Darwati Muhadi
Department of Clinical Pathology, Faculty of Medicine, Hasanuddin University/Dr. Wahidin Sudirohusodo, Makassar

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Analysis of Platelet Indices and Proteinuria in Primary Hypertensive Patients Deny Suryana; Yuyun Widaningsih; Fitriani Mangarengi; Darwati Muhadi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 2 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i2.1772

Abstract

Hypertension is a silent killer that causes premature death, an estimated 9.4 million people die each year due to hypertension and its complications. Primary hypertension promotes endothelial damage-causing platelet release reaction. Without treatment, it may cause renal damage, which leads to proteinuria. This study aimed to analyze the relationship of the platelet indices (PLT, PDW, PCT, MPV) in predicting proteinuria among patients with primary hypertension based on its stage. A retrospective study using medical records of patients diagnosed with primary hypertension by clinicians at Dr. Wahidin Sudirohusodo Hospital from January-December 2019. Complete Blood Count (CBC) using the flow cytometry and routine urine test with urine analyzer were performed. The statistical test used in this study were the independent T-test, Chi-Square test, and oneway ANOVA test. Receiver Operating Characteristics (ROC) were used to determine the cut-off. The sample consisted of 78 patients. Mean Platelet Volume (MPV) was significantly higher in proteinuria patients and stage two hypertension with p<0.001. There was a significant relationship between stage two hypertension and proteinuria with p=0.018. ROC analysis showed MPV Area Under the Curve (AUC) of 0.774 with p<0.001, which indicated that MPV can be used as a predictor of proteinuria with a cut-off point of 8.55. MPV increases on the platelet indices, proteinuria with stage 2 hypertension are caused by damage to glomerular endothelium, which leads to platelet activation characterized by degranulation, swelling, and increases in platelet mass and volume. There was a relationship between an increase of MPV and proteinuria in patients with stage 2 hypertension.
Analysis of Platelet Indices and Proteinuria in Primary Hypertensive Patients Deny Suryana; Yuyun Widaningsih; Fitriani Mangarengi; Darwati Muhadi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 2 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i2.1772

Abstract

Hypertension is a silent killer that causes premature death, an estimated 9.4 million people die each year due to hypertension and its complications. Primary hypertension promotes endothelial damage-causing platelet release reaction. Without treatment, it may cause renal damage, which leads to proteinuria. This study aimed to analyze the relationship of the platelet indices (PLT, PDW, PCT, MPV) in predicting proteinuria among patients with primary hypertension based on its stage. A retrospective study using medical records of patients diagnosed with primary hypertension by clinicians at Dr. Wahidin Sudirohusodo Hospital from January-December 2019. Complete Blood Count (CBC) using the flow cytometry and routine urine test with urine analyzer were performed. The statistical test used in this study were the independent T-test, Chi-Square test, and oneway ANOVA test. Receiver Operating Characteristics (ROC) were used to determine the cut-off. The sample consisted of 78 patients. Mean Platelet Volume (MPV) was significantly higher in proteinuria patients and stage two hypertension with p<0.001. There was a significant relationship between stage two hypertension and proteinuria with p=0.018. ROC analysis showed MPV Area Under the Curve (AUC) of 0.774 with p<0.001, which indicated that MPV can be used as a predictor of proteinuria with a cut-off point of 8.55. MPV increases on the platelet indices, proteinuria with stage 2 hypertension are caused by damage to glomerular endothelium, which leads to platelet activation characterized by degranulation, swelling, and increases in platelet mass and volume. There was a relationship between an increase of MPV and proteinuria in patients with stage 2 hypertension.
Transient Abnormal Myelopoiesis in Down Syndrome Patients Widya Pratiwi; Amaliyah T. Lopa; Darwati Muhadi; Mansyur Arif
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 3 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i3.2024

Abstract

Neonates with Down Syndrome (DS) have a propensity to develop the unique myeloproliferative disorder, Transient Abnormal Myelopoiesis (TAM). Transient abnormal myelopoiesis usually resolves spontaneously in < 3 months, but approximately 10% of patients with TAM die from hepatic or multi-organ failure. After remission, 20% of patients with TAM progress into acute myeloid leukemia associated with down syndrome (ML-DS). The patient was a full-term 2-day-old baby girl with a birth weight of 3300 gr. Physical examination revealed dysmorphic facial features, hypertelorism, macroglossia, and low set ears, which is a characteristic sign of DS face, skin rash, and there was no anus. On examination of peripheral blood smears and bone marrow aspiration, hematological abnormalities, and circulating blast cells were found. Early diagnosis of low-lying anorectal malformation (MAR) without fistula and down syndrome. In treating patients with TAM, it is first necessary to know whether they have trisomy 21 syndrome, then trace the existing hematological disorders to find the GATA 1 genetic mutation. The most crucial hematological problem in patients with DS is leukemia. Mutations in the GATA 1 gene and the presence of DS can result in abnormal proliferation of megakaryocytes and erythroid progenitors in the fetus and hematological abnormalities in TAM. Transient abnormal myelopoiesis can be fatal in up to 10% of patients and resolves spontaneously. Therefore, laboratory examinations are very significant, including blood tests, peripheral blood smears, supporting examinations such as bone marrow aspiration, monitoring of clinical symptoms, and close monitoring of comorbidities. Examination repeat or follow-up bone marrow aspiration is required within six months of patient follow-up to reduce the risk of further complications. In this case, a follow-up examination is highly recommended because if there are no changes, the further examination must be carried out.