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All Journal Jurnal Kedokteran Brawijaya Journal of Innovation and Applied Technology Indonesian Journal of Rheumatology International Journal of Community Service Learning CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL CRJIM (Clinical and Research Journal in Internal Medicine) Caring : Jurnal Pengabdian Masyarakat CoMPHI Journal : Community Medicine and Public Health of Indonesia Journal Jurnal Penyakit Dalam Indonesia Journal of Clinical Microbiology and Infectious Diseases
Wahono, Cesarius Singgih
Division Of Rheumatology And ImmunologyDepartment Of Internal Medicine University Of Brawijaya / Dr.Saiful Anwar Hospital Malang
Biochemistry, Genetics & Molecular Biology Computer Science & IT Economics, Econometrics & Finance Education Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Nursing Public Health Social Sciences Other

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A Successful Management of 29 year old Female with Left Central Retinal Artery Occlusion due to Manifestation of Primary Antiphospholipid Syndrome Herman Bagus Trianto; Cesarius Singgih Wahono; Nadia Artha Dewi
Indonesian Journal of Rheumatology Vol. 8 No. 2 (2016): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (410.77 KB) | DOI: 10.37275/ijr.v8i2.61

Abstract

Ocular involvement in Anti Phospolipid Syndrome (APS) includes a broad spectrum of manifestations from the anterior and posterior segment or the presence of neuro-ophthalmologic features. A female, 29 years old, came to ER handled by ophthalmology department, with chief complaint left visual loss suddenly since 4 hours before admission. Investigations revealed stable vital signs, VOD 20/20, VOS 1/300, funduscopy showedpale and cherry red spot on left retina, OCT revealed hyperreflective of left inner retinal layer, IgG aCL 51.7 U/mL (50.8 U/mL in OPD 3 months later), and the other examinations were within normal limit. Patient was diagnosed with Central Retinal Artery Occlusion due toPrimary Antiphospolipid syndrome. She was performed occular massage and anterior chamber paracintesis procedure, and given O2 6-8 lpm NRBM, Timolol 0.5% eye drop left eye bid, acetazolamide 250 mg bid, Kalium Slow Release 1 tab qd, Levofloxacine eye drop 1 drop/hour post surgery. After the result of IgM aCL available, we added warfarin 2 mg qd and aspirin 320 mg qd. Patient was discharged 2 days later as visual acuity improved with VOD 20/20 and VOS 0.5/60. Key words: Central retina artery occlusion, primary anti phospolipid syndrome, anti cardiolipin antibody
Erosive polyarthritis in multicentric reticulohistiocytosis mimics rheumatoid arthritis Bagus Putu Putra Suryana; L Puspitasari; Cesarius Singgih Wahono; H Kalim
Indonesian Journal of Rheumatology Vol. 4 No. 1 (2013): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (428.563 KB) | DOI: 10.37275/ijr.v4i1.90

Abstract

Multicentric reticulohistiocytosis (MRH) is a very rare multisystemic syndrome.1,2 The first case of MRH was described by Goltz and Layman in 1954 and so far only less than 200 cases have been reported.3-5 It is characterized by the insidious onset of polyarthritis that often evolves into a severe erosive deforming arthritis and characteristic skin lesions composed of nodules and plaques containing lipid-laden (periodic acidSchiff-positive) histiocytes and multinucleated giant cells.6 It most commonly affects the handsand cervical spine.7 MRH is also known as lipoid dermatoarthritis, lipoid rheumatism, and giant cell reticulohistiocytosis.4 MRH is occured due to infiltration of multinucleated giant cells and histiocytes into various tissues. The typical pictures include skin nodules and destructive polyarthritis.3 This entity is frequently mistaken for rheumatoid arthritis (RA).3 MRH is often associated with systemic complication and various types ofmalignancy. Therefore, sometimes it is considered a paraneoplastic syndrome
Validation of Modified COPCORD Questionnaire Indonesian Version as Screening Tool for Joint Pain and Musculoskeletal Diseases Muhammad Anshory; Cesarius Singgih Wahono; Handono Kalim; Harun Al Rasyid
Indonesian Journal of Rheumatology Vol. 10 No. 1 (2018): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (348.818 KB) | DOI: 10.37275/ijr.v10i1.95

Abstract

Background: WHO-ILAR COPCORD Program is a program that aimed to obtain data on joints pain and musculoskeletal diseases in developing countries, one aspect which has not been studied is the ability of COPCORD questionnaire as a screening tool which standardized for  screening  joint pain and musculoskeletal diseases. Objective of this study is to assess the validity of modified COPCORD questionnaire Indonesian version in screening joint pain and musculoskeletal disease compared to examination by rheumatologists.Methods: The initial phase of the research is determining essential points, translation to Indonesian, and back translation. The second stage is testing questionnaires in communities which 100 respondents involved. Dependent variable is the diagnosis of rheumatic diseases and independent variables are pain in less and more than 7 days, high degree pain in less and more than 7 days, history of NSAIDs/Steroids/DMARDs use, and disabilities. Validation test was assessed by calculating the sensitivity, specificity, PPV, NPV, LR+, and ROC curve. Bivariate analysis using Chi Square analysis, and multivariate analysis using logistic regression.Results: The sensitivity test results is best obtained on the question history of NSAIDs/steroids/DMARDs use (100%)  and specificity is best obtained on the question about disability (98%). ROC curve analysis which the results >85% obtained on the question of pain >7 days (90%), high degree pain >7 days (93%), and history of NSAIDs/steroids/DMARDs use (92%).  LR+ to diagnose rheumatic diseases found in all questions. Chi square analysis showed that all questions were significant with p <0.05 and odds ratio (OR) obtained most on high degree pain more than 7 days (OR: 180.167; 95% CI: 38.196-849.834).Conclusion: The modified COPCORD questionnaire Indonesian version has been adapted and can be a good tool in the screening of joint pain and musculoskeletal diseases compared to examination by rheumatologists. Keyword: Validation, Questionnaire, COPCORD
Effects of vitamin D3 (cholecalciferol) supplementation on systemic lupus erythematosus patients with hypovitaminosis D on serum pro-inflammatory cytokines (IL-6, IL-7, IFN-Gamma), anti-inflammatory cytokine (TGF-Beta) and anti-ds DNA levels Cesarius Singgih Wahono; Irene Saveria; Cameleia Diah Setyorini; Zoraida Dwi Wahyuni; Handono Kalim; Kusworini Handono
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.v12i2.150

Abstract

A B S T R A C TSystemic lupus erythematosus (SLE) is a chronic systemic autoimmune diseaseand can attack almost all organs and tissues of the human body. Beside geneticfactors, environmental factors are thought to play a role, such as ultraviolet light,viral infections and smoking, causing a breakdown of self-tolerance which cantrigger an autoimmune response. The study was conducted in the outpatient andinpatient units of the Rheumatology Division of the Department of InternalMedicine Saiful Anwar General Hospital/Faculty of medicine UniversitasBrawijaya, Malang. Subjects were female patients, aged > 18 years who had beendiagnosed as SLE by internist-rheumatologist based on the 1997 ACR criteria, withSLEDAI score > 3. After 3 months of supplementation, there was a significantdecrease in serum levels of the three pro-inflammatory cytokines (IL-6, IL-17, IFN-gamma), as shown in table 3, compared to before treatment, as well as anti-dsDNA levels.Serum TGF-beta1 levels increased significantly, while 25 (OH) D3 levels also increasedsignificantly.
Indonesian Rheumatology Association Recommendation for Management of Autoimmune Rheumatic Disease Patients During COVID-19 Pandemic Cesarius Singgih Wahono; Perdana Aditya; Herlina Yani; RM Suryo Anggoro KW; Faisal Parlindungan; Anna Ariane; Andi Raga Ginting; Ika Vemilia; Lisa Kurnia Sari
Indonesian Journal of Rheumatology Vol. 12 No. 1 (2020): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v12i1.160

Abstract

Background: Coronavirus-19 (COVID-19) disease is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), first reported from Wuhan, the capital of Hubei province, China, in December 2019. Since the occurrence of COVID-19 pandemic, there have been concerns about the risk of SARS-CoV-2 infection and complications in systemic autoimmune-rheumatic patient. Therefore, we intend to make recommendations for the management of autoimmune rheumatic diseases during this pandemic. Method: Indonesian Rheumatology Association (IRA) held an online meeting on May 17th2020 and formed a task force that was in charge to make recommendation for management of adult autoimmune rheumatic disease patients during COVID-19 pandemic. This task force consisted of 9 IRA members that held their first online meeting on May 18th2020. The draft of the recommendation were reviewed in three online meetings that resulted in final recommendation through consensus from all of task force members. The final draft of recommendation was approved by IRA executive board on July 10th2020. Result: The management of autoimmune-rheumatic diseases during the COVID-19 pandemic must consider several important factors such as underlying rheumatic-autoimmune disease factors, risk factors for COVID-19 exposure in autommune-rheumatic disease patients and the presence of COVID-19 infection symptoms Discussion: Recommendations for pharmacological management of autoimmune rheumatic disease patients during COVID-19 pandemic are according to exposure to COVID-19 and the presence of symptoms. There are four groups of patients that are the focus of this recommendation: 1) autoimmune rheumatic disease patients without symptoms of infection AND without risk of exposure to COVID-19; 2)autoimmune rheumatic disease patients without symptoms of infection AND with close contact (exposure) to COVID-19 probable or confirmed patients; 3) autoimmune rheumatic disease patients with symptoms of COVID-19 infection but the infection status is not yet known (suspected and probable case of COVID-19); and 4) autoimmune rheumatic disease patients with confirmed COVID-19 infection. Each groups have different management approaches. Conclusion: Recommendations for the management of autoimmune rheumatic diseases during this pandemic is needed to guide doctors that treat autoimmune rheumatic diseases.
Should Patient with Autoimmune Inflammatory Rheumatic Diseases (AIIRD) be vaccinated with COVID-19 Vaccines? Cesarius Singgih Wahono; Perdana Aditya; Faisal Parlindungan; RM. Suryo Anggoro KW; Anna Ariane; Herlina Yani; Andi Raga Ginting; Lisa Kurnia Sari; Pande Ketut Kurniari; Ratih Manuaba; Ika Vemilia; Rudy Hidayat; Sumariyono Sarmidi; Harry Isbagjo
Indonesian Journal of Rheumatology Vol. 13 No. 1 (2021): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v13i1.167

Abstract

Vaccination is a very important measure for the prevention of various infections worldwide including the recent COVID-19 disease. However, until now the COVID-19 vaccine with various platforms has not been clinically tested on autoimmune inflammatory rheumatic disease (AIIRD) patients, due to caution against possible side effects and unknown efficacy. Several recent studies proved that there is increased risk of SARS-CoV-2 infection in AIIRD patients and moreover, those patients also have worse COVID-19 outcomes. Thus, patients with AIIRD should be prioritized for vaccination because they have an increased burden of infections, including COVID-19. Many studies showed that inactivated/non-live vaccine is safe for AIIRD patients and do not cause disease exacerbations. We conclude that benefits of vaccination greatly outweigh the risks of infection and therefore, COVID-19 vaccines can also be administered safely in stable AIIRD patients.
Pathogenesis, Clinical Presentations and Diagnosis of IgG4-related Disease: A Review Perdana Aditya Rahman; Cesarius Singgih Wahono; Fajar Maulana Raharjo; Handono Kalim; Mokhamad Fahmi Rizki Syaban
Indonesian Journal of Rheumatology Vol. 13 No. 2 (2021): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v13i2.189

Abstract

IgG4-Related Disease (IgG4RD) was identified by the International Classification of Diseases (ICD) in 2012. Numerous diseases, including Mikulicz’s disease, Kuttner’s tumor, Riedel’s thyroiditis, and Ormond’s disease, are pathologically associated with IgG4. Here, we present a review of the clinical presentation and pathogenesis of IgG4-associated disease. IgG4-RD term has been used to refer to a group of diseases involving multiple organs in which there is an abundant IgG4-positive lymphoplasmacytic infiltration, storiform fibrosis, obliterative phlebitis, and mild to moderate tissue eosinophilia, all of which show clinically as a tumefactive lesion, usually in more than one organ. IgG4 exhibits a unique property called an unstable disulfide bond between its heavy chain, as described by Fab-arm exchange which enables the recombination of a single IgG4 heavy chain with other IgG4 heavy chains, resulting in a bispecific antibody incapable of cross-linking and thus of forming an immune complex. IgG4-RD pathomechanism that causes serum IgG4 increase and tissue IgG4-plasma-cell deposition that is pathogenic, rather than the IgG4 itself. Genetic predisposition, autoimmunity, T-cell dysregulation, infection, and dysbiosis are just a few of the underlying pathomechanisms. Clinical symptoms are also frequently complex and may involve many organs. Confirmation of a diagnosis required a comprehensive anamnesis and examination.
Indonesian Rheumatology Association (IRA) Recommendations for Diagnosis and Management of Glucocorticoid-induced Osteoporosis Bagus Putu Putra Suryana; Rudy Hidayat; Laniyati Hamijoyo; Radiyati Umi Partan; Yulyani Werdiningsih; Surya Darma; RM Suryo Anggoro; Anna Ariane; Faisal Parlindungan; Mirza Zaka Pratama; Harry Isbagio; Handono Halim; Cesarius Singgih Wahono; Sumariyono
Indonesian Journal of Rheumatology Vol. 14 No. 2 (2022): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v14i2.216

Abstract

Background: Patients receiving long-term glucocorticoid therapy are at risk of developing GIOP. However, until today, there is still no guideline that specifically explains how to diagnose and manage GIOP patients in Indonesia. Methods: 10 selected rheumatologists from the Indonesian Rheumatologist Association (IRA) made recommendations based on key questions formed by a steering committee from IRA. These recommendation materials were taken from several online databases such as Pubmed, Science Direct, and Cochrane. Level of evidence and grades of recommendation were then assigned, and every member of the panelist team will assign a score for the level of agreement. Results: A total of 17 recommendations regarding screening, prevention, diagnosis, therapy, and monitoring for GIOP were made. Conclusion: These recommendations can be used for adult patients receiving long-term glucocorticoids with or at risk of developing GIOP. The prevention measure, diagnostic, therapy, and monitoring algorithm in this recommendation are all created with the consideration of Indonesia’s clinical setting, facility, and drug availability.
REDUCING LUPUS PATIENTS' HOPELESSNESS THROUGH BEAUTY CLASS IN MALANG CITY IN HONOR OF WORLD LUPUS DAY Cesarius Singgih Wahono; Elvira Sari Dewi; Tri Wahyudi Iman Dantara; Perdana Aditya Rahman; Kusworini Handono; Nurdiana Nurdiana; Hani Susianti; Dian Hasanah; Choirinnisa Meilia Ayu Putri; Nora Ariyanti; Handono Kalim
Caring : Jurnal Pengabdian Masyarakat Vol 2, No 3 (2022): CARING Jurnal Pengabdian Masyarakat (Desember 2022)
Publisher : Caring : Jurnal Pengabdian Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.caringjpm.2022.002.03.4

Abstract

Lupus is a systemic autoimmune rheumatic disease with mild to severe clinical features and can lead to hopelessness if not treated properly. The purpose of this activity is to give a beauty class and see how it affects the hopelessness of lupus patients in honor of World Lupus Day. Methods: Organizing World Lupus Day activities such as experts seminars on lupus at a glance, being friendly with lupus, and staying beautiful with lupus; a musical drama and dance performance by a lupus support group with the theme “You Are Beautiful”; and a lupus beauty class. The activity was completed in one day in May 2018 by collecting pre-test and post-test data on the incidence of hopelessness in lupus patients using the Beck Hopelessness Scale (BHS). A total of 100 lupus patients participated in the activity, and all of them underwent pre- and post-testing. The Wilcoxon Signed Rank Test with α=0.05 was used to analyze the collected data. Results: All participants expressed delight and satisfaction with their participation in this activity. The mean BHS scores before and after the beauty class were 8.62+2.68 and 6.36+1.59, respectively, with a significant difference (p=0.000). Conclusion: Beauty class is a fun way for lupus patients to feel less hopeless about their illness. Every year, an activity to commemorate World Lupus Day is required, which is beneficial for lupus patients.
The Role of Soluble Costimulatory Molecules as the Biomarkers for Aging Predictors Kusworini Handono; Mirza Zaka Pratama; Hani Susianti; Cesarius Singgih Wahono; Nimas Eka Firdaningrum; Siti Roziah Ria Famuji; Norma Hanifah Sumarta; Ade Wildan Rizky Fachry; Levrita Nindya Poetri; Handono Kalim
Jurnal Kedokteran Brawijaya Vol. 32 No. 3 (2023)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.03.4

Abstract

This study aimed to determine the role of the soluble costimulatory molecules in aging and the association with the presence of comorbid in aged individuals. Thirty-two elderly and twenty healthy subjects were included in this study. The soluble costimulatory molecules sCD28, sCD80, sCD86, sCD163, and sCTLA4 were measured using ELISA. The presence of comorbid was documented from medical records. Charlson Comorbidity Index (CCI) was measured to evaluate the survival/mortality risk for the subjects. The levels of the majority of soluble costimulatory molecules significantly increased in the elderly participants, while the level of sCD86 was comparable. There were weak positive correlations between the subject's age and levels of sCD28 (R=0.214, p=0.048), sCTLA4 (R=0.238, p=0.041), and sCD80 (R=0.317, p=0.012). sCD80 were discovered to be the best to predict immune aging in the elderly with AUC 0.71 [0.57-0.86], sensitivity 53,1%, specificity 80.0%, and cut off 129ng/ml. Most of the elderly participants had at least one comorbid, in which approximately 25.0% and 3.1% of the subjects were classified as mild and moderate CCI. Multivariate analysis showed that comorbidities in elderly individuals have been associated with levels of sCTLA4 ≥26.5ng/ml and sCD80 ≥129.0ng/ml. Furthermore, subjects with comorbid (CCI ≥1) were associated with sCD80 ≥129.0ng/ml (OR 12.44 [95% CI 1.32–117.03], p=0.027). Considering these results, sCD28, sCTLA4, and sCD80 can be developed as biomarkers for predicting immune aging and elderly comorbidities, respectively.
Co-Authors A Rifa’i Abd. Rasyid Syamsuri Achmad Rifa’i, Achmad Achmad Rifa’i Ade Wildan Rizky Fachry Agustina Tri Endharti Andri Reza Rahmadi Anna Ariane Anna Ariane Anna Ariane Bagus Putu Putra Suryana Bormasa, Pelpina Cameleia Diah Setyorini Choirinnisa Meilia Ayu Putri Desfryda, Elynca Putri Dessy Wulandari, Dessy desy wulandari Dewi Purnama Sari Dian Hasanah Diyah, Nurima Dwinadella, Sephia Eka Kurniawan Elvira Sari Dewi Erawati, Dini Rachma Faisal Parlindungan Faisal Parlindungan Faisal Parlindungan Fajar Maulana Raharjo Ginting, Andi Raga H Kalim Handono Halim Handono Kalim Handono Kalim Handono Kalim Handono Kalim Handono Kalim Handono Kalim Hani Susianti Harry Isbagio Harry Isbagjo Harun Al Rasyid Harun Al Rasyid Herlina Yani Herlina Yani Herman Bagus Trianto Herman Bagus Trianto, Herman Bagus Ika Vemilia Ika Vemilia Ika Vemilia Warlisti Irene Saveria Kalim, H Kusworini Handono Kusworini Handono Kusworini Handono Kusworini Handono Kusworini Handono Kusworini Handono Kusworini Kusworini L Puspitasari Laksono Trisnantoro Laniyati Hamijoyo, Laniyati Larasati, Yeni Levrita Nindya Poetri Lisa Kurnia Sari Lisa Kurnia Sari Malikul Chair Mat Suwito Mokhamad Fahmi Rizki Syaban Muhammad Anshory Muhammad Anshory, Muhammad Nadia Artha Dewi Najirman Najirman Nimas Eka Firdaningrum Nora Ariyanti Norma Hanifah Sumarta Nurdiana Nurdiana Nurdiana Nurdiana Pande Ketut Kurniari Pande Ketut Kurniari Perdana Aditya Perdana Aditya Perdana Aditya Rahman Pratama, Mirza Zaka Puspitasari, L Putri, Choirinnisa Meilia Ayu Radiyati Umi Partan Rakhma Yanti Helmi Ratih Manuaba Retnoningsih, Dewi Rifa’i, A RM Suryo Anggoro RM Suryo Anggoro KW RM. Suryo Anggoro KW Rudy Hidayat Rudy Hidayat Sanarto Santoso Sari, Tita Luthfia Siti Roziah Ria Famuji Solly Aryza Sumariyono Sumariyono Sarmidi Surya Darma Suryana, Bagus Putu Putra Suwito, Mat Tri Wahyudi Iman Dantara Wisnu Barlianto Wulansari Manuaba, Ida Ayu Ratih Yeni Larasati Yulyani Werdiningsih Zaenal Kusuma Zoraida Dwi Wahyuni