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Early Diagnosis of Interstitial Lung Disease Anita Masniari Pulungan; Fanny Fachrucha
Respiratory Science Vol. 3 No. 1 (2022): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v3i1.43

Interstitial Lung Disease (ILD) includes more than 200 diseases that involve the interstitial lung. The diagnosis of ILD depends on the onset of symptoms, causes, and clinical manifestations. An anamnesis comprehensive and physical examination are essential in diagnosing ILD. In addition, laboratory tests are carried out in certain clinical conditions. The analysis of biomarkers in ILD is helpful for diagnosis, disease monitoring, and prediction of prognosis. Pulmonary function studies support the diagnosis of ILD and as a predictor of prognosis. High-resolution Computed Tomography (HRCT) is the main diagnostic procedure in ILD patients. In certain conditions, a lung biopsy may be considered. Multidisciplinary discussion (MDD) enhances accurate diagnosis. An accurate early diagnosis of ILD is necessary to ensure that patients receive optimal management, reduce the risk of developing pulmonary fibrosis and reduce the risk of death. Early diagnosis of ILD define as early identification of symptoms, laboratory and radiological findings at the early stage of the disease

Krebs von den Lungen-6 (KL-6) and Surfactant-D as Biomarkers of Interstitial Lung Disease: A Literature Review Fanny Fachrucha; Muhamad Rizqy Fadhillah; Syazatul Syakirin Sirol Aflah
Jurnal Respirologi Indonesia Vol 44, No 1 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v43i4.439

Interstitial Lung Disease (ILD) is a group of lung diseases characterized by various patterns of lung tissue damage, including inflammation and fibrosis of the lung interstitium, both with known or unknown causes (idiopathic). In establishing the diagnosis of ILD, a comprehensive approach including history-taking, physical examination, and supporting examinations, is needed and managed in a multidisciplinary manner. Biomarkers are diagnostic tools known to be accessible, inexpensive, reproducible, and non-invasive for helping diagnose ILD patients. Growing evidence has supported the idea that many biomarker molecules can detect lung injury in ILD, including Krebs von de lungen-6 (KL-6) and Surfactant D (SP-D). KL-6 and SP-D could be utilized in the detection, disease monitoring, prognostication, and therapeutic responses of ILD patients. This review aimed to discuss several potential Kl-6 and SP-D biomarkers against ILD and discusses their clinical utility.

Proportions of Hypertension in Stable COPD Patients at the National Respiratory Center Persahabatan Hospital Dewantoro, Luhur; Wiyono, Wiwien Heru; Yunus, Faisal; Agustin, Heidy; Damayanti, Triya; Antariksa, Budhi; Fachrucha, Fanny; Samoedro, Erlang; Elhidsi, Mia
Jurnal Respirologi Indonesia Vol 44, No 3 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i3.774

Background: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Most of these deaths are related to cardiovascular disease. This is due to systemic inflammation that causes increased vascular stiffness and hypertension. These comorbidities lead to poor quality of life, low exercise tolerance, and an increased risk of hospitalization. This study aims to report the proportion of hypertension among stable COPD patients in the Indonesian population.Methods: This cross-sectional study was conducted at the National Respiratory Center Persahabatan Hospital between February and March 2023. Stable COPD patients admitted to the Asthma and COPD Polyclinic who met the criteria were enrolled. Clinical information, vital signs, spirometry results, and DLCO measurements were collected.Results: There were 84 subjects participating in this study. The result of this study shows a 60.7% proportion of hypertension in stable COPD patients. Hypertension has a significant correlation with pulmonary functional values (P=0.021), severity degree of clinical COPD (P=0.004), Brinkman index (P=0.008), and age (P=0.0001). However, hypertension association with COPD duration (P=0.505) and DLCO (P=0.122) were not significant.Conclusion: The hypertension proportion in stable COPD Indonesian patients is 60.7%. Hypertension shows a significant association with pulmonary function values, severity degree of clinical COPD, Brinkman index, and age.

Diagnosis and Management of Interstitial Lung Abnormalities (ILA): An Article Review Pande, I Wayan Pande Adhyaksa; Fachrucha, Fanny
Respiratory Science Vol. 5 No. 2 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i2.163

Interstitial lung abnormalities (ILA) are radiological findings on chest computed tomography (CT) scans that occupy more than 5% of the lung area across upper, middle, and lower lung fields. Interstitial lung abnormalities manifest through several imaging features, including ground-glass opacities (GGO), reticular patterns, diffuse centrilobular nodules, non-emphysematous cysts, honeycombing, and traction bronchiectasis, while emphysema is excluded from its definition. Although global prevalence data for ILA are limited, epidemiological studies report a prevalence ranging from 3% to 10% in various populations. The ILA shares a similar pathological pathway with ILD. Histologically, the structural alterations are caused by a series of inflammations in the parenchyma, the part of the lung that is involved in gas exchange (bronchioles, alveolar ducts, and alveoli). Numerous proteins and pro-fibrotic components reside in this compartment. Connective tissue builds up because of these proteins' recurrent activation cycles. Identified risk factors for developing ILA include advanced age, cigarette smoking, exposure to inhaled substances such as dust and air pollution, and genetic predispositions. The ILA is further categorized into three subtypes: non-subpleural, nonfibrotic subpleural, and fibrotic subpleural, which reflect different radiological characteristics. Currently, there is no definitive treatment for ILA, and management strategies primarily involve clinical assessment, regular radiological follow-ups, and control of risk factors to mitigate disease progression. Given the potential implications of ILA on respiratory health, ongoing research is essential to elucidate its natural history and inform future therapeutic approaches.

Oxygen Therapy in Exacerbation of Interstitial Lung Disease Aritonang, Rachel S; Fachrucha, Fanny; Elhidsi, Mia; Desianti, Ginanjar Arum
Respiratory Science Vol. 4 No. 3 (2024): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v4i3.129

Interstitial lung diseases (ILD) are a group of diseases that involve damage in the interstitial tissue, causing diffusion disorders which ultimately lead to hypoxemia. One of the conditions that aggravate hypoxemia in ILD patients is acute exacerbation. Acute exacerbation is a condition of deterioration of ILD that can occur in less than 1 month. During an acute exacerbation, there will be a worsening of the HRCT pattern with increased ground glass opacities and a worsening of the clinical picture including hypoxemia. Acute exacerbations are closely related to increased mortality rates. Oxygen administration is one of the supportive therapies that can be given to acute exacerbations. The provision of oxygen therapy is adjusted to the patient's needs using a high-flow nasal cannula, non-invasive ventilation, invasive mechanical ventilation, and extracorporeal membrane oxygenation.

Krebs von den Lungen-6 (KL-6) and Surfactant-D as Biomarkers of Interstitial Lung Disease: A Literature Review Fachrucha, Fanny; Fadhillah, Muhamad Rizqy; Aflah, Syazatul Syakirin Sirol
Jurnal Respirologi Indonesia Vol 44 No 1 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v43i4.439

Interstitial Lung Disease (ILD) is a group of lung diseases characterized by various patterns of lung tissue damage, including inflammation and fibrosis of the lung interstitium, both with known or unknown causes (idiopathic). In establishing the diagnosis of ILD, a comprehensive approach including history-taking, physical examination, and supporting examinations, is needed and managed in a multidisciplinary manner. Biomarkers are diagnostic tools known to be accessible, inexpensive, reproducible, and non-invasive for helping diagnose ILD patients. Growing evidence has supported the idea that many biomarker molecules can detect lung injury in ILD, including Krebs von de lungen-6 (KL-6) and Surfactant D (SP-D). KL-6 and SP-D could be utilized in the detection, disease monitoring, prognostication, and therapeutic responses of ILD patients. This review aimed to discuss several potential Kl-6 and SP-D biomarkers against ILD and discusses their clinical utility.

Proportions of Hypertension in Stable COPD Patients at the National Respiratory Center Persahabatan Hospital Dewantoro, Luhur; Wiyono, Wiwien Heru; Yunus, Faisal; Agustin, Heidy; Damayanti, Triya; Antariksa, Budhi; Fachrucha, Fanny; Samoedro, Erlang; Elhidsi, Mia
Jurnal Respirologi Indonesia Vol 44 No 3 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i3.774

Background: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Most of these deaths are related to cardiovascular disease. This is due to systemic inflammation that causes increased vascular stiffness and hypertension. These comorbidities lead to poor quality of life, low exercise tolerance, and an increased risk of hospitalization. This study aims to report the proportion of hypertension among stable COPD patients in the Indonesian population.Methods: This cross-sectional study was conducted at the National Respiratory Center Persahabatan Hospital between February and March 2023. Stable COPD patients admitted to the Asthma and COPD Polyclinic who met the criteria were enrolled. Clinical information, vital signs, spirometry results, and DLCO measurements were collected.Results: There were 84 subjects participating in this study. The result of this study shows a 60.7% proportion of hypertension in stable COPD patients. Hypertension has a significant correlation with pulmonary functional values (P=0.021), severity degree of clinical COPD (P=0.004), Brinkman index (P=0.008), and age (P=0.0001). However, hypertension association with COPD duration (P=0.505) and DLCO (P=0.122) were not significant.Conclusion: The hypertension proportion in stable COPD Indonesian patients is 60.7%. Hypertension shows a significant association with pulmonary function values, severity degree of clinical COPD, Brinkman index, and age.

Interstitial Lung Disease Related to Dematomyositis: Rare Case Dian Megawati; Fanny Fachrucha
Malang Respiratory Journal Vol. 8 No. 1 (2026): Volume 8 No 1, March 2026 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2026.008.01.05

Background: Dermatomyositis is a rare disease caused by inflammation of the muscles and connective tissues. One of the most common complications is interstitial lung disease (ILD) caused by a humoral immune response. Case: The case presented is a 48-year-old woman with classic symptoms of DM accompanied by respiratory symptoms and low lung fuctiond who was objectively proven to have ILD as a complication. Multidisciplinary collaboration was carried out to treat the patient. Conclusion: ILD is one of the complication and predictors of poor prognosis in DM patients. Comprehensive management and regular monitoring are needed to inhibit disease progression. Keywords: dermatomyositis, complication, ILD

A Compounding Challenge: An Evidence-Based Case Report on the Association Between Obesity and Asthma Exacerbations in Pregnancy Muhammad Bimo Ramadhan; Halidza Nursasqia Pasyah; Aurora Serena Ueda; Rafi Akbar Putranto; Fanny Fachrucha
Jurnal Respirologi Indonesia Vol 46 No 2 (2026)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v46i2.1083

Background: Asthma exacerbations during pregnancy have been associated with an increased risk of adverse perinatal outcomes. Asthma control through inflammatory mechanisms is hypothesized to worsen in the case of obesity during pregnancy. However, the scientific evidence regarding the association between the two variables remains contradictory. Therefore, this evidence-based case report aims to determine the association between early-pregnancy obesity and asthma exacerbation during pregnancy by synthesizing findings from various related studies. Methods: A literature search was conducted using relevant keywords in the databases PubMed, ScienceDirect, Cochrane, and ClinicalTrials.gov. The Oxford Centre for Evidence-Based Medicine (CEBM) framework was used to appraise the studies that met the inclusion and exclusion criteria. Results: This review identified five studies, comprising one systematic review and meta-analysis and four cohort studies. These studies were appraised as having acceptable validity, importance, and applicability. Four of the five studies reported a significantly increased risk of asthma exacerbation in pregnant women with early-pregnancy obesity. Stevens et al reported a decreased risk of exacerbation among pregnant women with obesity compared with the control group, attributing this to differences in perception thresholds between the groups and the possibility of study bias. Conclusion: Pregnant women with obesity in early pregnancy have a higher risk of experiencing asthma exacerbations during pregnancy compared to non-obese groups. Consequently, these patients require intensified monitoring and optimized asthma management to prevent maternal and perinatal complications.

Supraventricular Arrhythmias in Idiopathic Pulmonary Fibrosis: Clinical Links and Implications I Wayan Pande Adhyaksa; Fanny Fachrucha; Sunu Budhi Raharjo; Henda Ageng Rasena; Kevin Aristyo
Jurnal Respirologi Indonesia Vol 46 No 3 (2026)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v46i3.1126

Idiopathic pulmonary fibrosis (IPF) and supraventricular arrhythmias (SVAs) share a profound pathophysiological connection beyond incidental comorbidity. This review synthesizes current evidence demonstrating how progressive pulmonary fibrosis creates an arrhythmogenic cardiac substrate through three interdependent pathways. Pulmonary hypertension imposes chronic pressure overload on the right heart, leading to right atrial dilation, interstitial fibrosis, gap junction dysfunction, and electrical remodeling, creating conditions for re-entrant circuits. Chronic hypoxemia induces intracellular calcium overload, after-depolarizations, and sympathetic overactivity, providing functional arrhythmogenic triggers independent of structural remodeling. These mechanisms collectively transform the atrial myocardium into a vulnerable environment where re-entrant circuits and triggered activity persist. The resulting SVAs, particularly atrial fibrillation and flutter, are strongly associated with IPF's cardiopulmonary pathophysiology. This integrated perspective challenges clinicians to view IPF not as an isolated lung disease but as a systemic syndrome with significant cardiac implications. However, current evidence is largely observational, and further prospective studies are needed to establish screening and management guidelines.

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