood group antigen examination was carried out with a column agglutination test. The antigen mapping was analyzed to determine the possible development of panel cell reagents. Among 120 research subjects, 76.67% were male. Rhesus antigen mapping showed 73.3% DCe phenotype, 3.33% DcE, 3.33% Dce, 19.17% DCE. MNS system, 22.5% M-N+, 35.83% M+N+, 85% S-s+, 14.17% S+s+ and 0.83% S+s-. For the Kell system, no donor with phenotype K+k-, 5.83% K+k+, 94.17% K-k+. No donor with Kpa antigen and 100% with Kpb antigen. Based on Duffy system, 74.17% Fy (a+b), 23.33% Fy(a+b+), 1.7% Fy(a-b+), 0.8% Fy(a-b-). For Kidd system 36.67% Jk(a+b-), 45.83% Jk(a+b+), 17.5% (Jk(a-b+) and no donor with Jk(a-b-). The screening analysis of donor antigens allows the development of panel cell reagents using two types of panel cells. Most donors have a Rhesus DCe phenotype with other dominant antigens, M+N+, S-s+, K-k+, Kpb, Fy(a+b-), and Jk(a+b+). The development of panel cell reagents can be done with the antigen composition of R1R1 (D, C, e, M, S, k, Kpb, Fya, Jka) and R2R2 (D, c, E, M, N, s, K,k, Kpb, Fya, Fyb, Jka, Jkb).  
Cerebral Malaria from a Plasmodium falciparum and Plasmodium malariae Co-Infection: A Case Report on a Diagnostic Challenge Vera Akmilia; Anak Agung Ayu Yuli Gayatri; Anak Agung Wiradewi Lestari
Archives of The Medicine and Case Reports Vol. 6 No. 3 (2025): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v6i3.779

Abstract

Severe malaria, primarily caused by Plasmodium falciparum, is a life-threatening medical emergency. Its diagnosis can be significantly complicated by mixed-species infections, where the presence of a less virulent Plasmodium species may mask the true etiological agent of the severe disease, leading to potential delays in appropriate therapy. This report details a case of cerebral malaria where such a diagnostic challenge occurred. An 18-year-old male with a recent travel history to a malaria-endemic area in Indonesia presented with a one-day history of decreased consciousness (Glasgow Coma Scale score of 9) following a week-long febrile illness. The clinical presentation met the World Health Organization's criteria for severe malaria, specifically cerebral malaria. Initial microscopic examination of a peripheral blood smear exclusively identified Plasmodium malariae. However, a concurrently performed rapid diagnostic test (RDT) was positive for both the pan-malarial antigen and the P. falciparum-specific histidine-rich protein 2 (HRP-2) antigen. This critical discordance prompted treatment for severe falciparum malaria with intravenous artesunate and triggered an expert re-evaluation of the blood smears. Subsequent analysis confirmed a co-infection with both P. falciparum and P. malariae. The patient showed significant clinical improvement within three days of initiating appropriate therapy. In conclusion, this case underscores the peril of diagnostic anchoring in severe malaria. Clinical severity must supersede laboratory findings that are incongruent with the patient's condition. The presence of a Plasmodium species other than falciparum on an initial smear does not rule it out as the cause of a severe syndrome. Discordant results between microscopy and RDTs are a critical red flag for mixed infections and mandate immediate, expert parasitological re-evaluation to ensure timely, life-saving treatment.
Antibody-synthesizing lymphocytes (AS-LYMP) and reactive lymphocytes (RE-LYMP): novel predictors of severe dengue Saputra, I M Yullyantara; Gustawan, I Wayan; Utama, Made Gede Dwilingga; Lestari, AA Wiradewi; Adibrata, Antony Abel; Dewi, Eleonora Anindya Tiara
Paediatrica Indonesiana Vol. 66 No. 2 (2026): March 2026
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Background Dengue fever is a major public health problem in Indonesia, where children are particularly at risk of severe disease. Early recognition of severe dengue is critical to reduce morbidity and mortality. Novel lymphocyte activation markers, such as antibody-synthesizing lymphocytes (AS-LYMP) and reactive lymphocytes (RE-LYMP), may improve risk stratification. Objective To evaluate antibody-synthesizing lymphocytes (AS-LYMP) and reactive lymphocytes (RE-LYMP) as potential diagnostic risk stratification markers for severe dengue fever. Methods This cohort retrospective study was conducted at Ngoerah General Hospital, Denpasar, Bali, and included children under 18 years with confirmed dengue infection. AS-LYMP and RE-LYMP counts were obtained using a Sysmex XN-3000 analyzer. Diagnostic performance was evaluated by receiver operating characteristic (ROC) curve analysis, and optimal cut-off points were identified using the Youden index. Results Seventy-nine dengue patients were analyzed: 15 without warning signs, 39 with warning signs, and 25 with severe dengue. Both AS-LYMP and RE-LYMP counts were significantly elevated in severe dengue (P<0.001) compared to other two groups. The ROC analysis showed acceptable accuracy for AS-LYMP (AUC 0.749; cut-off 0.83 × 10³/μL; sensitivity 80.0%; specificity 63.0%) and RE-LYMP (AUC 0.729; cut-off 1.04 × 10³/μL; sensitivity 80.0%; specificity 59.3%). Hemoglobin level and leukocyte count demonstrated predictive value, but with lower accuracy. Conclusion AS-LYMP and RE-LYMP are promising biomarkers for early identification of severe dengue in children. Integration into routine hematology testing may support timely clinical decision-making.
Co-Authors Aakash Aakash Airin Que Anak Agung Ayu Lydia Prawita Anak Agung Ayu Yuli Gayatri Anak Agung Gde Bisma Sanjaya Anak Agung Ngurah Subawa Anak Agung Putri Satwika Antony Abel Adibrata Aryati Aryati Bagus Anom Sudiada Bagus Ari Pradnyana Dwi Sutanegara Budi Santosa Budi Santosa Desak Gde Diah Dharma Santhi Dewi, Eleonora Anindya Tiara Dewi, Ni Made Ratih Purnama Dharayani, Luh Anandita Diah Pradnya Paramita Edward Kurnia Setiawan Limijadi, Edward Kurnia Setiawan Eka Wiratnaya Ekarini Katharina Yunarti Nabu Ekarini Katharina Yunarti Nabu Endrawati KJ Felim, Jethro Gde Ary Putra Kamajaya Gede Wira Mahadita Haneetha Yogarajah I A Putri Wirawati I Gde Raka Widiana I Gst Agung Dwi Mahasurya I Gusti Ngurah Wien Aryana I Gusti Putu Suka Aryana I Kadek Arya Candra I Ketut Suyasa I Made Gede Dwi Lingga Utama I Nyoman Astika I Nyoman Hery Sumertayasa I Nyoman Indrawan Mataram I Nyoman Santa Wijaya I Nyoman Wande I Nyoman Wande I Putu Sidhi Rastu Karyana I Putu Yuda Prabawa I Wayan Agus Surya Pradnyana I Wayan Gustawan I Wayan Putu Sutirta Yasa I Wayan Suryanto Dusak I.A. Putri Wirawati Ida Ayu Ari Utami Ida Bagus Putu Putrawan Indrayani, Pande Kadek Putri Rahayu Intan Astariani Ketut Gede Mulyadi Ridia Ketut Siki Kawiyana Ketut Suega Komang Agus Widhy Utama Putra Komang Septian Sandiwidayat Krisna Yoga Pratama Made Ayu Widyaningsih Made Dyah Khrisnadewi Made Kris Budiman Made Wirabhawa Mardiyah Hayati Michael Ferdinand Milaviwanda, Luh Komang Ayu Ni Gusti Ayu Putu Lestari Santika Dewi Ni Kadek Mulyantari Ni Ketut Rai Purnami Ni Komang Krisnawati Ni Luh Gede Yoni Komalasari Ni Luh Putu Pranena Sastri Ni Made Stithaprajna Pawestri Prabawa, I Putu Yuda Putu Astawa Putu Ayu Krisna Cahyaning Putri Putu Gde Hari Wangsa Putu Putri Titamia Saraswati Putu Ugi Sugandha R. A.T. Kuswardhani Sagung Novita Widyaningrat Saputra, I M Yullyantara Sianny Herawati Sianny Herawati Sri Darmawati Sudana, I Nyoman Gde Sudewa Djelantik Teguh Triyono Thaha .. Tjok Gde Oka Tjokorda Gede Oka Usi Sukorini Vera Akmilia Wande IN Wayan Aryadana Wayan Giri Putra Wijaya Kusuma Wira Gotera Yenny Kandarini