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All Journal Jurnal Riset Rumpun Ilmu Kedokteran (JURRIKE)
Fara Julyta Aliyah
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Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Efek Hook pada Prolaktinoma: Tantangan Diagnosis pada Remaja dengan Galaktorea dan Amenore Fara Julyta Aliyah; Rijal Bulqini
JURNAL RISET RUMPUN ILMU KEDOKTERAN Vol. 5 No. 1 (2026): April: Jurnal Riset Rumpun Ilmu Kedokteran
Publisher : Pusat riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/jurrike.v5i1.8379

Abstract

Prolactinoma is the most common functional pituitary adenoma, particularly in adolescent females, and is typically characterized by amenorrhea and galactorrhea resulting from hyperprolactinemia. However, in certain cases, serum prolactin levels may appear normal due to the hook effect, an immunoassay measurement error caused by extremely high prolactin concentrations that interfere with antigen–antibody complex formation. We report the case of a 17-year-old female presenting with a five-month history of galactorrhea, accompanied by breast pain, headache, and primary amenorrhea. Brain MRI revealed a pituitary mass measuring 1.4 × 0.8 × 0.5 cm, suspicious for prolactinoma, while serum prolactin was within the normal range (17.33 ng/mL). The discrepancy between clinical manifestations, lesion size, and laboratory findings raised suspicion of the hook effect. The patient was treated with dopamine agonists, bromocriptine and cabergoline, and referred for multidisciplinary management involving endocrinology, neurosurgery, and obstetrics–gynecology. Despite the absence of prolactin dilution testing, MRI findings supported the diagnosis of prolactinoma, and the patient demonstrated a favorable clinical response to therapy. This case highlights the importance of recognizing laboratory variability, performing comprehensive hormonal evaluation, and considering prolactin dilution assays when clinical and laboratory findings are discordant, particularly in adolescent patients with suggestive symptoms.
Kehamilan Dini Setelah Sleeve Gastrectomy pada Pasien dengan Triple Metabolic Burden: Kasus Kompleks Diabetes Tipe 2, Hipotiroid, dan Preeklampsia Berat dengan Pertumbuhan Janin Terhambat Amal Bahrum Penas; Cut Meurah Yeni; Yusra Septivera; Cut Rika Maharani; Fara Julyta Aliyah
JURNAL RISET RUMPUN ILMU KEDOKTERAN Vol. 5 No. 2 (2026): Agustus: Jurnal Riset Rumpun Ilmu Kedokteran
Publisher : Pusat riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/jurrike.v5i2.9152

Abstract

Bariatric surgery is effective in treating obesity and type 2 diabetes mellitus (T2DM); however, pregnancy occurring within 12–24 months after surgery carries significant risks. This report presents a complex pregnancy case in a patient with a history of sleeve gastrectomy, post-hemithyroidectomy hypothyroidism, and T2DM. A 29-year-old primigravida conceived 2 months after undergoing sleeve gastrectomy, which successfully induced T2DM remission, with HbA1c decreasing from 11% to 5.5%. Although glycemic control and euthyroid status were maintained throughout pregnancy, the patient developed severe preeclampsia at 35–36 weeks of gestation, complicated by intrauterine growth restriction (IUGR) and oligohydramnios. An emergency cesarean section delivered a male infant weighing 2000 grams with Apgar scores of 8 and 9 at the first and fifth minutes, respectively. The neonate required 14 days of NICU care due to respiratory distress syndrome, respiratory failure, and hyperbilirubinemia. Maternal gestational weight gain was suboptimal at only 4 kg, below the recommended range for pregnant women with obesity. This case highlights the importance of adhering to the recommended surgery-to-conception interval following bariatric surgery. Early pregnancy after surgery, combined with multiple metabolic comorbidities, may contribute to adverse maternal and neonatal outcomes. Multidisciplinary management, comprehensive nutritional monitoring, and optimization of comorbidities before conception are essential to improve pregnancy outcomes in this population.
Low Grade Fibromyxoid Sarcoma pada Pelvis yang Menyerupai Keganasan Ovarium: Laporan Kasus Salah Diagnosis Tanpa CT Scan Praoperatif Puteri Moetia Charisma; Munizar Munizar; Hasanuddin Hasanuddin; Dewi Karlina Rusly; Fara Julyta Aliyah
JURNAL RISET RUMPUN ILMU KEDOKTERAN Vol. 5 No. 2 (2026): Agustus: Jurnal Riset Rumpun Ilmu Kedokteran
Publisher : Pusat riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/jurrike.v5i2.9153

Abstract

Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft tissue tumor with deceptively benign histological features but significant potential for local recurrence and distant metastasis. Pelvic LGFMS is extremely uncommon and may mimic gynecological malignancies, leading to diagnostic challenges. This report describes a 39-year-old woman presenting with progressive abdominal enlargement, bloating, early satiety, and dyspnea. Physical and ultrasonographic examinations suggested a malignant ovarian tumor. The patient underwent exploratory laparotomy without preoperative CT scan evaluation. Intraoperatively, multiple solid masses involving the intestines, mesentery, omentum, peritoneum, and ovaries were identified, with the largest measuring 20 × 15 cm. Histopathological examination confirmed the diagnosis of LGFMS. The absence of preoperative cross-sectional imaging contributed to diagnostic difficulty in this case. CT scan and MRI are important for evaluating tumor origin, tissue characteristics, and involvement of surrounding structures. Definitive diagnosis requires histopathology supported by immunohistochemistry, particularly MUC4, and molecular confirmation when available. Comprehensive diagnostic evaluation is essential to avoid misdiagnosis, optimize management, and improve long-term outcomes in patients with pelvic LGFMS.
Co-Authors Amal Bahrum Penas Cut Meurah Yeni Cut Rika Maharani Dewi Karlina Rusly Hasanuddin Hasanuddin Munizar Munizar Puteri Moetia Charisma Rijal Bulqini Yusra Septivera