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All Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
Ninik Sukartini
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Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience

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KELEBIHAN ZAT BESI SEKUNDER BERKAITAN DENGAN SATURASI TRANSFERIN DAN FERITIN Isabella Valentina; Ninik Sukartini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 20, No 1 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v20i1.447

Abstract

Iron overload disorder is a condition due to an excessive rate of iron acquisition compared to the rate of body iron loss that happens constantly. The clinical manifestations vary depending on the location of the damaged organs. Consequently, the symptoms of iron overload may mimic many diseases such as cirrhosis, diabetes mellitus, arthropathy, and skin pigmentation. The laboratory results which may point to iron overload are as follows: transferrin saturation >45%, serum ferritin level >300 ng/ml in men and >200 ng/ml in women. It is thus imperative that the molecular mechanism of iron metabolism and pathogenesis of iron overload are well understood in order to correct the interpretation of the laboratory results for iron overload. The standard management is blood removal by phlebotomy to maintain the level of the serum ferritin at 50 ng/mL in order to prevent irreversible hepatic cirrhosis
KEKURANGAN ZAT BESI DI PEREMPUAN HAMIL MENGGUNAKAN HEMOGLOBIN RETIKULOSIT (RET-HE) Petriana Primiastanti; Ninik Sukartini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 3 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v19i3.414

Abstract

Iron deficiency is the most common nutrional deficiency in the world, mostly in developing and industrial countries. Population with highest risk of iron deficiency generally are reproductive-age women. In Indonesia, the prevalence of iron deficiency anemia in pregnant women is about 50.5%. Anemia due to iron deficiency in pregnancy can affect both mother as well as the foetus. In order to prevent permanent systemic complication, it is important to do early detection before iron deficiency anaemia developes. In the early phase of iron deficiency prior to anaemia, additional tests of ferritin, serum iron and saturation index are needed besides the complete blood count. A new parameter named reticulocyte hemoglobin equivalent (RET-He) has been developed to detect the level of hemoglobin in an immature erythrocyte or reticulocyte. Reticulocytes will be present in the peripheral circulation for only 24−48 hours, so the RET-He will give more appropriate information about the condition of bone marrow iron. When the bone marrow iron is depleted, the RET-He will show a decrease. In several hematology analyzers, for example Advia 2120 and Sysmex XE 2100, this parameter can be tested together with CBC, so no additional blood sample is needed. The aim of this study is to know iron deficiency in healthy first and second trimester pregnant women by screening using RET-He and compare the result to other parameters that are now available, such as: hemoglobin, ferritin, transferrin saturation. Those parameters can develop RET-He cut-off with optimal sensitivity and specificity. The study comprised 100 healthy pregnant women from I and II trimester who did not develop anemia yet during their last pregnancy. The subjects were divided into three (3) groups based on ferritin and transferrin saturation: 67 women (67%) without iron deficiency, 17 women (17%) with iron deficiency stage I, and 16 women (16%) with iron deficiency stage II. Hemoglobin, RET-He, and transferrin saturation showed a mean±SD of 12.35±1.02 g/dL, 33.60±1.88 pg and 28.63±1.07%, respectively. Median ferritin (min-max) was 40.10 (6.24–191.30)ng/mL. By using receiver operating curve (ROC) in this study RET-He point was found at 33.65 pg as an optimal cut-off point to differentiate iron deficiency with sensitivity and specificity of 67% and 64.18% respectively. From cross tabs table of RET-He with ferritin as the gold standard and 33.65 pg as the cut-off point results were 47.8% positive predictive value (PPV), 79.6% negative predictive value (NPV), positive likelihood ratio (LR) 1.86 and negative likelihood ratio (LR) 0.52. In this study, significant differences between non iron deficiency and the iron deficiency stage II groups and between iron deficiency stage I and iron deficiency stage II groups were found. There was no difference between the non iron deficiency and iron deficiency stage I groups.
ERYTHROCYTE INDICES TO DIFFERENTIATE IRON DEFICIENCY ANEMIA FROM β TRAIT THALASSEMIA (Indeks Eritrosit untuk Membedakan Anemia Defisiensi Besi dengan Thalassemia β Trait) Yohanes Salim; Ninik Sukartini; Arini Setiawati
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.v23i1.1184

Abstract

Anemia defisiensi zat besi dan thalassemia β trait merupakan penyebab tersering anemia mikrositik hipokrom di Indonesia. Keduapenyakit tersebut sulit dibedakan hanya dengan pemeriksaan hematologi, oleh karena itu diperlukan pemeriksaan tambahan sepertiferitin dan analisis hemoglobin. Banyak penelitian yang membedakan kedua penyakit tersebut dengan indeks eritrosit. Berbagai indekseritrosit memiliki nilai diagnostik yang berbeda di setiap negara dan belum ada data di Indonesia. Penelitian ini melakukan uji diagnostikIndeks Mentzer, RDW, Green-King, Sirdah dan mencari nilai cut-off baru yang dapat memberikan nilai diagnostik lebih baik. Penelitianterdiri dari 98 subjek definitif anemia defisiensi besi dan 80 subjek thalassemia β trait. Indeks Mentzer didapatkan kepekaan 83,6%,kekhasan 66,2%, NPP 75,2%, NPN 76,8% dan Indeks RDW mempunyai kepekaan 91,8%, kekhasan 75%, NPP 81,8%, NPN 88,2%. Nilaidiagnostik Indeks Green-King didapat kepekaan 96,9%, kekhasan 67,5%, NPP 78,5%, NPN 94,7%, sedangkan Indeks Sirdah adalahkepekaan 92,8%, kekhasan 58,7%, NPP 73,3%, NPN 87,0%. Nilai cut-off baru Indeks Mentzer adalah 13,44, RDWI 233,4, Green-King75,06 dan Sirdah 32,52. Keempat Indeks eritrosit dapat diterapkan untuk orang Indonesia dengan Indeks Green-King sebagai indeksyang terbaik.
Co-Authors Arini Setiawati Isabella Valentina Petriana Primiastanti Yohanes Salim