Garuda - Garba Rujukan Digital

Correlation of matrix metalloproteinase-9 level, erythrocyte sedimentation rate, rheumatoid factor, and the duration of illness with radiological findings in rheumatoid arthritis patients G Aji; Ida Ayu Ratih Wulansari Manuaba; Jeffrey A Ongkowijaya; Bambang Setiyohadi; Sumariyono Sumariyono
Indonesian Journal of Rheumatology Vol. 2 No. 1 (2010): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Background: Rheumatoid arthritis (RA) is a common autoimmune disease of the joint indicated by chronic inflammation of synovium, cartilage destruction, and osteopenia. The end results of RA are joint deformity and disability that will decrease the quality of life ofthe patients. Until now there is not a specifi c marker to assess the process of joint and bone damage in RA. Available markers such as C-reactive protein and erythrocyte sedimentation rate (ESR) indicate more about the infl ammatory status of the patient. Thediscovery of matrix metalloproteinases (MMPs) enzyme overexpression in RA has brought a new hope for the discovery of more specifi c markers of joint damage.Objective: To study the correlation of MMP-9 level, ESR, rheumatoid factor (RF), and the duration of illness with joint damage in RA patients.Methods: A cross-sectional study was conducted on RA outpatients in rheumatology clinic at Cipto Mangunkusumo General Hospital, Jakarta from January to October 2009. From the patients who fulfilled the inclusion criteria and did not fulfi ll the exclusion criteria, blood sample was collected for MMP-9 level, RF, and ESR examinations; hand radiography (posterior-anterior view) was also taken. Results: From the study of 46 patients, we found a significant correlation between MMP-9 level and radiographic feature of bone erosion (r = 0.3, p = 0.02) and between the duration of illness and Sharp score (r = 0.36, p = 0.014). There was no correlation between ESR and radiological fi ndings nor between RF and radiological fi ndings. Linear regression analysis showed the duration of illness as the most infl uencing factor toradiological fi ndings in RA patients.Conclusion: We found a signifi cant correlation between MMP-9 level and radiographic feature of bone erosion, and between the duration of illness and radiological fi ndings in RA patients.

Arthritis in leprosy without specific skin lesion Sumartini Dewi; Bambang Setiyohadi
Indonesian Journal of Rheumatology Vol. 2 No. 1 (2010): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Leprosy patients could display a great variability of signs and symptoms. An overabundance of rheumatic manifestations, occuring alone or in varying combinations, are associated with leprosy, particularly with lepra reactions A study involving seventy cases of leprosy found that rheumatic manifestations were seen in 61.42% of cases: arthritis in 54.28% and soft tissue rheumatism in 17.14%. Enthesitis was seen in 2.84% of cases. Rheumatic manifestations may be the primary complaint, thus delaying accurate diagnosis. Musculoskeletal involvement in leprosy is the third most frequent manifestation after dermatological and neurological involvements. It can occur at anytime during the infection. Articular inflammation in leprosy, which closely mimics other rheumatic disorders, usually occurs in reactive states, particularly erythema nodosum leprosum (ENL).1 About 1â€“5% of leprosy patients are reported of developing arthritis (synovial inflammation) at some stage of the disease but this rate increases to over 50% during lepra reactions.2 Here we report a case of arthritis in leprosywithout any typical skin lesion thus causing a delay in diagnosis.

Complete manifestations of BehÃ§etâ€™s disease V Umami; Bambang Setiyohadi
Indonesian Journal of Rheumatology Vol. 2 No. 1 (2010): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

BehÃ§etâ€™s disease (BD) is a chronic, relapsing, inflammatory disease characterized by recurrent oral aphthae and any of several systemic manifestations that include genital aphthae, ocular disease, skin lesions, neurologic disease, vascular disease, or arthritis. Hippocrates may had described BD in the fifth century B.C.; however, the first official description of the syndrome was attributed to the Turkish dermatologist Hulusi BehÃ§et in 1924. In 1930, the Greek physician Adamantiades reported a patient with inflammatory arthritis, oral and genital ulcers, phlebitis, and iritis.1 Since then, the syndrome has been referred to as BD.1,2 The manifestations of BD are thought to be caused by an underlying vasculitis. Although this disease is recognized worldwide, the prevalence is highest in the eastern Mediterranean, the Middle Eastern, and East Asian countries, thus the nickname Silk Road disease. The disease tends to be more severe in areas where it is more common. Prevalence rates all over the world are increasing, probably because of improved recognition and reporting. BehÃ§etâ€™s disease occurs primarily in young adults. The mean age at onset is between 25 and 30 years. The incidence of disease in males and females is approximately equal along the Silk Road, but in Japan, Korea, and Western countries the disease occurs more frequently in women. Caseconfirmation can be challenging because many patients labeled as having BD have oral ulcers as the primary or sole manifestation.3

Erosive osteoarthritis Jeffrey A Ongkowijaya; Bambang Setiyohadi; Sumariyono Sumariyono
Indonesian Journal of Rheumatology Vol. 2 No. 1 (2010): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Osteoarthritis (OA) is a degenerative joint disease characterized by the erosion of cartilage joints, hypertrophy of the marginal bone, subchondral sclerosis, and the morphological and biochemical changes of synovial membrane and joint capsule.This clinical syndrome is characterized by joint pain caused by degeneration of the joints. It is the most common joint disease to afflict the elderly and it occurs more often with age.1â€“3 Erosive osteoarthritis is a subset of OA in which there is a destruction of the joints as a result of inflammation.3,4 Changes mainly occur on the distal interphalangeal (DIP) joints, proximal interphalangeal (PIP) joints, carpometacarpal (CMC) joints, and very rarely occur on other joints of hand or of other body parts.3â€“5 The diagnosis is in accordance with the criteria of American College of Rheumatology (ACR) for OA and is supported by the existence of bone erosion on the radiological image. The management of this disease is merely for palliative purpose.

Risk of cardiovascular disease in rheumatoid arthritis patients A P Utari; Rudy Hidayat; Bambang Setiyohadi
Indonesian Journal of Rheumatology Vol. 3 No. 1 (2011): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Despite rheumatoid arthritis (RA) therapy development has been in advance level today, its mortality remains increasing in general population. The mortality is mainly caused by early-manifested atherosclerosis and other cardiovascular complications. Available evidences showthis condition appears in early stage of the disease. Thus, early detection and management of cardiovascular risk, followed by control of these factors are necessaryto reduce morbidity and mortality of RA patients

Experience with cyclophosphamide in the treatment of a young woman with refractory dermatomyositis Bambang Setiyohadi; R Sinto
Indonesian Journal of Rheumatology Vol. 3 No. 1 (2011): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Dermatomyositis is an idiopathic inflammatory myopathy characterized by the presence of rash and moderate-to-severe muscle weakness secondary to inflammation of the muscle. It can be a difficult condition to treat. Systemic corticosteroids are the first choice of treatment. However, about a quarter of patients either fail to respond to steroids or develop steroid-related toxicity. Second-line agents such as azathioprine and methotrexate are then added either alone, or in combination with corticosteroids. Failure of the disease to respond tosecond-line agents can then be a problem and this is often referred to as â€œrefractory dermatomyositisâ€. Unfortunately, there is neither agreement nor wellestablished guidelines on the best regimen or combination of immunosuppressive agents in the case of refractory dermatomyositis.

Septic arthritis in malignancy Bambang Setiyohadi; D Santosa; Titis Titis; A A Abdullah
Indonesian Journal of Rheumatology Vol. 3 No. 1 (2011): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Septic arthritis is an infection of a joint, which canbe caused by bacteria, viruses, fungi, or parasites. The infection may happen in distant sites of the body, which then spread hematogenously, or it could also result from open wounds, surgery, or unsterile injections.1 Septic arthritis is a serious condition that, if left undiagnosed and untreated, can cause joint destruction and an irreversible loss of joint function.2,3 Based on epidemiological data, the incidence of septic arthritis in general population is 2â€“10 cases in 100,000 people annually and is increased in those who have risk factors for septic arthritis, such as rheumatoid arthritis (RA) and joint prosthesis. In those with RA, the incidence of septic arthritis rises up to 30â€“70 cases in 100,000 people annually, and in those with prosthesis the figure is around 40â€“68 cases in 100,000 people annually.4,5 Septic arthritis can affect all age groups, but it is more prevalence in the elderly and in children under 5 years old, in which the prevalence is 8.4 and 5 cases, respectively, in 100,000 people annually.5 Septic arthritis is usually monoarticular, whereas polyarticular involvement occurs in only 10â€“15% of cases. The knee is involved in around 50% of cases.Septic arthritis is still a challenge for cliniciansince there has not been a significant decline in both morbidity and mortality in the last two decades.2 Late recognition and therapy can cause permanent joint dysfunction and even death; thus, early diagnosis and prompt therapy is expected to decrease the morbidity and mortality rate in septic arthritis.6 In this case report we would like to present a case of a woman suffering from septic arthritis with an underlying immunocompromised condition of malignancy

Correlation of interleukin-17 with disease activity and hand joint damage in patients with rheumatoid arthritis Jeffrey Arthur Ongkowijaya; Bambang Setiyohadi; Ida Ayu Ratih Wulansari Manuaba; Yoga I Kasjmir
Indonesian Journal of Rheumatology Vol. 2 No. 2 (2010): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Background: Rheumatoid arthritis (RA) is a disease involving various types of cytokines. One of them is interleukin-17 (IL-17), which is known to have a pleiotropic effect on various of cells and is thought to be a cytokine effector contributing to the pathogeniccondition in RA.Methods: The study was conducted on 46 RA patients at rheumatology clinic at the Cipto Mangunkusumo General Hospital who were diagnosed based on the 1987 American College of Rheumatology criteria. Sample selection was done using consecutive sampling. Tests on patients were conducted to collect data needed to obtain the scores for 28-joint Disease Activity Score (DAS28), global health visual analogue scale, swollen joint count, tender joint count, sedimentation rate, Sharp score (radiograph of both hands), and the IL-17 level.The correlation between IL-17 level and DAS28 wasÂ calculated using the Pearsonâ€™s correlation test while the correlation between IL-17 level and Sharp score was calculated using the Spearmanâ€™s test.Results: The majority of patients (87%) were women. The largest percentage was in the 51- to 60-year-old group (39.1%). Most patients (43.1%) had moderate disease activity. There were 27 patients (58.69%) with positive rheumatoid factor. The mean IL-17 level was17.28 pg/mL with a standard deviation of 11.43 pg/mL. There was no correlation of IL-17 level with disease activity (p = 0.446, r = 0.021) and Sharp score (p = 0.304, r = 0.077) in subjects of this study.Conclusion: There was no signifi cant correlation of IL-17 with disease activity and joint damage.

Prevalence of antiâ€“C-reactive protein autoantibody and its correlation with disease activity in systemic lupus erythematosus patients at Cipto Mangunkusumo General Hospital Lusiani Lusiani; Bambang Setiyohadi; N Sukmana; M Abdullah
Indonesian Journal of Rheumatology Vol. 2 No. 2 (2010): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Background: Systemic lupus erythematosus (SLE) is a complex autoimmune disease with various underlying mechanisms characterized by autoantibody overproduction. It has been known that mortality and morbidity of SLE was higher in Asian patients compared with white patients. Several studies had showed that C-reactive protein (CRP) has the ability to suspend the progression of SLE through regulatory and clearance pathway, and low level of CRP and high level of anti-CRP antibody has been detected in SLE patients. A question raise whether mortality and morbidity in Asian SLE patients are associated with anti-CRP antibody.Objective: To study the prevalence of anti-CRP antibody and its relationship with disease activity in SLE patients at Cipto Mangunkusumo General Hospital,Jakarta.Methods: This is a cross-sectional study conducted at Cipto Mangunkusumo General Hospital from December 2009 until May 2010. Subjects were SLE patients whowere diagnosed based on the 1982 American College of Rheumatology criteria. Disease activity was measured using the Mexican SLE Disease Activity Index scoringsystem. Anti-CRP antibody assay was performed using the Western blot analysis. Correlation between the presence of anti-CRP antibody and disease activitywas evaluated using the T-test and multivariate logistic regression analysis.Result: Forty SLE patients with a mean age of 31.65 (SD 8.84) were enrolled in the study, 33 of which (82.5%) had positive autoantibody to CRP pentamer. The anti-CRP antibody was signifi cantly correlated (p = 0.024) with disease activity. Conclusions: There was a relatively large proportion of patients with positive anti-CRP antibody among SLE patients in Cipto Mangunkusumo General Hospital. Therewas also a signifi cant correlation between anti-CRP antibody and the disease activity.

Invasive aspergillosis in a systemic lupus erythematosus patient Bambang Setiyohadi; M S Azizi; Ika Wulan Yuliani; N Sukmana; Suhendro Suhendro; M Simadibrata; C Matin Rumende; A S Sulaiman; R Wahyuningsih; Lisnawati Lisnawati; M A Yudharto; N Anggraini; F Oktaviana; R Sandra
Indonesian Journal of Rheumatology Vol. 2 No. 2 (2010): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Systemic lupus erythematosus (SLE) is an autoimmune disease with a broad clinicalmanifestation characterized by production of antibodies against cellular nuclear components. The prevalence of SLE among many countries is variable, ranging from 2.9 to 400 per 100,000. In Cipto Mangunkusumo General Hospital, the incidence of SLE between 1990 and 1998 is 37.3 per 10,000 hospitalization.1 Patients with autoimmune disease have at least twofold risk of acquiring infections compared with healthy individuals. This may be due to the immunosuppresant therapy but could also caused by the primary immune dysregulation that was the basis for the pathogenesis of their disease, or other autoimmune disease manifestations such as lymphopenia.2 Infection is the main factor increasing the mortality and morbidity of SLE patients. A study in New York conducted between 1966 and 1976 involving 223 SLE patients reported 150 cases of infection, of which 23 were opportunistic infection: 12 were candidiasis while 11 others were deep fungal infection. The use of corticosteroids in SLE is the main factor that predispose patients to infection, particularly fungal infection.3 Aspergillosis is the term used to denote all disease caused by any one of the pathogenic and allergenic species of Aspergillus. The annual incidence of aspergillosis in the United States is reported to be 1â€“2 per 100,000.4 Aspergillus fumigatus is the cause of most cases of invasive aspergillosis, almost all cases of chronic aspergillosis, and most allergic syndromes. The mortality rate of invasive aspergillosis is 50% when properly diagnosed and treated; otherwise it could be as high as 100%

Title

Found 11 Documents
Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title Search

Found 11 Documents Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title

Found 11 Documents
Search