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All Journal Journal of Tropical Life Science : International Journal of Theoretical, Experimental, and Applied Life Sciences Jurnal Kedokteran Brawijaya Research Journal of Life Science Majalah Kesehatan FKUB Indonesian Journal of Rheumatology International Journal of Community Service Learning Caring : Jurnal Pengabdian Masyarakat ADPEBI International Journal of Business and Social Science
Dian Hasanah
Laboratorium Fisiologi, Fakultas Kedokteran, Universitas Brawijaya
Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Environmental Science Health Professions Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Nursing Public Health Social Sciences

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Journal : Indonesian Journal of Rheumatology

 1 
The Differences in Serum Complements and Anti-dsDNA Levels between Renal and Non-renal Manifestations in Systemic Lupus Erythematosus Bagus Putu Putra Suryana; Lya Rosita; Nursamsu Djais; Dian Hasanah
Indonesian Journal of Rheumatology Vol. 11 No. 1 (2019): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v11i1.121

Abstract

Background. Systemic lupus erythematosus (SLE) has diverse clinical manifestations, including renal and non-renal. Renal manifestation is related to significant morbidity and mortality. SLE is also characterized by serological aberrations, including levels of complement C3, C4 and anti-dsDNA, but the association of them with clinical manifestations including renal and non-renal is unclear. This study investigated the associations of C3, C4 and anti-dsDNA levels with renal and non-renal manifestations in SLE patients. Method. A cross-sectional study was conducted in the Polyclinic of Rheumatology, Dr. Saiful Anwar Hospital Malang. A number of 43 subjects fulfilled the 1997 American College of Rheumatology criteria participated in this study, that consisted of 11 patients with renal manifestation and 32 patients with non-renal manifestations. Serum C3 and C4 levels were measured using immunoturbidimetry, and serum anti-dsDNA levels were measured using enzyme-linked immunosorbent assays (ELISA). The independent T-test was used to compare C3 levels and the Mann-Whitney U test was used to compare C4 and anti-dsDNA levels between groups. Result. SLE with renal manifestation had significant lower levels of serum C3 compare to non-renal manifestations (mean ± SD: 71.27 ± 32.65 mg/dL and 94.47 ± 26.29 mg/dL respectively, p=0.022). SLE with renal manifestation also had significantly lower levels of serum C4 compare to non-renal manifestations (mean ± SD: 14.55 ± 8.20 mg/dL and 25.50 ± 11.05 mg/dL respectively, p=0.002). Conversely, SLE with renal manifestation had significantly higher levels of serum anti-dsDNA compare to non-renal manifestations (mean ± SD: 249.27 ± 240.34 IU/mL and 109.91 ± 166.11 IU/mL respectively, p=0.014). Conclusion. SLE patients with renal manifestation have significantly lower levels of serum C3 and C4 and a higher level of serum anti-dsDNA than SLE patients with non-renal manifestations.
Behçet's Disease with Multiorgan Infection: Alternative Treatment to Systemic Immunosuppressants Dian Hasanah
Indonesian Journal of Rheumatology Vol. 12 No. 2 (2020): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v12i2.122

Abstract

A B S T R A C T Background. Behçet's disease is a rare systemic autoimmune vasculitis. The presence of infection makes it difficult to manage. Case. Ms. X, 19 years old, complained of mouth and genitalia ulcers and joints pain. She had typhoid fever two months before; and a week after recovery, she experienced reddish skin lesions on her legs. Her condition was weak and the pain visual analog score (VAS) was 9/10. Multiple oral ulcers were found in her oral cavity and vulva. Her lungs were hypersonor. There were hyperpigmented maculae in her lower extremities. Her ankle joints were painful in passive and active movements. Blood leukocytes: 13,210/µl, urine leukocytes: 20-23/hpf, ANA, anti-dsDNA and Pathergy tests were negative. The diagnosis of Behçet's disease was based on multiple oral and genital ulcers, history of erythema nodosum and arthritis. The patient was treated with topical triamcinolone. Joint ulcers and pain worsened; so that intravenous methylprednisolone was administer. Two days later, the patient had cough and oxygen desaturation. Chest X-ray showed emphysematous lungs and pneumonia. Methylprednisolone was stopped, ceftriaxone and levofloxacin were given, treatment for ulcers and arthritis was replaced with colchicine and rebamipide. Sucralfate is given for gargle and applied to the genital ulcers. On the seventh day, the ulcers were greatly reduced, joint pain resolved, cough subsided and VAS became 2/10. On the twelfth day, the chest X-ray was normal and ulcers were healed, ankle pain was suffered again accompanied by swelling. The patient was treated with methylprednisolone and azathioprine. Discussion. Treatment for this disease is immunosuppressants. In severe conditions with infection, colchicine can be an alternative treatment. Adjuvant treatment are rebamipide and/or sucralfate. Emphysematous lungs can be caused by alpha-1 antitrypsin deficiency or pulmonary vasculitis, which can be manifested in autoimmune diseases. Emphysematous lungs, leads us to follow up on the development to other autoimmune disorders such as lupus. Conclusion. Behçet's disease with infection can be successfully managed with colchicine, rebamipide and sucralfate.
Co-Authors Abd. Rasyid Syamsuri Agustina Tri Endharti Andini Putri Wulandari Antania Kashira Winarta Artamevia, Dian Bahtiar Usman, Bahtiar Choirinnisa Meilia Ayu Putri desy wulandari Dewi Purnama Sari Dian Artamevia Edwin Widodo Elvira Sari Dewi Handono Kalim Handono Kalim Hani Susianti Harbiyanti, Novita Titis Kurnianingsih, Nia Kusworini Handono Kusworini Handono Kusworini Handono Lya Rosita Muhammad Anshory, Muhammad Nora Ariyanti Novi Kurnianingsih Nurdiana Nurdiana Nurdiana Nurdiana Nursamsu Djais Perdana Aditya Rahman Retty Ratnawati Retty Ratnawati Sarfilianty Anggiani, Sarfilianty Sari, Retty Kharisma Sari, Tita Luthfia Solly Aryza Suryana, Bagus Putu Putra Syifa Mustika Tri Wahyudi Iman Dantara Wahono, Cesarius Singgih Wahyu Dewi Tamayanti, Wahyu Dewi Wisnu Barlianto