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INDONESIA
Indonesian Journal of Rheumatology
Published by Indonesian Rheumatology Association
ISSN : 20861435     EISSN : 25811142     DOI : -
Core Subject : Health,
Medicine & Pharmacology
Indonesian Journal of Rheumatology is a peer-reviewed open access journal on rheumatic diseases and connective tissue disorders. This is an official journal of Indonesian Rheumatology Associantion (IRA) and published twice a year since 2009. Our mission is to encourage the development of scientific and medical practice in rheumatic diseases and connective tissue disorders. This journal is self-focused on rheumatic disease and connective tissue disorders in the form of original article (extended and/or concise reports), review articles, editorial letters, leaders, lesson from memorable cases, book reviews, and matter arising. Both in clinical and laboratory including animal studies.
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Articles 9 Documents
 1 
Search results for , issue " Vol 2, No 1 (2010)" : 9 Documents clear
Calcinosis and myocarditis in systemic lupus erythematosus patient Dewi, Sumartini; Wachjudi, Rachmat Gunadi
Indonesian Journal of Rheumatology Vol 2, No 1 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Systemic lupus erythematosus (SLE) patients have multi-organ involvement related to their chronic inflammatory, autoimmune disease. Calcinosis can be clinical manifestations of SLE. Tissue calcinosis is reported in approximately 17% patients and myocarditis in 20-55% patients. Thus, both manifestations are not unusual in SLE. Tachypnea, tachycardia, pericardial effusion, and wheezing are often present and can be misleading in SLE patient.1,2 Calcinosis is less common in SLE, sometimesit is found as an incidental radiological finding. Calcification in SLE maybe periarticular, within joints or muscles, or in the subcutis (calcinosis universalis).1 Calcinosis is classified into four subsets: dystrophic, metastatic, idiopathic, or calciphylaxis/iatrogenic. When calcinosis cutis is isolated to a small area in extremities and joints, it is called calcinosis circumscripta; whereas its diffuse form, refers to calcinosis universalis, affects subcutaneous and fibrous structures of muscles and tendons. The pathophysiology of this condition is unknown and no effective therapy is currently available.3,4,5 Systemic lupus erythematosus can involve the myocardium, pericardium, cardiac valves,and coronary arteries. Myocarditis in SLE is not likely to produce major regional wall motion abnormalities but may contribute to global left ventricular dysfunction.7,8We report a young woman with SLE who developed calcinosis and myocarditis.
Diabetes insipidus in neuropsychiatric-systemic lupus erythematosus patient Pangestu, Y; Wardoyo, A; Wijaya, Linda K; SETIYOHADI, BAMBANG; Albar, Zuljasri; Sukmana, N; Budiman, Budiman; Djoerban, Z; Effendy, S; Aziza, L; Sitorus, F
Indonesian Journal of Rheumatology Vol 2, No 1 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Systemic lupus erythematosus (SLE) is an idiopathic autoimmune chronic inflammatorydisease that is unique in its diversity of clinical manifestations, variability of disease’s progression, and prognosis. The disease is characterized by the remission and multiple flare-ups in between the chronic phase that may affect many organ systems.The prevalence of SLE in the US population is 1:1000 with a woman to man ratio of about 9-14:1. At Cipto Mangunkusumo Hospital, Jakarta in 2002, there was 1.4% cases of SLE of the total number of patients at the Rheumatology Clinic. Neuropsychiatric manifestations of SLE (NP-SLE) have a high mortality and morbidity rates. The incidence of NP-SLE ranges 18-61%. Diagnosis of NP-SLE is difficult because there is no specific laboratory examination. Accordingly, in all SLE patients with central nervous system (CNS) dysfunction, additional tests will be necessary to confirm an NP-SLE diagnosis and exclude other causes. Similar to diabetes insipidus, SLE is a systemic disease which affects many organ systems, one being the endocrine system. No data has specified the occurrence rate of diabetes insipidus in SLE patients. This disease arises from a number of factors able to interfere with the mechanism of neurohypophyseal renal reflex resulting in the body’s failure to convert water.3 There are three general forms of the disease, a polydipsicpolyuric syndrome caused by partial/complete vasopressin deficiency (central-diabetes-insipidus/CDI), vasopressin resistance of the kidney tubules (nephrogenic-diabetes-insipidus/NDI), and primary polydipsia. CDI occurs in about 1 in 25,000 persons
Vitamin D and inflammation Albar, Zuljasri
Indonesian Journal of Rheumatology Vol 2, No 1 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

The discovery that most body cells and tissues have vitamin D receptors and that some of them have the enzymatic machinery to convert the circulating form of vitamin D (25-hydroxyvitamin D) into the active form (1,25- dihydroxyvitamin D/1,25(OH)2D3 ) gave a new insight about the function of this vitamin. In the course of time, more and more evidences showed that a low vitamin D level leads to the occurrence or recurrenceof cardiovascular diseases, type II diabetes mellitus (DM), cell dedifferentiation (oncogenesis), and immune derangement (autoimmune diseases such as lupus, typeI DM, rheumatoid arthritis, and multiple sclerosis). Most researchers have agreed that a minimum 25(OH)D3 serum level of about 30 ng/ml or more is necessary for favorable calcium absorption and good health. Until proven otherwise, the balance of the research clearly indicates that oral supplementation in the range of 1,000 IU/day for infants, 2,000 IU/day for children, and 4,000 IU/day for adults is safe and reasonable to meetphysiologic requirements, to promote optimal health, and to reduce the risk of several serious diseases.
Osteoarticular tuberculosis of the right foot: a diagnostic delayed Akil, Natsir; Setiyohadi, Bambang; Lubis, A MT; Fawziah, A
Indonesian Journal of Rheumatology Vol 2, No 1 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Extrapulmonary tuberculosis (TB) involving the musculoskeletal system occurs in approximately 1% to 3% of patients with extrapulmonary TB. Concurrent pulmonary or intrathoracic TB is present in less than 50% of cases.1 Spine is the most frequent site of osseous tuberculous involvement. Other affected sites include the hip, knee, foot, elbow, hand, and bursal sheaths.2 Tuberculosis of the foot and ankle remains anuncommon site of the infection, present in 8% to 10% of osteoarticular infection. The diagnosis of osteoarticular tuberculosis is often delayed due to a lack of familiarity with the disease.3 We describe a patient with foot pain and swelling without any respiratory symptom as initial presentation of pulmonary and osteoarticular tuberculosis
Hyperuricemia and Pro Inflammatory Cytokine (IL-1β, IL-6, and TNF-α) Hadi, Suyanto; Sudarsono, D; Suntoko, Bantar
Indonesian Journal of Rheumatology Vol 2, No 1 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Background. Rugerio et al 2006 reported that there were a positive correlation between the level of hyperuricemia and the level of IL-1β, IL-6, and TNF-α pro infl ammatory cytokines value. On the other hand, Choi et al reported a negative correlation between hyperuricemia and the level of pro infl ammatory cytokine in the late phase of hyperuricemia.Methods. Venous blood samples were collected and stored at a temperature of - 80oC from in- and outpatients with hyperuricemia with age of more than 17years old at Dr. Kariadi Hospital, Semarang. The level of uric acids (mg/dl) were examined with enzymatic colorimetric technique (Roche Diagnostics) whereasthe levels of IL-1β, IL-6, and TNF-α pro infl ammatory cytokines (pg/ml) were examined with enzyme linked immunosorbent assay (ELISA) technique using ultrasensitive commercial kit (Human ultra sensitive, Biosource International Inc Europe), and ELX 800, 2002 machine. The normality of the data was tested withOne-Sample Kolmogorov-Smirnov technique and the correlation was tested with Spearman correlation (data with abnormal distribution) or Pearson correlation (datawith normal distribution).Results. There was a weak positive correlation between the level of hyperuricemia and the level of IL-1 β cytokine in Spearman correlation test with r value = 0.246 and p value > 0.05 in Spearman correlation test. On the other hand, there was a weak negative correlation between the level of hyperuricemia and the level of TNF-α cytokine with r value = - 0.096 and p value > 0.05. There was also weak negative correlation between the level of hyperuricemia and the level of IL-6 cytokine with r value = - 0.072 and p value > 0.05 in Pearson correlation test.Conclusion. There was a weak positive correlation but not sifnificant between the level of hyperuricemia and the level of IL-1β.
Septic arthritis caused by Salmonella sp Hambali, Wirawan; Sumariyono, Sumariyono; Chen, K
Indonesian Journal of Rheumatology Vol 2, No 1 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Septic arthritis is a rare joint disorder, and can be caused by various pathogenic microorganisms, including bacteria, virus, mycobacterium, and fungus. The incidence of this infection is between 2 to 10 cases per 100,000 populations annually andcan reach as high as 30 to 70 cases per 100,000 in immunodeficient population. This disorder is frequently unidentified in early phase of the disease due to its unspecific symptoms and signs.1 This joint infection can cause numerous problems to the patient ranging from joint damage, bone erosion, osteomyelitis, fibrosis, ankylosis, sepsis,or even death.1-5 The case-fatality rate for this disorder can reach up to 11%, comparable to the case fatality rate for other community infections such as pneumonia.2,6 Salmonella sp. is a Gram-negative bacillus bacterium with main invasion predilection in intestinal villi.7 This microorganism rarely causes septic arthritis although several cases have been reported before. Ortiz-Neu et al. demonstrated that septic arthritis caused by Salmonella sp. has high relapse incidence and a tendency to turnchronic, making the treatment more difficult and challenging
Correlation between anti-cyclic citrullinated peptide antibodies and the severity of clinical manifestation, laboratory manifestation, and radiological joint destruction in rheumatoid arthritis patients Suwito, Mat; Handono, Kusworini; Suryana, Bagus Putu Putra; Kalim, Handono; Wahono, Cesarius Singgih
Indonesian Journal of Rheumatology Vol 2, No 1 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Background. The second generation anti-cyclic citrullinated peptide test (CCP2) displays sensitivity comparable to that of rheumatoid factor (RF) (approximately 80%) but with superior specificity (98%) . Several observations have indicated that early rheumatoid arthritis (RA) patients with positive anti-CCP may develop a more erosive disease than those without anti-CCP.Objective. The purpose of this cross-sectional study was to investigate the correlation between anti-CCP antibodies and clinical and laboratory parameters and radiological joint destruction in RA patients.Methods. We studied 31 patients with RA fulfilling the 1987 revised criteria of American College of Rheumatology in Rheumatology Clinic of Saiful Anwar General Hospital, Malang, Indonesia. Clinical parameters were collected such as age, sex, visual analog scale,disease duration and diseases activity score (DAS28-3(CRP)). Laboratory parameters were WBC, hemoglobin, platelet count, erythrocyte sedimentation rate, and Creactive protein. Analyzed autoantibody profiles were RF and anti-CCP (ELISA methode). Radiological jointdestruction was evaluated from bilateral postero-anterior manus x ray (Sharp score).Results. Anti-CCP antibodies were detected in 48.4% of RA patients with mean antibody concentration was 291.24±143.67 (range 16-523.8) units. Anti CCP level was significantly correlated with duration of RA (month) (p=0.04, r=0.371), RF level (p=0.002, r=0.542) andSharp score (p=0.048, r=0.358), but was not significantly correlated with other clinical and laboratory parameters.Conclusion. Anti-CCP level was correlated with duration of disease, RF, and Sharp score.
Chronic polyarthritis mimicking rheumatoid arthritis in a patient with leprosy Haribowo, A S; Suryana, Bagus Putu Putra; Handono, Kusworini
Indonesian Journal of Rheumatology Vol 2, No 1 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Currently leprosy is now still a global threat in the world even after the introduction of multidrug therapy (MDT), including in Indonesia.1 World Health Organization (WHO) data revealed that in 2002 there were 597,000 cases worldwide and the prevalence is only less than 1 every 10,000 populations.2 Nevertheless, the latest data showedthat 83% of leprosy cases concentrated in only 6 countries: Indonesia, India, Brazil, Madagascar, Myanmar, and Nepal.3 The most common manifestations of leprosyare cutaneous and neuritic manifestation. Rheumatologic manifestation is another common manifestation of leprosy.4-7 Prevalence of rheumatologic manifestation of leprosy is range from 1% to 77% of all leprosy patients.4-11 Study conducted by Mandal et al in India revealed that the prevalence of rheumatologic manifestation was 5.9%, in Brazil,6 another study by Pereira revealed the prevalence of 9.1%.5 Hadi, in Indonesia,showed the prevalence of arthritic manifestation was 7.5%.8 Rheumatologic  manifestations that can be found in leprosy are polyarthritis or oligoarthritis, soft tissue rheumatism, noninflammatory arthritis, and also enthesitis.4-7 We report a patient presenting with polyarthritis as the primary manifestation of leprosy.
Profile of osteophyte location in different grades of functional status in patients with knee osteoarthritis Mesanti, O; SETIYOHADI, BAMBANG; Kasjmir, Yoga I; Budihusodo, U; Oemardi, M
Indonesian Journal of Rheumatology Vol 2, No 1 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Background. Osteophyte is a reparative response to cartilage breakdown in osteoarthritis (OA) and osteophyte formation is a knee stabilizing factor. Disability could be found in patients with knee OA. Objective. To identify the profile of osteophyte formation (location, size, and direction) based on knee radiograph and functional status examination in knee OA patients who presented to the Rheumatology Clinic, Cipto Mangunkusumo Central National General Hospital.Methods. Samples were taken by consecutive approach. Knee radiographs (weight bearing anteroposterior and30 degrees flexion skyline views) and functional status examinations were performed on 100 patients with knee OA (90 females and 10 males with ages ranging from 51 to 74 years old). A radiologist assessed films for osteophyte profile such as location, size, and direction according to standard atlas. One knee with the severe radiological assessment based on OA grade was selected from one patient to be the profile. LequesneAlgofunctional Index was also taken from the patients. Results. The site of osteophyte in patients with knee OA was mostly found at lateral femur (85/100 subjects). Based on specific location, grade 2 osteophyte at lateral femur was the most frequent size (49/100 subjects) and osteophyte extending toward the lower middle atlateral patella (65/100 subjects) was the most frequent direction of osteophyte. The most frequent profile for size and direction of osteophyte at specific location was the grade 2 osteophyte extending toward the lower middle at lateral patella (35/100 subjects). Severe functional status impairment was found in 53% of the patients. The most frequent functional status found according to specific location of osteophyte was severe functionalstatus impairment in patients with oste ophyte at lateral femur (46/100 subjects). The most frequent functional status of OA patients based on the size and direction of osteophyte at specific location was the severe functional impairment in the patients with grade 2  osteophyte at lateral femur (27/100 subjects) and the patients with osteophyte extending towards the lower middle at lateral patella (37/100 subjects) respectively.Conclusions. Osteophyte at lateral femur, osteophyte at lateral tibiofemoral compartment, grade 2 osteophyte at lateral femur, and osteophyte extending toward the lower middle at lateral patella were the profiles of osteophyte which mostly showed severe functional status impairment in patients with knee OA.

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