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All Journal Medical Journal of Indonesia Indonesian Journal of Cancer Indonesian Journal of Rheumatology World Nutrition Journal Indonesian Journal of Cancer The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia
Ikhwan Rinaldi
Divisi Hematologi Onkologi Medik, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia, Rumah Sakit Dr. Cipto Mangunkusumo
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Polisitemia Sekunder pada Pasien Laki-Laki Muda dengan Sindrom Nefrotik Wardhani, Ariani Intan; Nugroho, Pringgodigdo; Rinaldi, Ikhwan; Sarasawati, Meilania; Miranda, Monik Ediana; Harahap, Agnes Stephanie
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

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Abstract

Polycythemia is a condition characterized by an abnormal increase in the total red blood cell mass and is classified into primary and secondary polycythemia. Secondary polycythemia occurs as a physiological response to tissue hypoxia or increased erythropoietin production, without intrinsic abnormalities in erythroid progenitor cells. This condition is rare, particularly when associated with nephrotic syndrome. This report aims to describe a case of secondary polycythemia associated with focal segmental glomerulosclerosis (FSGS). A 20-year-old man presented with generalized edema for five months prior to admission, accompanied by foamy urine. Physical examination revealed peripheral edema and minimal ascites. Laboratory investigations demonstrated massive proteinuria and elevated hemoglobin levels. Renal biopsy confirmed the diagnosis of FSGS, while bone marrow biopsy showed normocellular findings without evidence of malignancy or fibrosis. The patient was treated with methylprednisolone, ramipril, and simvastatin, and underwent four sessions of phlebotomy along with antiplatelet therapy. Following treatment, there was improvement in hemoglobin levels, proteinuria, and blood pressure control. Secondary polycythemia has been reported to be associated with various parenchymal kidney diseases, including FSGS. The proposed mechanisms include increased erythropoietin production due to renal ischemia or dysregulation of erythropoiesis feedback mechanisms. Phlebotomy is an important therapeutic intervention to prevent complications related to hyperviscosity and thromboembolism and has been shown to result in clinical improvement. This case illustrates a rare occurrence of secondary polycythemia in a patient with nephrotic syndrome due to FSGS. Accurate diagnosis and comprehensive management, including phlebotomy, can lead to meaningful clinical improvement. This report is expected to contribute to the literature on the diagnosis and management of secondary polycythemia in kidney disease.
Optimalisasi Rekam Medis Elektronik Berbasis Artificial Intelligence Rinaldi, Ikhwan; Sulistiadi, Wahyu
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

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Abstract

Electronic medical records (EMRs) are essential to modern healthcare systems, yet their implementation continues to face challenges such as disruption of doctor–patient communication, administrative burden, and documentation structures misaligned with clinicians’ clinical reasoning processes. This narrative review aims to assess the limitations of conventional EMRs and examine the potential of artificial intelligence (AI) to improve documentation efficiency, accuracy, and overall clinical performance. The literature indicates that AI technologies, including machine learning, deep learning, and natural language processing, can automate documentation, streamline workflows, enhance decision support, and reduce physician burnout, thereby allowing clinicians to devote more attention to patient care. Nevertheless, the integration of AI into EMRs must address ethical concerns such as algorithmic bias, data privacy, and accountability for AI-assisted decisions. In conclusion, AI-driven EMR optimization has the potential to create a more human-centered, efficient, and data-driven documentation ecosystem when supported by strong regulatory and ethical frameworks.
Co-Authors Achmad Fauzi Achmad Fauzy, Achmad Adhiatma, Kresna Adityo Susilo, Adityo Adna, Rury Maharani Afifah Is Agnes Stephanie Harahap Agus Sudiro Waspodo Aida Lydia Andhika Rachman Andri Sanityoso Sulaiman Angraeni, Sri Anna Rozaliyani Ari Fahrial Syam Arif Harryanto Reksodiputro Arif Harryanto Reksodiputro, Arif Harryanto Arini Setiawati Arry Haryanto Reksodiputro Artati Murwaningrum, Artati Bambang Setyohadi Bambang Setyohadi Birry Karim C Rinaldi A Lesmana Ceva W. Pitoyo Cleopas Martin Rumende Cleopas Martin Rumende Cosphiadi Irawan Czeresna Heriawan Soejono Dadang Makmun Dewi Mira Ratih Diana Sunardi Djatikusumo, Ari Dono Antono Dyah Purnamasari E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Edy Rizal Wahyudi Em Yunir Em Yunir, Em Endang Susalit Endy Novianto Endy Novianto, Endy Evy Yunihastuti Findy Prasetyawati Findy Prasetyawati, Findy Firsyada, Fajar Gurmeet Singh Hasan Maulahela Henry Ratno Diono Silalahi Henry Ratno Diono Silalahi, Henry Ratno Diono HILMAN TADJOEDIN, HILMAN Ibrahim, Febiansyah Ika Prasetya Wijaya Ilyas, Mohammad Imelda Maria Loho, Imelda Maria Iris Rengganis Irsan Hasan Jerry Eddya Putra Boer Juferdy Kurniawan Kaka Renaldi Karmel L Tambunan, Karmel L Kuntjoro Harimurti Kusumaningrum, Profitasari Kusumowidagdo, Gladys Lestari, Regina Lianda Siregar Lisnawati Rachmadi Lugyanti Sukrisman Lukman Edwar Lutfiah, Evah Marbun, Maruhum Bonar Hasiholan Mardianto, Umar Margaluta, Ariansah Martin, Cleopas Maruhum B.H. Marbun Miranda, Monik Ediana Mohammad, Nurhidayat Muhadi Muhadi Muhadi Muhadi, Muhadi MUHAMMAD SYAFIQ Muningtya Philiyanisa Alam Murdani Abdullah Murdani Abdullah Mustopa, Inna Intani Nabil Mubtadi Falah Nabil Mubtadi Falah, Nabil Mubtadi Nikko Darnindro Noto Dwimartutie Nunuk Mardiana, Nunuk Pratiwi, Amalia Nur Pringgodigdo Nugroho, Pringgodigdo Purwita Wijaya Laksmi Rahmat Cahyanur Rahmat Cahyanur Rasco Sandy Sihombing Rasco Sandy Sihombing, Rasco Sandy Ratih, Dewi Mira Regina Lestari Reinaldo Alexander Reksodiputro, Arry H. Reza Yogaswara Rino Alvani Gani Robert Sinto Rudi Putranto Rudi Putranto Rudy Hidayat Rudy Hidayat Sabrina Munggarani Yusuf Sarasawati, Meilania Saskia Aziza Nursyirwan, Saskia Aziza Sepmeitutu, Iwandheny Shufrie Effendi, Shufrie Sukamto Koesnoe Sulaiman, Andri Andri T. Djumhana Atmakusuma, T. Djumhana Tanadi, Caroline Tengku Riza Zarzani N Tri Juli Edi Tarigan Triyanta Yuli Pramana Virnanda Amu, Ivan Wahyu Sulistiadi Wardhani, Ariani Intan Wardoyo, Elizabeth Y Wardoyo, Elizabeth Yasmine Yogaswara, Reza Yudantha, Anggun R.