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All Journal Indonesian Journal of Health Science The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Anwar, Bariani
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Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Peran heart rate variability dan faktor inflamasi pada sindrom lelah kronik Anwar, Bariani; Faisal, Edward; Irvianita, Vinandia; Putranto, Rudi; Shatri, Hamzah
Indonesian Journal of Health Science Vol 4 No 6 (2024)
Publisher : PT WIM Solusi Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54957/ijhs.v4i6.1139

Abstract

Sindrom kelelahan kronis yang juga dikenal sebagai Myalgic Encephalomyelitis (ME), adalah kondisi kronis kompleks yang ditandai oleh kelelahan parah, disertai nyeri muskuloskeletal, gangguan kognitif, dan sistem autonom. Patofisiologi CFS melibatkan inflamasi kronis, disfungsi mitokondria, dan ketidakseimbangan sistem kekebalan, yang ditunjukkan dengan tingginya kadar sitokin pro-inflamasi. Aktivitas sitokin ini berperan dalam munculnya gejala utama seperti kelelahan, nyeri, dan penurunan kognitif. Diagnosis CFS merupakan proses yang kompleks karena didasarkan pada metode eksklusi dan belum adanya biomarker definitif sehingga menyebabkan banyak pasien tidak terdiagnosis. Heart Rate Variability (HRV) telah diajukan sebagai metode non-invasif untuk menilai disfungsi autonom pada CFS, di mana HRV rendah menunjukkan peningkatan risiko kelelahan dan disfungsi parasimpatis. Penggunaan HRV dan sitokin sebagai biomarker potensial menawarkan pendekatan yang lebih terukur dalam mendiagnosis CFS serta memprediksi prognosis. Namun, heterogenitas dalam hasil penelitian terkait peran sitokin menekankan pentingnya konsistensi metodologis di masa mendatang. Studi lanjutan tentang HRV dan inflamasi pada CFS diharapkan dapat berkontribusi pada strategi terapi yang lebih spesifik.
Recurrent Variceal Bleeding Due to Non-Cirrhotic Portal Hypertension in a Patient with Primary Myelofibrosis: Case Report Sitorus, Debora; Anwar, Bariani; Dinakrisma, Anastasia Asylia
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 26, No 3 (2025): VOLUME 26, NUMBER 3, December, 2025
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2632025293-297

Abstract

Acute upper gastrointestinal bleeding may arise from variceal or non-variceal sources. Primary myelofibrosis, classified as a subtype of myeloproliferative neoplasms, represents an uncommon clinically significant etiology of non-cirrhotic portal hypertension. The authors reported a case of a 39-year-old woman with recurrent variceal bleeding for six years. She presented with progressive weight loss, splenomegaly, and severe anemia. One year before her first episode of hematemesis, a bone marrow biopsy revealed myelofibrosis grade 2, and JAK2 V617F mutation was positive, confirming primary myelofibrosis. The treatment was discontinued due to high expense. Abdominal ultrasonography showed portal hypertension and changes suggestive of cirrhosis. She underwent successful endoscopic variceal ligation to control active bleeding, and initiation of a JAK inhibitor (ruxolitinib) was recommended for outpatient management to address the underlying disease. This case highlights that in patients presenting with variceal bleeding and portal hypertension in the absence of cirrhosis, myeloproliferative neoplasms, such as primary myelofibrosis should be considered as a differential diagnosis. This study aimed to raise awareness of primary myelofibrosis as a rare cause of non-cirrhotic portal hypertension and emphasize the importance of early recognition and targeted therapy to prevent recurrent bleeding and disease progression.
Co-Authors Dinakrisma, Anastasia Asylia E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Faisal, Edward Irvianita, Vinandia Rudi Putranto Sitorus, Debora