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All Journal JOURNAL OF SCIENCE AND SOCIAL RESEARCH Muhammadiyah Law Review Deka in Medicine
Raharjo, Fajar
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Journal : Deka in Medicine

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Case report: Therapeutic approach to secondary polycythemia vera in an adult with eisenmenger syndrome Lil Alamin, Rahmatan; Raharjo, Fajar; Gunawan, Michelle; Wardhani, Shinta
Deka in Medicine Vol. 1 No. 3 (2024): December 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2024.e433

Abstract

BACKGROUND: Secondary Polycythemia Vera due to Eisenmenger Syndrome remains a big challenge, and the reported cases regarding this condition are still scanty. CASE: This was a case of a 22-year-old girl who, since childhood, had complaints of fatigue most of the time and thus showed more intolerance to heavy physical work. She had a history of a congenital heart defect, with lip and finger cyanosis that increased upon fatigue, and she had undergone Bi-directional Cavo-pulmonary Shunt. Physical examination showed cyanosis with clubbing of fingers with low oxygen saturation. Further diagnosis testing revealed this was a case of Eisenmenger Syndrome due to congenital heart abnormalities, with Polycythemia Vera: Secondary to the diagnosis. The patient also had a hemoglobin level of 21.1g/dL and a hematocrit level of 64.2%. Based on the diagnosis, treatment was given in the form of hydration therapy along with medications. Additionally, phlebotomy was performed. Because the patient improved clinically from the applied treatment, the patient was discharged after 5 days. CONCLUSION: Early diagnosis, a multidisciplinary approach, and proper interventions are important in the management of Eisenmenger Syndrome and associated Polycythemia Vera to avoid complications and hence improve outcomes.
From joint to heart: Cardiovascular implications of rheumatoid arthritis Raharjo, Fajar; Anjarwani, Setyasih
Deka in Medicine Vol. 1 No. 3 (2024): December 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2024.e361

Abstract

Rheumatoid arthritis is a commonly encountered autoimmune disease and a progressive chronic inflammatory condition that often leads to permanent joint damage. Systemic inflammation in rheumatoid arthritis is linked to various comorbid conditions such as interstitial lung disease, osteoporosis, metabolic syndrome, cardiovascular disease, infections, malignancies, cognitive dysfunction, depression, and fatigue, which can increase morbidity and mortality in rheumatoid arthritis patients. Approximately 36% of patients report worse health and limitations in daily activities, while nearly 30% require more assistance with personal care compared to individuals without rheumatoid arthritis. Epidemiological data from 1990 to 2017 show an incidence of rheumatoid arthritis of 246.6 per 100,000 people aged 33-54 years, with prevalence in women 2-3 times higher. In Southeast Asia, the incidence is 89 per 100,000 in individuals aged 13-22 years, while in Indonesia, it is estimated at around 5-7.5 per 100,000 population. Cardiovascular disease is the primary cause of mortality in rheumatoid arthritis patients, with myocardial infarction being the major contributor. The pathogenesis of rheumatoid arthritis is still complex and involves immunological processes that occur long before joint inflammation symptoms appear, including genetic modifications and environmental factors that lead to deimination and joint disturbances. Cardiovascular manifestations, particularly myocardial infarction, occur due to an atherosclerotic process triggered by rheumatoid antibody complexes. Given the higher cardiovascular risk in rheumatoid arthritis patients, early detection and awareness of these manifestations are crucial for better management.
Co-Authors Anjarwani, Setyasih Dian Kristiawan Nugroho Eka Ardhianto Eksawati, Rini Indah Pratiwi Lil Alamin, Rahmatan Michelle Gunawan, Michelle Palupi, Dian Putra, Tegar Harbriyana RIO FERDIAN, MUHAMMAD BAGAS Wardhani, Shinta Wiratno, Amat YUDHAYANA, ADHI