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Evaluasi Pemeriksaan Imunoglobulin E Spesifik Menggunakan Immunoblot Assay dengan Baku Emas Skin Prick Test Yudhistira; Ninik Sukartini; Suzanna Immanuel; Iris Rengganis
Cermin Dunia Kedokteran Vol. 46 No. 2 (2019): Interna
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i2.505

Pendahuluan. Skin Prick Test (SPT) merupakan baku emas diagnosis alergi, tetapi tidak dapat dilakukan pada kondisi tertentu seperti dermatografisme, hamil, tidak dapat lepas obat antialergi, sehingga pemeriksaan IgE spesifik menjadi pilihan. Di Indonesia belum ada data perbandingan pemeriksaan IgE spesifik dengan SPT. Penelitian ini dilakukan untuk menentukan sensitivitas, spesifisitas, PPV, NPV, LR+ dan LR- pemeriksaan IgE spesifik menggunakan analisis immunoblot. Metode. Penelitian menggunakan desain potong lintang. Subjek penelitian adalah pasien poliklinik alergi imunologi. Pengambilan sampel dengan metode non-probability sampling dengan teknik consecutive sampling. Analisis dilakukan terhadap alergen tungau debu rumah (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis) dan kecoa. Hasil. Seratus subjek yang memenuhi kiteria masukan dan tolakan (76% perempuan, rerata usia 38.9 tahun) ikut serta dalam penelitian ini. Sensitivitas empat alergen bervariasi dengan rentang 32.4%-76.8%, spesifisitas 68.0%-85.7%, PPV 54.5%-94.5%, NPV 46.2%-65.3%, LR+ 1.8-5.0, dan LR- 0.3-0.8.Sensitivitas pemeriksaan IgE spesifik cukup baik pada tiga tungau debu rumah tetapi rendah pada kecoa; spesifisitas dan PPV bervariasi cukup sampai baik; NPV cukup baik. Simpulan dan Saran. Uji diagnostik IgE spesifik tungau debu rumah menunjukkan hasil cukup baik. Pemeriksaan IgE spesifik tidak dapat digunakan untuk skrining alergi kecoa. Background. Skin Prick Test (SPT) is considered as gold standard for diagnosis of allergy, but cannot be performed in some conditions such as dermatographism, pregnancy, and unable to abstain from antiallergy drugs. In these conditions, specific-IgE test is a test of choice. But there is no comparison data on specific IgE test with SPT in Indonesia. This study was to investigate sensitivity, specificity, PPV, NPV, LR+, and LR- of specific-IgE test of immunoblot assay kit. Method. The study was cross-sectional. Subjects were patients from allergy-immunology clinic who fulfilled inclusion and exclusion criteria. Sampling was performed using non-probability sampling method with consecutive technique. Analysis was performed for house dust mite allergen (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis) and cockroach. Result. Hundred subjects (76% was female, average age of 38.9 years) were involved. Sensitivity of four allergens were varied with range 32.4%-76.8%, specificity 68.0%-85.7%, PPV 54.5%-94.5%, NPV 46.2%-65.3%, LR+ 1.8-5.0, and LR- 0.3-0.8. Sensitivities of specific-IgE for three species of house dust mite were moderate, but low for cockroach; specificities and PPVs were moderate to high; NPVs were moderate. Conclusion. Diagnostic test of specific-IgE with house dust mite allergen shows adequate result. Specific IgE test cannot be utilized for screening of cockroach allergy.

Efek Tetes Mata Kombinasi Sodium Hialuronat dan Hydroxypropyl-Guar terhadap Stabilitas Lapisan Air Mata pada Mata Kering Terkait Sindrom Sjögren Indira Priya Darsini; Lukman Edwar; Iris Rengganis; Lisnawati; Joedo Prihartono
Cermin Dunia Kedokteran Vol 46 No 1 (2019): Obstetri-Ginekologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i1.521

Penelitian ini bertujuan untuk menilai stabilitas lapisan air mata pada mata kering terkait sindrom Sjögren (SS) yang diberi terapi tetes mata kombinasi sodium hialuronat 0,1% (SH) dan hydroxypropyl (HP)-guar, atau monoterapi tetes mata sodium hialuronat (SH). Sebanyak 17 pasien SS dibagi dalam 2 kelompok. Kelompok pertama mendapat kombinasi SH dan HP-guar, kelompok kedua mendapat terapi SH. NIKBUT, Schirmer, skor pewarnaan okular, dan sitologi impresi, serta keluhan subjektif dinilai sebelum dan sesudah pemberian obat. Setelah terapi selama 28 hari, terdapat peningkatan median NIKBUT, Schirmer, skor pewarnaan okular, densitas sel Goblet, dan perbaikan keluhan subjektif pada mata kering terkait SS. The objectives of the study is to assess the stability of dry eye LAM associated with Sjögren syndrome (SS) during combination therapy of sodium hyaluronate 0.1% (SH) and hydroxypropyl (HP) -guar, or monotherapy sodium hyaluronic (SH). A total of 17 SS patients in this study were divided into 2 groups. The first group received a combination of SH and HP-guar while the second group received SH therapy. NIKBUT, Schirmer, ocular staining score, and impression cytology, as well as subjective complaints was assessed before and after drug administration. After 28 days of therapy, there was a median increase in NIKBUT, Schirmer, ocular staining scores, Goblet cell density, and subjective complaints on SS-related dry eyes.

Predictors of Mortality in Hospitalized HIV/AIDS Patients Puspitasari, Estie; Yunihastuti, Evy; Rengganis, Iris; Rumende, Cleopas Martin
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 1
Publisher : UI Scholars Hub

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Introduction. Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) is a big problem that threatening in Indonesia and many countries in the world. The knowledge on the characteristics and prediction of outcome were important for patients management. There are no studies on the predictors of mortality in Indonesia. Methods. We performed a retrospective cohort study among hospitalized patients with HIV/AIDS in Cipto Mangunkusumo Hospital between 2011-2013. Datas on clinical, laboratory measurement, outcome (mortality) and causes of death during hospitalization were gathered from medical records. Bivariate analysis using Chi- Square test were used to evaluate seven prognostic factors (male sex, not came from referral hospital, never received/failed to continue antiretroviral therapy (ART), clinical WHO stage 4, hemoglobin level /dL, eGFR level /min/1.73 m2 and CD4+ count ≤200 cell/µL). Multivariate logistic regression analysis was performed to identify independent predictors of mortality. Results. Among 606 hospitalized HIV/AIDS patients (median age 32 years; 64.2% males), 122 (20.1%) were newly diagnosed with HIV infection during the hospitalization and 251 (41.5%) had previously received ART. Median length of stay was 11 (range 2 to 75) days. There were 425 (70.1%) patients being hospitalized due to opportunistic infection. In-hospital mortality rate was 23.4% with majority (92.3%) due to AIDS related illnesses. The independent predictors of mortality in multivariate analysis were clinical WHO stage 4 (OR=6.440; 95% CI 3.701-11.203), hemoglobin level /dL (OR=1.542; 95% CI 1.015- 2.343) and eGFR level /min/1.73 m2 (OR=3.414; 95% CI 1.821-6.402). Conclusions. In-hospital mortality rate was 23.4%. Clinical WHO stage 4, hemoglobin level /dL and eGFR level / min/1.73 m2 were the independent predictors of in-hospital mortality among hospitalized patients with HIV/AIDS.

Peranan Gejala Klinis dan Pemeriksaan Darah Tepi dalam Diagnosis Dini Influenza pada Pasien dengan Gejala Influenza Like Illness Susilo, Adityo; Suwarto, Suhendro; Rengganis, Iris; Harimurti, Kuntjoro
Jurnal Penyakit Dalam Indonesia Vol. 1, No. 2
Publisher : UI Scholars Hub

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Pendahuluan. Influenza merupakan penyakit infeksi yang disebabkan oleh virus influenza. Pada manusia, influenza sering menimbulkan penyakit pernapasan akut dengan manifestasi klinis berupa influenza like illness. Penegakkan diagnosis influenza seringkali sulit oleh karena manifestasi klinis yang tidak khas. Demam disebut sebagai gejala klinis terpenting dan limfopenia didapatkan sebagai suatu temuan laboratoris yang konsisten. Usaha untuk mengetahui proporsi dan mengelaborasi gejala klinis dan pemeriksaan darah tepi sederhana diperkirakan dapat meningkatkan probabilitas diagnosis influenza. Tujuan. Mengetahui proporsi influenza serta mengevaluasi peranan gejala klinis dan pemeriksaan laboratorium sederhana pada pasien penyakit pernapasan akut dengan influenza like illness sehingga dapat digunakan sebagai faktor prediktif terhadap diagnosis influenza. Metode. Studi potong lintang berbasis diagnostic research pada pasien penyakit pernapasan akut dewasa dengan gejala influenza like illness di Puskesmas Kecamatan Pulo Gadung dan Puskesmas Kelurahan Rawamangun antara Maret hingga Juni 2011. Spesimen analisis virus menggunakan bahan apus nasofaringeal, dengan teknik analisis PCR kualitatif dan imunokromatografi antigen. Hasil. Dari 90 orang subyek penelitian didapatkan 13 orang (14,4%) terbukti terinfeksi virus influenza A melalui teknik PCR. Variabel demam menunjukkan hasil uji kemaknaan yang signifikan terhadap influenza (p 0,003) dengan prevalence ratio 6,28 (95% CI 1,476-26,759). Sensitifitas demam, batuk dan pilek terhadap influenza masing-masing adalah 85% dan negative predictive value demam sebesar 98%. Variabel determinan lainnya tidak menunjukkan hasil yang bermakna terhadap influenza pada uji kemaknaan statistik. Simpulan. Proporsi influenza pada pasien dengan gejala ILI diperoleh cukup tinggi dengan proporsi demam yang terbukti lebih tinggi pada pasien influenza. Sensitivitas demam, batuk dan pilek terhadap influenza tinggi dengan negative predictive value yang memuaskan untuk seluruh variabel determinan

Vaksinasi pada Lansia Rengganis, Iris
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 4
Publisher : UI Scholars Hub

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Approach to Diagnosis and Treatment of Drug Allergy Pandapotan, Roy Akur; Rengganis, Iris
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 1
Publisher : UI Scholars Hub

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Drug allergy is a serious medical problem. Drug allergy can be defined as an adverse drug reaction involving immunological mechanism. However, it is not easy to decide whether an adverse drug reaction is an allergic reaction, and it requires a systematically diagnostic approach. Beside a thorough history taking and physical examination, there are general and specific laboratory examination to investigate drug allergy which can be done in vivo, in vitro, or biopsy. The management of drug allergy include the avoidance of the precipitating event, and specific methods to reduce the drug reaction which include threating through, dosing test, desensitization, and the administration of premedication for certain drugs.

Proporsi Defisiensi Vitamin D pada Pasien Poliklinik Alergi dan Imunologi Iris Rengganis; Aria Kakalih; Danny Rasjiid Garna
Cermin Dunia Kedokteran Vol 46 No 12 (2019): Kardiovakular
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i12.394

Vitamin D mempengaruhi dan meregulasi fungsi sistem imun tubuh. Tujuan: Mengetahui proporsi defisiensi vitamin D-25(OH) pasien poliklinik Alergi dan Imunologi, serta untuk meninjau tatalaksana defisiensi vitamin D-25(OH) di poliklinik Alergi dan Imunologi. Metode: Penelitian retrospektif data rekam medis pasien Poliklinik Alergi dan Imunologi yang mendapat terapi vitamin D serta kadar vitamin D-25 (OH). Hasil: Sejumlah 97,1% pasien memiliki kadar vitamin D kurang dari normal (insufisiensi vitamin D dan defisiensi vitamin D). Setelah pemberian vitamin D dosis tinggi (1000 IU/hari atau lebih) selama 3 bulan, terjadi peningkatan bermakna status vitamin D. Simpulan: Proporsi defisiensi vitamin D tinggi pada pasien penyakit imunologi dan pemberian vitamin D dosis tinggi (1000 IU/hari atau lebih) dapat meningkatkan status vitamin D pasien dengan penyakit imunologi. Vitamin D plays a role in influencing and regulating the function of the immune system in the body. Objective: To determine the proportion of vitamin D-25 (OH) deficiency in patients in the Allergy and Immunology Polyclinic, and to evaluate the management of vitamin D-25 (OH) deficiency in patients in the Allergy and Immunology Polyclinic. Methods: Retrospective study on medical records data from Allergy and Immunology Polyclinic patients with vitamin D-25 (OH) level data and with vitamin D therapy. Results: Vitamin D level less than normal in 97,1% patients. After administration of high dose vitamin D (1000 IU/day or more) for 3 months, a significant increase in the patient’s vitamin D status was observed. conclusion: The proportion of vitamin D deficiency in patients with immunological diseases is high and administration of high doses vitamin D (1000 IU/day or more) can improve the vitamin D status

Evaluasi Pemeriksaan Imunoglobulin E Spesifik Menggunakan Immunoblot Assay dengan Baku Emas Skin Prick Test Yudhistira; Ninik Sukartini; Suzanna Immanuel; Iris Rengganis
Cermin Dunia Kedokteran Vol 46 No 2 (2019): Interna
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i2.505

Pendahuluan. Skin Prick Test (SPT) merupakan baku emas diagnosis alergi, tetapi tidak dapat dilakukan pada kondisi tertentu seperti dermatografisme, hamil, tidak dapat lepas obat antialergi, sehingga pemeriksaan IgE spesifik menjadi pilihan. Di Indonesia belum ada data perbandingan pemeriksaan IgE spesifik dengan SPT. Penelitian ini dilakukan untuk menentukan sensitivitas, spesifisitas, PPV, NPV, LR+ dan LR- pemeriksaan IgE spesifik menggunakan analisis immunoblot. Metode. Penelitian menggunakan desain potong lintang. Subjek penelitian adalah pasien poliklinik alergi imunologi. Pengambilan sampel dengan metode non-probability sampling dengan teknik consecutive sampling. Analisis dilakukan terhadap alergen tungau debu rumah (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis) dan kecoa. Hasil. Seratus subjek yang memenuhi kiteria masukan dan tolakan (76% perempuan, rerata usia 38.9 tahun) ikut serta dalam penelitian ini. Sensitivitas empat alergen bervariasi dengan rentang 32.4%-76.8%, spesifisitas 68.0%-85.7%, PPV 54.5%-94.5%, NPV 46.2%-65.3%, LR+ 1.8-5.0, dan LR- 0.3-0.8.Sensitivitas pemeriksaan IgE spesifik cukup baik pada tiga tungau debu rumah tetapi rendah pada kecoa; spesifisitas dan PPV bervariasi cukup sampai baik; NPV cukup baik. Simpulan dan Saran. Uji diagnostik IgE spesifik tungau debu rumah menunjukkan hasil cukup baik. Pemeriksaan IgE spesifik tidak dapat digunakan untuk skrining alergi kecoa. Background. Skin Prick Test (SPT) is considered as gold standard for diagnosis of allergy, but cannot be performed in some conditions such as dermatographism, pregnancy, and unable to abstain from antiallergy drugs. In these conditions, specific-IgE test is a test of choice. But there is no comparison data on specific IgE test with SPT in Indonesia. This study was to investigate sensitivity, specificity, PPV, NPV, LR+, and LR- of specific-IgE test of immunoblot assay kit. Method. The study was cross-sectional. Subjects were patients from allergy-immunology clinic who fulfilled inclusion and exclusion criteria. Sampling was performed using non-probability sampling method with consecutive technique. Analysis was performed for house dust mite allergen (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis) and cockroach. Result. Hundred subjects (76% was female, average age of 38.9 years) were involved. Sensitivity of four allergens were varied with range 32.4%-76.8%, specificity 68.0%-85.7%, PPV 54.5%-94.5%, NPV 46.2%-65.3%, LR+ 1.8-5.0, and LR- 0.3-0.8. Sensitivities of specific-IgE for three species of house dust mite were moderate, but low for cockroach; specificities and PPVs were moderate to high; NPVs were moderate. Conclusion. Diagnostic test of specific-IgE with house dust mite allergen shows adequate result. Specific IgE test cannot be utilized for screening of cockroach allergy.

Efek Tetes Mata Kombinasi Sodium Hialuronat dan Hydroxypropyl-Guar terhadap Stabilitas Lapisan Air Mata pada Mata Kering Terkait Sindrom Sjögren Indira Priya Darsini; Lukman Edwar; Iris Rengganis; Lisnawati; Joedo Prihartono
Cermin Dunia Kedokteran Vol 46 No 1 (2019): Obstetri-Ginekologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i1.521

Penelitian ini bertujuan untuk menilai stabilitas lapisan air mata pada mata kering terkait sindrom Sjögren (SS) yang diberi terapi tetes mata kombinasi sodium hialuronat 0,1% (SH) dan hydroxypropyl (HP)-guar, atau monoterapi tetes mata sodium hialuronat (SH). Sebanyak 17 pasien SS dibagi dalam 2 kelompok. Kelompok pertama mendapat kombinasi SH dan HP-guar, kelompok kedua mendapat terapi SH. NIKBUT, Schirmer, skor pewarnaan okular, dan sitologi impresi, serta keluhan subjektif dinilai sebelum dan sesudah pemberian obat. Setelah terapi selama 28 hari, terdapat peningkatan median NIKBUT, Schirmer, skor pewarnaan okular, densitas sel Goblet, dan perbaikan keluhan subjektif pada mata kering terkait SS. The objectives of the study is to assess the stability of dry eye LAM associated with Sjögren syndrome (SS) during combination therapy of sodium hyaluronate 0.1% (SH) and hydroxypropyl (HP) -guar, or monotherapy sodium hyaluronic (SH). A total of 17 SS patients in this study were divided into 2 groups. The first group received a combination of SH and HP-guar while the second group received SH therapy. NIKBUT, Schirmer, ocular staining score, and impression cytology, as well as subjective complaints was assessed before and after drug administration. After 28 days of therapy, there was a median increase in NIKBUT, Schirmer, ocular staining scores, Goblet cell density, and subjective complaints on SS-related dry eyes.

Correlation of Dermatophagoides Pteronyssinus with Serum Der-P Spesific Ige and Igg4 Nuraeni, Hanny Siti; Wibowo, Heri; Kwarta, Cytyta Putri; Rengganis, Iris
jitek Vol 13 No 1 (2025): September 2025
Publisher : Poltekkes Kemenkes Jakarta III

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32668/jitek.v13i1.1925

Repeated exposure to allergens induces an increase in regulatory T cells that produce interleukin 10 (IL-10) that can lead to B cells switching to immunoglobulin G4 (IgG4). Allergen-specific IgE was used as marker of allergen exposure but was only detected in atopic subjects, not in normal subjects. Therefore, an immunological marker that could be used to scan for exposure is needed. This study was conducted to determine Dermatophagoides pteronyssinus (Der p) density, serum IgE and IgG4-specific Der p levels, and to determine the correlation of Der p density with specific serum levels of IgE and IgG4 Der p in normal and atopic subjects. We calculated the amount and density of Der p in house dust mites (HDM) using the Fain and Hart (1986) method and measured Der p serum levels of IgE and IgG4 using indirect ELISA. We found that the most dominant HDM species was Der p. IgE-specific Der p level in atopic asthma patients were higher than in normal patients (p=0.002), whereas IgG4-specific Der p level in both atopic asthma and normal patients did not exhibit significant differences (p= 0.667). The density of Der p demonstrated a positive correlation with IgG4-specific Der p levels (Spearman r=0.388, p=0.008) compared to IgE-specific Der p.Compared to IgE, the density of Der p demonstrated a correlation with Der p-specific serum IgG4 levels, which means that Der p-specific IgG4 can be used to determine the exposure and accumulation of Der p in the residence of subjects.

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