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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.
Arjuna Subject : -
Articles 9 Documents
 1 
Search results for , issue " Vol 2, No 2 (2010)" : 9 Documents clear
Multiple autoimmune syndrome (Graves’ disease, systemic lupus erythematosus, and systemic sclerosis) in a young woman in Jakarta Dewi, Sumartini; Setiyohadi, Bambang; Mokoagow, M I
Indonesian Journal of Rheumatology Vol 2, No 2 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Multiple autoimmune syndrome (MAS) is a condition in which patients have at least threedistinct autoimmune conditions. The definition of MAS is based on 91 reported cases of such associations in the literature. A review of the literature and cluster analysis of MAS disclosed systemic lupus erythematosus (SLE), Sjögren’s syndrome, and autoimmune thyroid disease (AITD) as the “chaperones” of autoimmune diseases. This entity was described by Humbert and Dupond in 1988 as a syndrome consisting of the presenceof three or more autoimmune diseases in a single patient. While describing the syndrome, their observations led them to a rough classification of clusters based on the co-occurrence of autoimmune disease, which they identified as types one through three.1 In MAS-1, the authors grouped myasthenia gravis, thymoma, dermatopolymyositis, and autoimmune myocarditis together. In MAS-2, they grouped Sjögren’s syndrome, rheumatoid arthritis,primary biliary cirrhosis, systemic sclerosis (SSc), and AITD. MAS-3 consists of AITD, myasthenia gravis and/or thymoma, Sjögren’s syndrome, pernicious anemia, idiopathic thrombocytopenic purpura, Addison’s disese, type 1 diabetes, vitiligo, autoimmune hemolytic anemia, and SLE.1,2,3 The importance of this concept is the probability thathaving three autoimmune diseases simultaneously in one patient goes beyond epidemiological inferences or statistical chance. Disorders of autoimmune pathogenesis occur with increased frequency in patients with a history of another autoimmune disease. The tendency to develop another disease occurs in about 25% of these patients.3,4 We report a case in which the presence of Graves’ disease/AITD, SLE, vasculitis, and SSc with pulmonary hypertension and Raynaud’s phenomenon in one patient
Atherosclerosis prevalence and the correlation between atherosclerosis risk factors and carotid intima-media thickness in below 40-year-old women with systemic lupus erythematosus Sari, R M; Kasjmir, Yoga I; Antono, D; Setiati, S
Indonesian Journal of Rheumatology Vol 2, No 2 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Objectives: To determine the prevalence of atherosclerosis in female systemic lupus erythematosus (SLE) patients aged below 40 years old and the factors correlated with carotid intima-media (CIM) thickening.Methods: A cross-sectional study was conducted on 80 female SLE respondents aged below 40 years old who were either in- or outpatient of Cipto Mangunkusumo General Hospital, Jakarta. History of disease and treatment was taken, and laboratory test and  ultrasonography of the carotid artery to evaluate CIM thickness were performed.Results: The prevalence of atherosclerosis was 40%, comprising of CIM thickening and/or presence of atherosclerotic plaque in the carotid artery. The median values of CIM thickness in the right common carotid artery, right carotid bulb, left common carotid artery, and left carotid bulb were 0.040 cm, 0.04535 cm, 0.0430 cm, and 0.047 cm, respectively. There was also a positive correlation reported of CIM thickness with increased age, the duration of SLE disease, and the duration of steroid treatment.Conclusions: We found a positive correlation of CIM thickness with age, the duration of SLE disease, and the duration of steroid treatment in female SLE patients aged below 40 years.
Role of interleukin-17 in the pathogenesis of rheumatoid arthritis Ongkowijaya, Jeffrey A; Setiyohadi, Bambang; Sumariyono, Sumariyono; Kasjmir, Yoga I
Indonesian Journal of Rheumatology Vol 2, No 2 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Rheumatoid arthritis (RA) is a systemic autoimmune disorder with an unknown etiology. It typically affects the peripheral synovial joints symmetrically. The roles of T and B cells, macrophages, plasmocytes, host tissue cells (synoviocytes, chondrocytes), and osteoclastsin RA are more defi ned. In RA, cytokines secreted by cells implicated in adaptive and natural immunity have important roles in causing infl ammation, articular destruction, and other comorbid diseases related to RA. Other than the clear roles of interleukin (IL)-1 and tumor necrosis factor α, there are other cytokines that are suspected of having roles in the pathogenesis of RA, IL-17 for instance. Interleukin-17 is a proinfl ammatory cytokine,  produced by Th17 cells, and has pleiotropic effects on various cells contributing to the pathogenic condition of RA. Several studies showed that this cytokine maintains the infl ammation and causes more destruction of joint cartilage. Advances in the understanding of the role of IL-17 elicits the idea to modulate IL-17 and/or Th17 cells as the potential targetsof therapy in RA
Arthritis in leprosy without specific skin lesion Dewi, Sumartini; Setiyohadi, Bambang
Indonesian Journal of Rheumatology Vol 2, No 2 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Leprosy patients could display a great variability of signs and symptoms. An overabundance of rheumatic manifestations, occuring alone or in varying combinations, are associated with leprosy, particularly with lepra reactions A study involving seventy cases of leprosy found that rheumatic manifestations were seen in 61.42% of cases: arthritis in 54.28% and soft tissue rheumatism in 17.14%. Enthesitis was seen in 2.84% of cases. Rheumatic manifestations may be the primary complaint, thus delaying accurate diagnosis. Musculoskeletal involvement in leprosy is the third most frequent manifestation after dermatological and neurological involvements. It can occur at anytime during the infection. Articular inflammation in leprosy, which closely mimics other rheumatic disorders, usually occurs in reactive states, particularly erythema nodosum leprosum (ENL).1 About 1–5% of leprosy patients are reported of developing arthritis (synovial inflammation) at some stage of the disease but this rate increases to over 50% during lepra reactions.2 Here we report a case of arthritis in leprosywithout any typical skin lesion thus causing a delay in diagnosis.
Correlation of autoantibodies with the Disease Activity Score 28 and radiographic hand joint damage in rheumatoid arthritis patients Manuaba, Ida Ayu Ratih Wulansari; Sumariyono, Sumariyono; Isbagio, Harry
Indonesian Journal of Rheumatology Vol 2, No 2 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: Rheumatoid arthritis (RA) is a systemic chronic infl ammatory disease of the joint that causes deformity or disability leading to a decreased function in RA patients. According to the 1987 American College of Rheumatology, rheumatoid factor (RF) is used as one of the diagnostic criteria because until today it is still considered as the primary autoantibody in RA although it has a lower specifi city than that of anticyclic citrullinated peptide (anti-CCP). Besides RF and anti-CCP, anti-RA33 is another autoantibody found. Thepresence of the three autoantibodies in RA patient serum is important because it is the starting point of the pathogenesis of the autoimmune process in RA.Methods: This is a cross-sectional study using consecutive sampling. Forty six subjects, all suffering from RA, were recruited for this study. All of them were tested for RF, anti-CCP, anti-RA33 titers using enzymelinked immunosorbent assay (ELISA) method and hadtheir hand radiograph taken to obtain the Sharp score to evaluate joint damage. During this study, 28-joint Disease Activity Score (DAS28) (4 parameters) was also evaluated using erythrocyte sedimentation rate as one of the parameters.Results: The study found that the correlation between the three antibodies and DAS28 was not statistically signifi cant: RF (r = 0.200, p = 0.091), anti-CCP (r =0.117, p = 0.220), and anti-RA33 (r = 0.126, p = 0.202). There was a signifi cant correlation between antiCCP and the Sharp score (r = 0.300, p = 0.021). The correlation between the other two autoantibodies and the Sharp score was not statistically significant:RF (r = 0.194, p = 0.098), anti-RA33 (r = 0.156, p = 0.150).Conclusion: There was a signifi cant correlation between anti-CCP autoantibody and  radiographic hand joint damage in RA patients so that it could be used as an indicator for occurrence of an erosive or a more severe RA.
Complete manifestations of Behçet’s disease Umami, V; Setiyohadi, Bambang
Indonesian Journal of Rheumatology Vol 2, No 2 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Behçet’s disease (BD) is a chronic, relapsing, inflammatory disease characterized by recurrent oral aphthae and any of several systemic manifestations that include genital aphthae, ocular disease, skin lesions, neurologic disease, vascular disease, or arthritis. Hippocrates may had described BD in the fifth century B.C.; however, the first official description of the syndrome was attributed to the Turkish dermatologist Hulusi Behçet in 1924. In 1930, the Greek physician Adamantiades reported a patient with inflammatory arthritis, oral and genital ulcers, phlebitis, and iritis.1 Since then, the syndrome has been referred to as BD.1,2 The manifestations of BD are thought to be caused by an underlying vasculitis. Although this disease is recognized worldwide, the prevalence is highest in the eastern Mediterranean, the Middle Eastern, and East Asian countries, thus the nickname Silk Road disease. The disease tends to be more severe in areas where it is more common. Prevalence rates all over the world are increasing, probably because of improved recognition and reporting. Behçet’s disease occurs primarily in young adults. The mean age at onset is between 25 and 30 years. The incidence of disease in males and females is approximately equal along the Silk Road, but in Japan, Korea, and Western countries the disease occurs more frequently in women. Caseconfirmation can be challenging because many patients labeled as having BD have oral ulcers as the primary or sole manifestation.3
Predictor of joint damage in rheumatoid arthritis Sumariyono, Sumariyono; Isbagio, H
Indonesian Journal of Rheumatology Vol 2, No 2 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Objective: This study was implemented to determine the joint damage predictor in rheumatoid arthritis (RA).Methods: A cross-sectional study was conducted on outpatients of the rheumatology clinic at Cipto Mangunkusumo General Hospital who had suffered from RA for more than 2 years during the period from October 1, 1999 to June 30, 2000. During this period, we obtained 23 RA patients who fulfi lled the inclusion and exclusion criteria. We evaluated the patients’ medical data that included gender, education, age of onset, rheumatoid factor (RF), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Then we carriedout examinations and tests including X-ray of hand and wrist joints, RF, CRP, and ESR. The degree of joint damage was evaluated using the Larsen score.Results: Twenty three patients—all women, mean age of onset was 36.7 years, mean duration of disease was 62.8 months, educational level with high school degree or above were found in 19 cases (82.6%), and RF (+) at initial treatment were found in 10 cases (43.5%). The mean ESR at initial treatment was 77.9 mm/hr and CRP at initial treatment was between 0 and 768 mg/dL. The Larsen score ranged between 0 and 68 with a meanof 21.7. In bivariate analysis, the Larsen score was signifi cantly higher in the group with positive RF at initial treatment compared to that in the group with negative RF at initial treatment (p = 0.031). C-reactive protein and ESR at initial treatment and the age of onset did not have any signifi cant correlation with the Larsen score, but there was a signifi cant correlation of CRP and ESR during the study with the the Larsen score.Conclusion: RF level was the most signifi cant predictor in determining the degree of joint damage according to the Larsen score while initial positive RF had lower signifi cance level.
Erosive osteoarthritis Ongkowijaya, Jeffrey A; Setiyohadi, Bambang; Sumariyono, Sumariyono
Indonesian Journal of Rheumatology Vol 2, No 2 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Osteoarthritis (OA) is a degenerative joint disease characterized by the erosion of cartilage joints, hypertrophy of the marginal bone, subchondral sclerosis, and the morphological and biochemical changes of synovial membrane and joint capsule.This clinical syndrome is characterized by joint pain caused by degeneration of the joints. It is the most common joint disease to afflict the elderly and it occurs more often with age.1–3 Erosive osteoarthritis is a subset of OA in which there is a destruction of the joints as a result of inflammation.3,4 Changes mainly occur on the distal interphalangeal (DIP) joints, proximal interphalangeal (PIP) joints, carpometacarpal (CMC) joints, and very rarely occur on other joints of hand or of other body parts.3–5 The diagnosis is in accordance with the criteria of American College of Rheumatology (ACR) for OA and is supported by the existence of bone erosion on the radiological image. The management of this disease is merely for palliative purpose.
Correlation of matrix metalloproteinase-9 level, erythrocyte sedimentation rate, rheumatoid factor, and the duration of illness with radiological findings in rheumatoid arthritis patients Aji, G; Manuaba, Ida Ayu Ratih Wulansari; Ongkowijaya, Jeffrey A; Setiyohadi, Bambang; Sumariyono, Sumariyono
Indonesian Journal of Rheumatology Vol 2, No 2 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: Rheumatoid arthritis (RA) is a common autoimmune disease of the joint indicated by chronic inflammation of synovium, cartilage destruction, and osteopenia. The end results of RA are joint deformity and disability that will decrease the quality of life ofthe patients. Until now there is not a specifi c marker to assess the process of joint and bone damage in RA. Available markers such as C-reactive protein and erythrocyte sedimentation rate (ESR) indicate more about the infl ammatory status of the patient. Thediscovery of matrix metalloproteinases (MMPs) enzyme overexpression in RA has brought a new hope for the discovery of more specifi c markers of joint damage.Objective: To study the correlation of MMP-9 level, ESR, rheumatoid factor (RF), and the duration of illness with joint damage in RA patients.Methods: A cross-sectional study was conducted on RA outpatients in rheumatology clinic at Cipto Mangunkusumo General Hospital, Jakarta from January to October 2009. From the patients who fulfilled the inclusion criteria and did not fulfi ll the exclusion criteria, blood sample was collected for MMP-9 level, RF, and ESR examinations; hand radiography (posterior-anterior view) was also taken. Results: From the study of 46 patients, we found a significant correlation between MMP-9 level and radiographic feature of bone erosion (r = 0.3, p = 0.02) and between the duration of illness and Sharp score (r = 0.36, p = 0.014). There was no correlation between ESR and radiological fi ndings nor between RF and radiological fi ndings. Linear regression analysis showed the duration of illness as the most infl uencing factor toradiological fi ndings in RA patients.Conclusion: We found a signifi cant correlation between MMP-9 level and radiographic feature of bone erosion, and between the duration of illness and radiological fi ndings in RA patients.

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