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All Journal Jurnal Penyakit Dalam Indonesia Neurona
Nadia Ayu Mulansari, Nadia Ayu
Divisi Hematologi Onkologi Medik, Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Indonesia/Rumah Sakit Dr. Cipto Mangunkusumo, Jakarta
Health Professions Medicine & Pharmacology Neuroscience

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Prediksi Respons Terapi Leukemia Granulositik Kronis: Skor Mana yang Lebih Baik? Mulansari, Nadia Ayu
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 4
Publisher : UI Scholars Hub

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Leukemia granulositik kronik (LGK) merupakan suatu keganasan myeloproliferatif dengan karakteristik ditemukannya kromosom Philadelphia (Ph). Kromosom Ph ini disebabkan oleh translokasi resiprokal antara kromosom 9 dan 22 [t(9;22)] dan terbentuknya fusi gen BCR-ABL1. Fusi gen tersebut akan menghasilkan suatu protein yang menderegulasi aktivitas dari tirosin kinase (p210) yang berperan pada patogenesis LGK.
Bone Mass Density in HIV/AIDS Patients Mulansari, Nadia Ayu; Sukmana, Nanang; Setyohadi, Bambang; Setiati, Siti
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 4
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FAKTOR-FAKTOR YANG MEMENGARUHI LUARAN THERAPEUTIC PLASMA EXCHANGE PADA KRISIS MIASTENIA DI RSUPN CIPTO MANGUNKUSUMO Manfaluthy Hakim; Triana Ayuningtyas; Ahmad Yanuar; Nadia Ayu Mulansari; Winnugroho Wiratman; Luh Ari Indrawati; Astri Budikayanti; Fitri Octaviana
NEURONA Vol 38 No 4 (2021)
Publisher : PERDOSNI

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Introduction: Myasthenic crisis (MC) occurs due to worsening symptoms of myasthenia gravis (MG) characterized by acute respiratory failure, prolonged post-thymectomy intubation or bulbar weakness causing dyspnoea. Therapeutic Plasma Exchange (TPE) has been accepted as first-line therapy for MC. The management of TPE is not quite ideal according to the American Society of Apheresis (ASFA) recommendations. Aim: To determine the factors that in????uenced the outcomes of MC patients who underwent TPE Methods: This study was a cross-sectional design by taking secondary data on MC cases that received TPE at RSUPN Cipto Mangunkusumo from January 2014 to September 2018. The diagnosis of MC is based on clinical examination. Bivariate analysis was carried out on factors that infuenced TPE outcomes in MC. Results: A total of 38 cases met the inclusion criteria. Good outcomes after undergoing TPE are found in 60.5% of cases. The onset of MG (p=0.039) and type of MG (p= 0.001) have a significant relationship with TPE outcome on MC. Early-onset MG and ocular to generalized MG show good outcomes. Antibody specificity variables showed a strong trend in infuencing TPE outcome in MC (p=0.055). Patients with MC who underwent TPE according to ASFA showed faster clinical improvement than those who underwent TPE not according to ASFA. Discussion: Early-onset MG and ocular to generalized MG are factors that can affect the excellent outcome of TPE in MC. Patients who undergo TPE, according to ASFA, show faster clinical improvement. Keywords: ASFA, myasthenic crisis, therapeutic plasma exchange
Penyakit Sel Sabit pada Pasien Laki-laki Berusia 27 Tahun yang Sebelumnya Didiagnosis sebagai Talasemia: Sebuah Laporan Kasus Cahyanur, Rahmat; Kurniawan, Andree; Sharfina, Ratuafni; Mulansari, Nadia Ayu
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 4
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Sickle cell disease (SCD) is a hemoglobinopathy inherited in an autosomal recessive pattern arising from a mutation causing substitution of valine for glutamic acid in the sixth amino acid of the β-globin chain. The clinical manifestation of SCD varies from acute pain, chronic anemia, to multi-organ infarct and failure. SCD is known to be rare in Indonesia. However, we recently encountered a SCD patient presenting with recurrent pain and hypesthesia since a year ago. The diagnosis of SCD in this patient was established based on the results of peripheral blood smear and hemoglobin electrophoresis. The patient had previously been diagnosed with thalassemia at the age of 19 years old due to a history of icterus, thus delaying prompt treatment. This further emphasizes the challenges in distinguishing SCD, which is relatively rare in Indonesia compared to thalassemia, especially considering the complexity and the variability in the phenotypic presentation of SCD. The patient was then given supportive therapy consisting of blood transfusion and symptomatic treatment, as well as consideration to administer hydroxyurea if the patient’s clinical condition worsens.
Evaluasi Pengukuran Kekakuan Limpa dalam Memprediksi Perdarahan Varises Esofagus Berulang pada Pasien Sirosis Hati Tahir, Andi Cahaya; Kurniawan, Juferdy; Simadibrata, Marcellus; Rizka, Aulia; Shatri, Hamzah; Lesmana, Cosmas Rinaldi A.; Mulansari, Nadia Ayu
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 1
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Introduction. Esophageal variceal bleeding is one of the complications caused by an increase in pressure within the portal vein blood vessels. The gold standard examination for portal pressure is the hepatic venous pressure gradient (HVPG), but HVPG examination is invasive, involving transjugular catheterization of the hepatic vein. Currently, non-invasive methods for measuring portal hypertension are being developed to predict esophageal varices and esophageal variceal bleeding using spleen stiffness measurements. This study aimed to evaluate the accuracy of spleen stiffness measurement in predicting recurrent esophageal variceal bleeding in patients with liver cirrhosis. Methods. This study used a retrospective cohort design with secondary data sourced from medical records at Cipto Mangunkusumo Hospital. Spleen stiffness assessment was conducted using the vibration controlled transient elastography (VCTE) spleen-dedicated stiffness measurement (FibroScan®, Echosens, France) with a frequency of 100Hz. After six weeks post-first esophageal variceal bleeding in liver cirrhosis patients, an evaluation of recurrent esophageal variceal bleeding was performed. The collected data were analyzed using SPSS 26. The ability of spleen stiffness measurement to predict recurrent esophageal variceal bleeding was assessed by evaluating the AUROC (area under the curve of receiver operating characteristic) curve. Results. A total of 102 liver cirrhosis patients who experienced first-time esophageal variceal bleeding were included in the study. Recurrent esophageal variceal bleeding was found in 23/102 (22.5%) liver cirrhosis patients. There was a significant difference in spleen stiffness values between the two groups, with higher values in the group of patients with recurrent esophageal variceal bleeding (90.9 kPa (IQR: 86.5 – 96.2) vs. 59.3 kPa (IQR: 45.2 – 74.3), p < 0.001). The AUC value of spleen stiffness for predicting recurrent esophageal variceal bleeding provided good predictability, with an AUC value of 0.898 (95% CI 0.808 – 0.988), p < 0.001. The cut-off value of spleen stiffness at 70 kPa yielded a sensitivity of 87% and specificity of 65% in predicting recurrent esophageal variceal bleeding. Conclusion. Spleen stiffness measurement can be beneficial as an evaluation method to assess the likelihood of recurrent esophageal variceal bleeding in patients with liver cirrhosis at the 6th week after the first bleeding episode.
Co-Authors Ahmad Yanuar Andree Kurniawan Astri Budikayanti*, Teguh AS Ranakusuma*, Mursyid Bustami*, Joedo Prihartono** Aulia Rizka, Aulia Bambang Setyohadi Bambang Setyohadi C Rinaldi A Lesmana E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Fitri Octaviana Juferdy Kurniawan Luh Ari Indrawati Manfaluthy Hakim Marcellus Simadibrata Nanang Sukmana Nanang Sukmana Rahmat Cahyanur Sharfina, Ratuafni Siti Setiati Siti Setiati Tahir, Andi Cahaya Triana Ayuningtyas Winnugroho Wiratman