Dina Muktiarti, Dina
Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Indonesia-Rumah Sakit Cipto Mangunkusumo

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Interleukin-6 and disease activity in childhood systemic lupus erythematosus Satria, Cahya Dewi; Kurniati, Nia; Muktiarti, Dina
Paediatrica Indonesiana Vol. 63 No. 6 (2023): November 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.6.2023.456-63

Abstract

Background Systemic lupus erythematosus (SLE) is a complex disease with various manifestations. Interleukin-6 (IL-6) is a pleiotropic cytokine with a wide range of biological activities which plays an important role in immune regulation and inflammation. Serum level of IL-6 may be used as a parameter of disease activity, especially in pediatric SLE patients with mild disease activity or total remission with conflicting clinical manifestations and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores. Objective To identify the characteristics of serum IL-6 concentration in pediatric SLE with mild disease activities and total remission. Methods This case-control study was performed at the allergy-immunology outpatient clinic, Department of Child Health Dr. Cipto Mangunkusumo Hospital, Jakarta and Dr. Sardjito Hospital, Yogyakarta. Serum IL-6 concentration and disease activity were assessed in all pediatric SLE patients aged 1-18 years old. Disease activity was assessed with SLEDAI scores and serum level of IL-6 was measured by enzyme-linked immunosorbent assay. Results Among 60 subjects included in this study, 30 subjects with mild activities were in the case group and 30 subjects with total remissions were in the control group. There was no difference in serum IL-6 concentration between the case and control group (OR 0.483; 95%CI 0.041to 5.628; P=0.500). In this study, 2 subjects with urinary tract infection had high serum IL-6 concentrations. Conclusion There is no difference in serum IL-6 concentration between pediatric SLE patients with mild disease activities compared to total remissions.
Sindrom Nefrotik Monogenik: Pendekatan Klinis dan Diagnosis Fahlevi, Reza; Trihono, Partini Pudjiastuti; Muktiarti, Dina; Wahidiyat, Pustika Amalia; Hidayati, Eka Laksmi; Hafifah, Cut Nurul
Sari Pediatri Vol 26, No 3 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.3.2024.189-96

Abstract

Sindrom nefrotik merupakan penyakit ginjal yang sering ditemukan pada anak-anak, dengan insiden 1-3 per 100.000 anak di bawah usia 16 tahun. Sekitar 10-20% anak dengan sindrom nefrotik mengalami sindrom nefrotik resisten steroid (SNRS), dan 10-30% dari kasus ini disebabkan oleh kelainan genetik. Pada SNRS monogenik, terdapat dua jenis yaitu sindromik (dengan gejala ekstra-renal) dan non-sindromik (tanpa gejala ekstra-renal). Penanganan SNRS memerlukan pendekatan klinis yang berbeda tergantung pada etiologi genetiknya. Pemeriksaan genetik, termasuk gen tunggal, panel multigen, dan genomik komprehensif, dapat mengidentifikasi varian patogenik, menetapkan diagnosis yang akurat, menyesuaikan terapi (termasuk penghentian terapi imunosupresan dan pemberian terapi yang lebih spesifik) konseling genetik, serta penanganan komprehensif terhadap manifestasi ekstra-renal terkait. Oleh karena itu, pendekatan klinis yang efektif harus didasarkan pada hasil pemeriksaan genetik untuk pengelolaan yang optimal dan konseling yang lebih tepat.
Application of The JMF 10 Warning Signs for Early Detection of Primary Immunodeficiency among Children with Recurrent Infections in Indonesia Muktiarti, Dina; Hendarto, Aryono; Munasir, Zakiudin; Wulandari, Dewi; Satari, Hindra Irawan; Werdhani, Retno Asti; Wati, Ketut Dewi Kumara
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 9 No. - (2025): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v9i-.318

Abstract

Introduction: Limited awareness and diagnostic resources contribute to delayed recognition of primary immunodeficiency (PID). The Jeffrey Modell Foundation (JMF) 10 warning signs have been widely used for screening. However, their diagnostic performance has not been validated in Indonesia. Objective: To evaluate the diagnostic performance of the JMF 10 warning signs for early detection of PID among children with recurrent infections in Indonesia. Methods: This multicentre cross-sectional study was conducted across 10 hospitals in Jakarta involving 254 children aged 0–18 years who met the severe, persistent, unusual, and recurrent (SPUR) infection criteria. The diagnosis of PID was established based on clinical diagnosis by the European Society for Immunodeficiencies (ESID) Registry Working Definitions. Analysis was performed to determine the sensitivity, specificity, predictive values, and accuracy of the JMF 10 warning signs. Results: Diagnostic performance for PID improved with the number of warning signs, with overall accuracy increasing from 15% (1 sign) to 86.2% (≥5 signs). A total score of ≥3 signs was associated with higher occurrence of PID (PR 2.63; 95% CI 1.23–5.60; p = 0.008), providing an optimal balance of 75.7% sensitivity and 48.9% specificity. The two most specific indicators were recurrent severe sinus infections (99.5%) and ear infections (95%). All PID subjects required IV antibiotics. Conclusion: The JMF warning signs remain a valuable clinical screening tool for early detection of PID among Indonesian children. A threshold of three or more warning signs provides reasonable accuracy for screening and referral of PID in resource-limited settings.