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All Journal The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Nikko Darnindro
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Medicine & Pharmacology

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Current Diagnosis and Management of Helicobacter pylori Nikko Darnindro; Ari Fahrial Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 3, December 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (488.855 KB) | DOI: 10.24871/1432013165-173

Abstract

Helicobacter pylori (H. pylori) is a microbe which cause chronic infection in human. Currently, the prevalence in developed countries continue to decrease, but the same does not happen in developing countries. Orofecal transmission and its connection with environmental condition is assumed to be its cause.Impact of H. pylori infection in gastric mucosa is influenced by the bacteria pathogenesis which is able to survive in acid condition and causes inflammatory reaction. The diagnosis is differentiated through endoscopy or non-endoscopy depends on the alarm symptoms, local prevalence, pre-test probability, availability, cost and aim of examination.Management of H. pylori depends on the high rate of clarithromycin resistence. In area with resistency prevalence below 20% triple therapy can still be used, while in increasing resistency area, use of four times daily therapy or other antibiotics such as levofloxacin and furazolidone can be considered.Keywords: Helicobacter pylori, diagnosis, alternative therapy
Prolonged Cholestatic as a Typical Manifestation of Hepatitis A Infection: Diagnosis and Management Nikko Darnindro; Rinaldi A Lesmana
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (391.648 KB) | DOI: 10.24871/1422013120-125

Abstract

Hepatitis A virus (HAV), a positive-strand RNA virus, is stable at moderate temperature and low pH level. These characteristics allow the virus to survive in the environment and be transmitted through fecal-oral route.Twenty-year-old male came with jaundice and itchy skin since one month before admission. He was diagnosed as hepatitis A cholestasis type according to his history taking, physical examination, and laboratory result. Blood test showed elevated total bilirubin 27.4 g/dL, direct bilirubin 21.2 g/dL, indirect bilirubin 6.2 g/dL, alanin aminotransferase (ALT) 95 U/L, aspartate transaminase (AST) 134 U/L, alkaline phosphatase (ALP) 221 U/L, and gamma-glutamyltransferase (gGT) 17 U/L. His ultrasound results showed mild, non-specific hepatomegaly without common bile duct dilatation. The patient got symptomatic therapy with ursodeoxycholic acid (UDCA) 300 mg twice daily for his itchy skin and steroid therapy 0.5-1 mg/kg per day on the tenth day. He did not vomit or feel nausea anymore. After five days of steroid therapy, his total bilirubin level became 10.83 g/dL. He was discharged home with steroid therapy and steroid was tapered off during follow-up in the clinic.Prolonged cholestasis is one of atypical manifestation of hepatitis A which is rarely found. Cholestasis increases morbidity and prolongs hospitalization. Steroid therapy decreased bilirubin level and gave clinicalimprovement to the patient.Keywords: hepatitis A, prolonged cholestasis, steroid therapy
Co-Authors Ari Fahrial Syam Rinaldi A Lesmana