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Proteinuria Severity in Lupus Nephritis is Associated with Anti-dsDNA Level and Immune Complex Deposit Location in Kidney Engli, Katherina; Handono, Kusworini; Eko, Mudjiwijono Handaru; Susianti, Hani; Gunawan, Atma; Kalim, Handono
Journal of Tropical Life Science Vol 8, No 3 (2018)
Publisher : Journal of Tropical Life Science

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jtls.08.03.03

Abstract

Lupus nephritis (LN) is one of the manifestations of Systemic Lupus Erythematosus (SLE), with proteinuria being one of the clinical manifestations. The proteinuria pathogenesis is associated with anti-dsDNA antibody and the location of immune complex deposits within the kidney. This study aims to investigate the correlation of the severity of proteinuria with the location of immune complex deposits and the level of anti-dsDNA antibody in LN. Data were collected in cross-section. Fifty-three patients with LN in Saiful Anwar Hospital Malang, who underwent renal biopsy, were included. Hematoxylin-eosin staining and immunofluorescence analysis were used to assign subjects to different histopathological classes and determine the immune complex deposits. The spot urine samples were evaluated using the dipstick method for semi-quantitative proteinuria. The anti-dsDNA antibody levels were evaluated using the enzyme-linked immunosorbent assay (ELISA). Turbidity and enzymatic tests were conducted to elucidate urine protein and creatinine content, respectively. The level of proteinuria is significantly different among the different locations of immune complex based on the dipstick and protein/creatinine methods (p = 0.021 and p = 0.005, respectively). There was a significant correlation between anti-dsDNA antibody level and the severity of proteinuria (r = 0.326 based on dipstick and r = 0.28 based on protein/creatinine method). Thus, proteinuria in LN is determined by anti-dsDNA level and the location of immune complex deposits in the kidney.
Kadar Antibodi Anti-dsDNA dan Urine Monocyte Chemoattractant Protein-1 pada Nefritis Lupus Susianti, Hani; Salman, Yuliana; Gunawan, Atma; Handono, Kusworini
Jurnal Kedokteran Brawijaya Vol 27, No 2 (2012)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (879.079 KB) | DOI: 10.21776/ub.jkb.2012.027.02.8

Abstract

ABSTRAKKata Kunci: Lupus  eritematosus  sistemik  (LES) merupakan  penyakit  autoimun  yang  ditandai  oleh  peradangan  kronis  dan  akut. Biomarker klasik untuk mendeteksi adanya penyakit LES adalah antibody anti-double stranded DNA (anti-dsDNA) dan urine Monocyte Chemoattractant Protein-1   (uMCP-1).   Penelitian ini dilakukan untuk mengkaji hubungan antara kedua biomarker tersebut dengan klasifikasi histopatologis nefritis lupus untuk mengganti biopsi ginjal dalam penentuan kelas histopatologi nefritis lupus.   Penelitian ini dilakukan selama 11 bulan   berupa studi observasional dengan pengambilan sampel darah dan urin untuk mengetahui kadar antibodi anti-dsDNA dan MCP-1, serta biopsi ginjal untuk menentukan kelas nefritis lupus berdasarkan klasifikasi WHO tahun 1982.   Data hasil penelitian menunjukkan tidak ada perbedaan yang signifikan (p=0,208>α) antara mean rank kadar anti-dsDNA pada kelompok kontrol dan kelompok kasus,begitu pula dengan hasil perbandingan mean rank kadar uMCP-1 (p=0,247>α).   Uji korelasi Spearman's rho,menunjukkan hubungan signifikan kadar anti-dsDNA dan kadar uMCP-1 (r = 0,861; p<0,001). Dapat disimpulkan bahwa tidak terdapat perbedaan kadar biomarker antibodi anti-dsDNA dan urine MCP1 pada kejadian nefritis lupus dan klasifikasi histopatologi nefritis lupus, namun terdapat hubungan yang sangat erat antara kadar biomarker antibodi anti-dsDNA dengan kadar urine MCP-1. Nilai sensitifitas kadar anti-dsDNA dan uMCP-1  lebih rendah yaitu 20% – 40% dibandingkan dengan nilai spesifisitasnya, yaitu 50% – 83,33%.Kata Kunci: Anti-dsDNA, uMCP-1, klasifikasi histopatologi, nefritis  lupus
Membangun Desa Binaan Tanggap COVID-19, Lupus, Reumatik, dan Alergi: Upaya Menurunkan Angka Kejadian dan Mencegah Kekambuhan di Malang Handono, Kusworini; Wahono, Cesarius Singgih; Barlianto, Wisnu; Dewi, Elvira Sari; Sari, Tita Luthfia; Hasanah, Dian; Rahman, Perdana Aditya; Anshory, Muhammad; Wulandari, Desy; Sari, Dewi Purnama; Endharti, Agustina Tri; Nurdiana, Nurdiana; Kalsum, Umi; Susianti, Hani; Kalim, Handono
International Journal of Community Service Learning Vol 5, No 1 (2021): February 2021
Publisher : Universitas Pendidikan Ganesha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23887/ijcsl.v5i1.30161

Abstract

Kurangnya pengetahuan masyarakat tentang COVID-19, lupus, reumatik, dan alergi mempengaruhi keberhasilan terapi, penurunan angka kejadian, dan pencegahan kekambuhan. Tujuan pengabdian masyarakat adalah membangun desa-desa binaan tanggap COVID-19, lupus, reumatik, dan alergi di Malang oleh Tim Kelompok Kajian Lupus, Autoimun, Reumatik, dan Alergi (LAURA) Universitas Brawijaya. Warga desa binaan diberikan penyuluhan berupa seminar awam dan pelatihan tentang pertolongan awal pada penyakit COVID-19, lupus, reumatik, dan alergi, kemudian diminta mengisi kuesioner posttest untuk mengukur pemahaman. Desa-desa binaan diberikan thermo-gun dan wastafel untuk menerapkan protokol kesehatan. Satu bulan kemudian dievaluasi adanya kejadian COVID-19, lupus, reumatik, dan alergi di desa binaan. Hasil evaluasi menunjukkan rata-rata warga desa binaan memahami 78,3% materi yang diberikan dan menerapkan protokol kesehatan sesuai yang diajarkan saat penyuluhan. Dilaporkan tidak ada kejadian COVID-19 serta kekambuhan lupus, reumatik, dan alergi dalam satu bulan terakhir kegiatan. Kesimpulan: pembangunan desa-desa binaan di Malang meningkatkan tanggap warga terhadap COVID-19, lupus, reumatik, dan alergi.
Development of Candidate Antigens for Rapid Test Kit to Detect Autoantibodies in Patients with Systemic Lupus Erythematosus Wisnu Barlianto; Hani Susianti; Singgih Wahono; Nelly Ismayasih; Rossy Meilani; Kusworini Handono
Research Journal of Life Science Vol 4, No 1 (2017)
Publisher : Lembaga Penelitian dan Pengabdian kepada Masyarakat, Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (693.941 KB) | DOI: 10.21776/ub.rjls.2017.004.01.8

Abstract

Systemic Lupus Erythematosus (LES) is an autoimmune inflammatory disease characterized by the formation of anti-nuclear antibodies (ANA) and anti-double stranded DNA (anti-dsDNA) antibodies as diagnostic markers. Detection of such autoantibodies requires advanced equipment and trained personnel.This study was conducted to acquire candidate antigens that can be used for rapid test kit for practical and accurate detection of ANA and anti-dsDNA to speed up SLE diagnosis.Nuclear proteins and DNA derived from cell lines, hair follicles, and leukocytes of SLE patients and healthy individuals were isolated using QiaGEN kit and modified-manual procedure. Antigen-antibody bonds were tested by dot blot assay.The strongest binding between DNA antigens of a healthy individual and antibodies occurred at dilution factors of 1:5,120 for the antigen and 1:2,560 for the antibody. The strongest binding between nuclear protein antigens from the cell line and antibodies occurred at dilution factors of 1:512 for the antigen and 1:1,600 for the antibody.Nuclear antigens derived from cell line and DNA antigens of healthy individuals were antigen candidates for the development of ANA and anti-dsDNA rapid detection tests.
Evaluation of Urine Procalcitonin, Interleukin-6, Heparin Binding Protein, Leukocyturia, and Bacteriuria for Early Detecting Urinary Tract Infection Hani Susianti; I Putu Adi Santosa; Antonius Johanes; Esther Mayrita; Thiba Dina Merdikaningsih
Research Journal of Life Science Vol 6, No 1 (2019)
Publisher : Lembaga Penelitian dan Pengabdian kepada Masyarakat, Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.rjls.2019.006.01.2

Abstract

Urinary Tract Infection (UTI) is a common infectious disease. Urine culture as a gold standard is less practical and time- consuming. Examination of urine dipstick and microscopic is less accurate. Procalcitonin (PCT), IL-6 and Heparin Binding Protein (HBP) have known increase after infection, which potentially used for early detection of UTI. The aim of this study was to determine the diagnostic performance of urine IL-6, HBP, PCT, leukocyturia and bacteriuria level as biomarkers of UTI. The study was conducted on 51 UTI patients with positive urine culture, 16 UTI patients with negative urine culture, and 16 healthy control.  Urine IL-6, HBP, and PCT level were determined using ELISA. Leukocyturia and bacteriuria were measured using automated flowcytometry and fluorescent dye analyzers.  The gold standard for UTI diagnosis was urine culture. The sensitivity and specificity of urine PCT, IL-6, HBP, leukocyturia and bacteriuria were 60.78% and 65.62%; 72.55% and 56.25%; 96.07% and 50.00%; 80.39% and 78.12%; 80.39% and 59.09% respectively. The AUC of urine PCT, IL-6, HBP, leukocyturia and bacteriuria were 0.600; 0.605; 0.666; 0.877 and 0.830 respectively. For combinations of two biomarkers, the best sensitivity and specificity was demonstrated by urine PCT and leukocyturia.
Urine Specific Proteins and Alpha-1 Antitrypsin Concentrations to Assess the Severity of Lupus Nephritis Hani Susianti; Wisnu Barlianto; Dian Sukma Hanggara; Kusworini Handono; Purwanto Adipireno; Lisyani Suromo
Research Journal of Life Science Vol 4, No 1 (2017)
Publisher : Lembaga Penelitian dan Pengabdian kepada Masyarakat, Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (875.828 KB) | DOI: 10.21776/ub.rjls.2017.004.01.6

Abstract

Background. Current biomarkers for evaluating disease activity or severity in lupus nephritis (LN) are considered to be unsatisfactory. Pathological changes in glomerular basement membrane and selectivity of electrical discharge are causing specific patterns of urine proteins excretion. Together with alpha-1 antitrypsin (AAT), they are expected to become new biomarkers to assess LN activity.Method. Seventy-one urine samples were collected from healthy controls and LN patients. Patterns of urine specific proteins were determined using column chromatography and SDS-PAGE tests, LN activity was calculated using SLEDAI-renal domain score, and AAT concentrations was measured by ELISA.Result. The majority of proteins in the control group have molecular weights of >66 kDa (88%) and 21- to 25-kDa proteins were observed only in the case group. The p values for differences in urine AAT concentration between active LN and healthy controls, inactive LN and healthy controls, and active LN and inactive LN were 0.004, 0.046, and 0.054, respectively, whereas those for urine AAT/creatinine ratio were 0.489, 0.019, and 0.915, respectively.Conclusion: There were differences in the patterns of the molecular weight of proteins and urine AAT concentrations between case group and control group. However, no such differences were identified between active and inactive LN. 
INTERLEUKIN-4 DAN INTERFERON GAMMA DI NEFRITIS LUPUS: HUBUNGAN AKTIVITAS PENYAKIT SERTA KEKAMBUHAN Torajasa Achamar; Dany Farida; Hani Susianti; Kusworini Handono; Ati Rastini; R.I R.I; I Putu A.S; Atma Gunawan; Handono Kalim
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 2 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i2.1117

Abstract

Sampling for urinalysis to see the activity and the degree of recurrence of Lupus Nephritis (LN) is very difficult. New biomarkersthat are more simple, sensitive, specific and non-invasive in assessing the activity of the LN need to be investigated. Interleukin-4 (IL-4)and interferon gamma (IFN-γ) were implicated to LN process. Urine samples from 17 LN patients were taken every month for 6 (six)months to examine the level of uIL-4, uIFN-γ, activity and recurrence of LN. Significant differences were observed in the uIFN-γ levelsbetween the active and inactive LN groups (p=0.012), but not in uIL-4 levels (p=0.187). Correlations between each biomarker andrenal domain score were weak (r=0.201, p=0.042 for uIL-4; r=0.268, p=0.006 for uIFN-γ). Significant differences were also found inthe uIL-4 and uIFN-γ levels against LN recurrence (p=0.033; p=0.017). The best cut off values to assess recurrences and activity of LNwere 8.17 pg/mL for uIL-4 showed a sensitivity of 74%, specificity 71%, NPV 90%, PPV 42% to assess recurrences and to assess activityof LN showed sensitivity 46%, specificity 75%, NPV 48%, PPV 78%. The cut off 18.58 pg/mL for uIFN-γ to predict recurrent and assessthe activity of LN showed sensitivity 68%%, specificity 70%, NPV 88%, PPV 40% to predict the recurrent and to assess the activity of LNshowed sensitivity 57%, specificity 64%, NPV 49%, PPV 73%. Based on the research, uIL-4 and uIFN-γ are not good enough to predictrecurrence and activity of LN
Diagnostic Test of PIVKA-II as A Tumor Marker for Hepatocellular Carcinoma Dwi Priyadi Djatmiko; I Putu Adi Santosa; Elvin Richela Lawanto; Bogi Pratomo; Hani Susianti
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1436

Abstract

Alpha-Fetoprotein (AFP) is a tumor marker that has been widely used for HCC, but there has been no increased AFP in35-45% patients with HCC. Protein induced by vitamin K absence or antagonist II (PIVKA-II) is abnormal prothrombinsecreted in HCC and is expected to be used as a diagnostic marker of HCC. The objective of this study was to compare serumPIVKA-II levels in the patients with HCC, cirrhosis, and healthy control and determine the diagnostic value of PIVKA-II forhepatocellular carcinoma. This was a cross-sectional, analytical observational study to identify the diagnostic value ofPIVKA-II for HCC diagnosis. The diagnosis of 20 cirrhotic patients and 15 patients with HCC was established by using medicalhistory, physical examination, and additional tests according to the diagnosis criteria. A group of 12 individuals with normalliver function was used as healthy control subjects. Serum PIVKA-II levels were analyzed with the immunoassay method. Forthe comparison study, the independent-samples Kruskal Wallis test was used. Also, to determine sensitivity, specificity,positive and negative predictive value (PPV and NPV), ROC curve analysis, and 2x2 contingency table was used. The serumPIVKA-II levels in the patients with HCC were significantly higher than in cirrhotic patients (p=0.000) and healthy control(p=0.000). Sensitivity, specificity, PPV, and NPV of PIVKA-II for diagnosis of HCC in cirrhotic patients at a cut-off value of140.85 mAU/mL were 93.33%, 75%, 73.68%, and 93.75%, respectively (AUC=0.87).PIVKA-II had a high diagnostic value forHCC diagnosis. Diagnostic tests that compare serum PIVKA-II levels in any size of HCC nodules might be needed in thefuture.
PETANDA BIOLOGIK TERKINI LUPUS NEFRITIS Hani Susianti; Kusworini Handono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 20, No 2 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v20i2.1085

Abstract

Lupus Nephritis (LN) is one of the serious clinical manifestation of Systemic Lupus Erythematosus (SLE). Early detection and treatmentof renal activity may spare patients from renal damage. Conventional biomarkers such as urine sediment, proteinuria, creatinine, antidsDNA antibody and their complement levels are not specific and sensitive enough in detecting the ongoing disease activity in the lupuskidneys and early relapse of nephritis. Renal biopsy is the gold standard in providing information on the histopathology of LN, but isinvasive and it should take a serial of biopsies making it impractical when monitoring LN. Thus, some novel biomarkers are necessary toenhance the diagnostic accuracy and sensitivity of lupus renal disease, prognostic stratification, monitoring of treatment response anddetection of early renal flares as well. Some novel biomarkers have been studied in LN, however, validation on a large scale of patientswith different ethnic backgrounds is still needed.
Nilai diagnostik pemeriksaan Antinuclear Antibody (ANA) secara kuantitatif dengan metode Chemiluminescent Immunoassay (CLIA) pada pasien dengan penyakit autoimun Indah Adhita Wulandari; Hani Susianti; Dian Sukma Hanggara; Kusworini Handono; Raymond Poeng; I Komang Adi Widana; Deasy Ayuningtyas Tandio
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (391.806 KB) | DOI: 10.15562/ism.v13i1.1223

Abstract

Background: Many serological examination methods have been developed to assist in diagnosing autoimmune diseases, one of which is the Chemiluminescent Immunoassay (CLIA) method. The CLIA method is an alternative method that is faster and estimated to have the same accuracy with IFA as the gold standard examination. It can help diagnose autoimmune diseases more quickly and easily. This study aims to determine the diagnostic value and conformity of the Anti-Nuclear Antibody (ANA) examination using the IFA method with the CLIA method in patients with autoimmune diseases.Methods: The research design is a cross sectional study with consecutive sampling methods in autoimmune disease patients at Dr. Saiful Anwar Hospital Malang. ANA examination using the IFA method and the CLIA method. The data obtained by examining the IFA method is categorical, and the CLIA method is numerical. The diagnostic test uses the ROC curve and generates the AUC to determine the cut-off point. Furthermore, the suitability test was carried out using the Cohen's Kappa analysis technique. Data were analyzed using SPSS version 25 for Windows.Results: The research sample collected was 110. Patients with positive ANA IFA results showed the same results with the CLIA method (58,18%). The diagnostic test using the cut-off value of serum ANA levels of 41.79 AU/mL showed a sensitivity value of 98.4%, specificity 95.5%, a positive predictive value of 95.63% and a negative predictive value of 98.35% with an AUC of 0.990. The suitability value of the ANA examination with the IFA and CLIA methods with the Cohen's Kappa test showed very good results, which was 0.908 (p=0.000).Conclusion: There is a very good suitability value in examining the ANA parameters of the IFA method and the CLIA method. ANA CLIA examination has good diagnostic value. Latar Belakang: Banyak metode pemeriksaan serologi yang berkembang untuk membantu penegakan diagnosis penyakit autoimun, salah satunya metode Chemiluminescent Immunoassay (CLIA). Metode CLIA merupakan alternatif metode yang lebih cepat dan diperkirakan memiliki keakuratan yang sama dengan pemeriksaan baku emas Immunofluorescence Assay (IFA), sehingga dapat membantu menegakkan diagnosa penyakit autoimun dengan lebih cepat dan mudah. Penelitian ini bertujuan untuk mengetahui nilai diagnostik dan kesesuaian hasil pemeriksaan Anti-Nuclear Antibody (ANA) metode IFA dengan metode CLIA pada pasien dengan penyakit autoimun.Metode: Desain penelitian adalah studi potong lintang dengan metode consecutive sampling pada pasien penyakit autoimun di RSUD Dr. Saiful Anwar Malang. Pemeriksaan ANA menggunakan metode IFA dan metode CLIA. Data yang diperoleh dengan pemeriksaan metode IFA bersifat kategorikal, dan metode CLIA bersifat numerik. Uji diagnostik menggunakan kurva ROC dan menghasilkan AUC untuk menentukan cut-off-point. Selanjutnya dilakukan uji kesesuaian dengan teknik analisis Cohen’s Kappa. Data dianalisis dengan SPSS versi 25 untuk Windows.Hasil: Sampel penelitian terkumpul 110. Pasien dengan hasil ANA IFA positif yang menunjukkan hasil yang sama dengan metode CLIA adalah (58,18%). Uji diagnostik menggunakan nilai cut-off kadar ANA serum 41,79 AU/mL menunjukkan nilai sensitivitas 98,4%, spesifisitas 95,5%, nilai ramal positif 95,63% dan nilai ramal negatif 98,35% dengan AUC 0,990. Nilai kesesuaian pemeriksaan ANA dengan metode IFA dan CLIA dengan uji Cohen’s Kappa menunjukkan hasil yang sangat baik secara bermakna yaitu sebesar 0,908 (p=0.000)Kesimpulan: Terdapat nilai kesesuaian yang sangat baik pada pemeriksaan parameter ANA metode IFA dan metode CLIA. Pemeriksaan ANA CLIA memiliki nilai diagnostik yang bagus
Co-Authors Abd. Rasyid Syamsuri Ade Wildan Rizky Fachry Agustina Tri Endharti Airlangga, Dimas Ikhsan Anik Widijanti Antonius Johanes Ati Rastini Atma Gunawan Atma Gunawan Atma Gunawan Bayu Eka Nugraha Bogi Pratomo Bogi Pratomo Bogi Pratomo Choirinnisa Meilia Ayu Putri Chomsin Sulistya Widodo Dany Farida Deasy Ayuningtyas Tandio Deasy Ayuningtyas Tandio desy wulandari Dewi Purnama Sari Dian Hasanah Dian Sukma Hanggara Dian Sukma Hanggara Dian Sukma Hanggara Dimas Ikhsan Airlangga Dominica Pita Sari Dwi Priyadi Djatmiko Eko, Mudjiwijono Handaru Ekowati Retnaningtyas Elvin Richela Lawanto Elvira Sari Dewi Emanuel Hananto Engli, Katherina Engli, Katherina Alfa Esther Mayrita Gonius, Andry Handono Kalim Handono Kalim Handono Kalim Handono Kalim Hari Oki, Hambiah I Komang Adi Widana I Putu A.S I Putu Adi Santosa I Putu Adi Santosa Indah Adhita Wulandari Intanwati, Sherly Kalsumy, Umi Katherina Engli Kusworini Handono Kusworini Handono Kusworini Handono Kusworini Handono Kusworini Handono Kusworini Handono Laura Christiani Levrita Nindya Poetri Lisyani Suromo Meilani, Rossy Mona Yuliari Mudjiwijono Handaru Eko Muhammad Anshory, Muhammad Nelly Ismayasih Nimas Eka Firdaningrum Nora Ariyanti Norma Hanifah Sumarta Nugraha Setiawan Nugraha Setiawan Nugraha, Bayu Eka Nurdiana Nurdiana Nurdiana Nurdiana Perdana Aditya Rahman Pratama, Mirza Zaka Purwanto Adipireno Putri, Laily Ardhianti Putu Adi Santosa, Putu Adi R.I R.I Rahmawati, Hanifa Rizky Raymond Poeng Rossy Meilani Sari, Atika Windra Sari, Tita Luthfia Shahdevi Nandar Kurniawan, Shahdevi Nandar Singgih Wahono Siti Roziah Ria Famuji Solly Aryza Susanto Nugroho Syahrul Chilmi Thiba Dina Merdikaningsih Torajasa Achamar Tri Wahyudi Iman Dantara Wahono, Cesarius Singgih Wisnu Barlianto Wisnu Barlianto Wisnu Barlianto Yuliana Salman