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Ni Made Renny A Rena
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SEORANG PENDERITA SINDROM NEFRITIK AKUT PASCA INFEKSI STREPTOKOKUS Renny A Rena, Ni Made; Suwitra, Ketut
journal of internal medicine Vol. 10, No. 3 September 2009
Publisher : journal of internal medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (83.779 KB)

Abstract

Acute nephritic syndrome is classically de! ned by symptoms of oliguria, oedem, hypertension and also urinalysisabnormality such as proteinuria less than 2 grams/day, hematuria, or ! nding of erytrocite silinder in the urine. The etiology ofacute nephritic syndrome are disorders of primary glomerulopathy (idiopathic), glomerulopathy after infection, DisseminatedLupus Erythomatosus (DLE), vasculitis and hereditary nephritis (Alport syndrome). Acute nephritic syndrome is one of clinicalmanifestation of acute glomerulonephritis after streptococcal infection, which is in" lamation occur on tubulus and glomerularof the kidney, after streptococcal infection of skin or upper respratory tract. The most frequent cause by particular strain ofhemolyticus streptococcus ß group A type 12. Herewith, we reported a case of acute glomerulonephritis after streptococcalinfection with clinical manifestation acute neph! tic syndrome. A fourteen years old Balinese male patient found with anasarcaoedem, oliguria and hematuria. Previous medical history with infection of throat 2 weeks before admitted to hospital. On physicalexamination, we found with Stage II hypertension, laboratory data shown urinalysis: hematuria and proteinuria, protein esbach3.25 gram/liter/day, ASTO 200 IU/ml, ANA test negative and throat swab isolated Streptococcus viridans, alpha hemoliticus.Imaging data showed right pleural effusion and bilateral nephritis of the kidney. Patient gives a good respon to corticosteroid(metilprednisolone), diuretic and also ACE inhibitor
KELAINAN HEMATOLOGI PADA DEMAM BERDARAH DENGUE 1Ni Made Renny A Rena, 2Susila Utama, 2Tuty Parwati M 1 Divisi Hematologi Onkologi Medik, 2 Divisi Penyakit Tropik dan Infeksi Bagian / SMF Ilmu Penyakit Dalam, FK Unud RSUP Sanglah Denpasar Email: renny_ang@ Renny A Rena, Ni Made; Utama, Susila; Parwati M, Tuty
journal of internal medicine Vol. 10, No. 3 September 2009
Publisher : journal of internal medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (382.732 KB)

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Dengue infection can cause a unique and complex alteration to the homeostasis mechanism of the body. The underlying of bleeding, as a more frequent clinical manifestation of dengue was based on multiple factors such as thrombocytopenia, thrombopathy, Disseminated Intravascular Coagulation (DIC), prolonged of bleeding time and prothrombin time, decrease of some coagulation factors, hypoÞ brinogenemia and also increasing of Þ brin degradation products. Beside, kinin and bradikinin sytem was also activated. Endothelial dysfunction as one of coagulopathy disorder in dengue infection patients can shown as some clinical manifestation. Antigen antibody complex of dengue, activated the coagulation system, start from Haegeman factor (factor XII become factor XIIa). Therefore, factor XIIa activated the others coagulation factors respectively until Þ brin are produced, Þ brinolysis system are also activated, plasminogen change become plasmin through enzymatic process. Disseminated intravascular coagulation, is an emergency complication of dengue infection, which occur because activation of coagulation system and decreasing of thrombocyte level. Others condition such as shock, hypoxia, and acidosis also thought to be the factors that cause the DIC. Deterioration of all of the hemopoesis system, which are hypoplasia occur on the beginning of the infection and increasing of erythropoesis after Þ fth day of infection. This is caused by direct suppression of the viral and activation of the proinß ammatory cytokines
Case Report Diagnosis and Management of Essential Trombositosis in RSUD Sanjiwani Gianyar and RSUP Sanglah Ni Wayan Sri Wardani; I Ketut Ery Purnama Warsana Putra; Ni Made Renny A Rena
WMJ (Warmadewa Medical Journal) Vol 3 No 1 (2018): May 2018
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.3.1.644.15-20

Abstract

Abstract. Essential thrombocythemia (ET) is a very rare disorder with 1- /100,000 population in the world. The incidence of this abnormality is still obscure in Indonesia. We report a case of ET, women of age 74 years old that came to Sanjiwani Hospital with gum bleeding. This case is confirmed based on WHO criteria of ET which are the increasing of thrombocyte of a number of increase >450 /µL3, proliferation of megakaryocyte cell on bone marrow biopsy, also not meeting any other WHO criteria for also not meeting any other WHO criteria for BCR-ABL1+CML, Polycythemia Vera, Chronic Myeloid Leukemia, Myelodysplastic Syndrome, or other myeloid neoplasm diseases. Management of this case is based on risk adapted treatment algorithm considering three major risk factors for thrombosis (history of thrombosis, JAK2/MPL mutations, and advanced age). This case is categorized as high risk patient for thrombosis, so that treated with antiplatelet aggregation (aspilets) and anagrelide after hydroxyurea clinically unresponsive.
Co-Authors I Ketut Ery Purnama Warsana Putra I Made Susila Utama Ketut Suwitra Ni Wayan Sri Wardani Tuty Parwati M