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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 7 Documents
 1 
Search results for , issue " Vol 4, No 1 (2013)" : 7 Documents clear
Prevalence and factors associated with vitamin D deficiency in systemic lupus erythematosus patients Pangestu, Y; Setiati, S; Setiyohadi, Bambang; Sukmana, N
Indonesian Journal of Rheumatology Vol 4, No 1 (2013)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: In addition to the calcium-phosphorus metabolism, vitamin D might also play a role in the immune system. Studies have showed lower levels of vitamin D among SLE patients compared with controls. Researches regarding vitamin D in SLE patients have only been conducted in four seasons’ countries (Caucasians subjects in a large part) , but no data has been available in tropical countries, particularly Indonesia. The presence of VDR gene polymorphism in different populations will affect the role of vitamin D in the immune system. Objectives: To determine the prevalence of vitamin D deficiency and identify its risk factors such as lack of sunlight exposure, sunscreen usage, long-term corticosteroid therapy, disease activity, insufficient vitamin D supplementation, and obesity in SLE patientswith vitamin D deficiency.Methods: A cross-sectional study was conducted on SLE patients who were under treatment at Cipto Mangunkusumo General Hospital or members of Indonesian Lupus Foundation. Then those patients completed questionnaires and their 25(OH)D serum levels were measured. The cut-off value of 25(OH) D levels for vitamin D inadequacy is 75 nmol/L, which then grouped into vitamin D insufficiency (25(OH)D 25 - <75 nmol/L) and vitamin D deficiency (25(OH)D <25 nmol/L). SLE activity was assessed with MEX-SLEDAI.Results: During May-June 2008, 80 SLE patients were enrolled with 96.3% female subjects, median age of 26 years (range 17-56 years), 66.3% non-obese, 93.8% using steroid, 62.5% with active disease, and 63.8%have adequate sun exposure. In addition, 81.5% didnot use sunscreen and 83.8% did not take vitamin D supplementation. All patients had vitamin D inadequacy with 41.2% in insufficiency level and the other 58.8% in deficiency level. The median of 25 (OH)D levels were 21.85 nmol/L (range 11.5-57.7 nmol/L). It also has been found that vitamin D deficiency occurred more in subjects who were obese, used sunscreens, had lower exposure to sunlight, in a long-term high-dose steroid therapy, had active SLE disease, and had no vitamin D supplements.Conclusions: All SLE patients had vitamin D inadequacy. Vitamin D deficiency occurred more in subjects who were obese, used sunscreens, had lower exposure to sunlight, in a long-term high-dose steroid therapy, had active SLE disease, and had no vitamin Dsupplements.
Systemic sclerosis and hyperthyroidism in pregnancy Awalia, Awalia; Yuliasih, Yuliasih; Soeroso, Joewono
Indonesian Journal of Rheumatology Vol 4, No 1 (2013)
Publisher : Indonesian Rheumatology Association

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Abstract

Systemic sclerosis (SSc) is a connective tissue disease affecting women of childbearing age at least five times more than men. For a long time, pregnant women with SSc have high morbidity and mortality based on case reports and case series. Therefore, the disease was a contraindication for pregnancy. However, current retrospective studiesshow that despite of an increased frequency of prematurity and small for gestational age infants, overall maternal and neonatal survival is good. With close monitoring and appropriate therapy, most scleroderma patients can sustain a successful pregnancy.
The effect of disease duration on the incidence of peripheral arterial disease in young adults with systemic lupus erythematosus Merlyn, M; Setyohadi, Bambang; Soebardi, S; Harimurti, K
Indonesian Journal of Rheumatology Vol 4, No 1 (2013)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: Peripheral arterial disease is a chronic complication that affects morbidity and mortality in SLE patient. However, there were only a few of researches studying the relationship of disease duration and  peripheral arterial disease event overseas and it hasnever been studied in Indonesia.Objectives: To obtain information about the increased event of peripheral arterial disease in women of 40 years old or younger with SLE’s duration of five years or longer compared with less than five years.Methods: This was a case control study conducted between June - August 2012 at Cipto Mangunkusumo hospital, Jakarta. Subjects were women of 40 years old or younger with SLE who visited Rheumatolgy and Allergy-Immunlogy outpatient clinic. They were assignedto case and control groups and traced retrospectively using interview and medical record. The relationship between disease duration and peripheral arterial disease was estimated using OR and the role of confounding factors was analysed using logistic regression one byone, resulted in fully adjusted OR.Results: A total of 90 subjects were recruited, 18 subjects in case group and 72 subjects in control group.Traditional risk factors were similiar in both groups. In multivariat analysis, there was a relationship between disease duration 5 years or longer and peripheral arterialdisease with fully adjusted OR 1,9 (95%CI 0,575-6,543). Older age and steroid therapy were the confounding factors.Conclusion: There was an increased event of peripheral arterial disease in women of 40 years old or younger with SLE’s duration five years or longer compared withsubjects having the disease duration less than five years, but this increase was not statistically significant.Keywords: Peripheral arterial disease, lupus erythematosus systemic, disease duration
Erosive polyarthritis in multicentric reticulohistiocytosis mimics rheumatoid arthritis Suryana, Bagus Putu Putra; Puspitasari, L; Wahono, Cesarius Singgih; Kalim, H
Indonesian Journal of Rheumatology Vol 4, No 1 (2013)
Publisher : Indonesian Rheumatology Association

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Abstract

Multicentric reticulohistiocytosis (MRH) is a very rare multisystemic syndrome.1,2 The first case of MRH was described by Goltz and Layman in 1954 and so far only less than 200 cases have been reported.3-5 It is characterized by the insidious onset of polyarthritis that often evolves into a severe erosive deforming arthritis and characteristic skin lesions composed of nodules and plaques containing lipid-laden (periodic acidSchiff-positive) histiocytes and multinucleated giant cells.6 It most commonly affects the handsand cervical spine.7 MRH is also known as lipoid dermatoarthritis, lipoid rheumatism, and giant cell reticulohistiocytosis.4 MRH is occured due to infiltration of multinucleated giant cells and histiocytes into various tissues. The typical pictures include skin nodules and destructive polyarthritis.3 This entity is frequently mistaken for rheumatoid arthritis (RA).3 MRH is often associated with systemic complication and various types ofmalignancy. Therefore, sometimes it is considered a paraneoplastic syndrome
A survey on the clinical diagnosis and management of gout among general practitioners in Bandung Hidayat, II; Hamijoyo, L; Moeliono, M A
Indonesian Journal of Rheumatology Vol 4, No 1 (2013)
Publisher : Indonesian Rheumatology Association

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Abstract

Backgrounds: The global prevalence of gout and hyperuricemia is increasing in recent years. As the most visited health care service, it is thus become more important that general practitioners have proper approach in the diagnosis and treatment of patients withgout, in order to prevent complications of the disease as well as adverse effects of inappropriate and improper use of medications.Objective: To determine whether the practice of general practitioners on the clinical diagnosis and management of gout in Bandung have been appropriate, with the implementation of evidence-based medicine.Methods: This was a descriptive cross-sectional qualitative study, done by survey using a questionnaire, conducted among general practitioners who attended medical symposia in Bandung from January to March 2011.Result: There were 173 respondents participating in this survey. Median age of respondents was 33 years (range 23–73 years), with median duration of practice of 7 years (range 0–45 years). The largest proportion of the respondents often suggested measurement of serum uric acid to patients with any joint pain (45.7%), did not recommend synovial fluid examination to patients suspected of having gout (80.8%), usually prescribedallopurinol to patients with asymptomatic hyperuricemia (52.6%), initiated allopurinol therapy during acute gout attack (35.8%), discontinued allopurinol therapy when serum uric acid normalizes (61.8%), and only very rarely gave prophylactic treatment to patients who started allopurinol therapy (43.4%).Conclusion: The majority of general practitioners had not applied or aware about evidence-based medicine in the diagnosis and management of gouty arthritis.
Correlation of serum level of interleukin-6 and disease activity with bone-resorption activity in premenopausal rheumatoid arthritis patients Akil, Natsir; Isbagio, H; Sumariyono, Sumariyono
Indonesian Journal of Rheumatology Vol 4, No 1 (2013)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: Rheumatoid arthritis (RA) is a chronic, systemic disease characterized by inflammation and cellular proliferation in the synovial lining of joints that can ultimately result in cartilage and bone destruction.Patients with RA are at increased risk of osteoporotic fractures in both axial and appendicular bones. Several cytokines are involved in the pathogenesis of osteoporotic RA patients, including tumor necrosis factor α, interleukin (IL)-1, IL-6, and IL-17. Among these cytokines, IL-6 has a pivotal role in the pathogenesis of increased bone resorption in postmenopausal RA patients. There are currently scarce data concerning this process in premenopausal RA patients.Objective: To determine the correlation of serum level IL-6 and disease activity with bone-resorption activity in premenopausal RA patients. Methods: This is a cross-sectional study with consecutive sampling method conducted at the Division of Rheumatology, Cipto Mangunkusumo General Hospital from June until August 2010. Bone-resorption activity was quantified using serum C-terminal crosslinking telopeptide of type I collagen (CTx-I) level, while disease activity was assessed using the 28-joint disease activity (DAS28) score. Statistical analysis was performed to investigate the correlation of serum IL-6 level and disease activity with serum CTx-I level.Results: There were 38 patients enrolled in this study. Mean serum level of IL-6 was 10.99 pg/mL (SD 16.06). Mean serum level of CTx-I was 405.37 pg/mL (SD 199.32). There was no significant correlation (p = 0.252) between serum IL-6 level with serum CTx-I level;however, a significant correlation existed (r = 0.389, p = 0.033) among seropositive patients. There was no significant correlation (p = 0.257) between the DAS28score with serum CTx-I level.Conclusion: There were no significant correlation either of serum IL-6 level or disease activity with serum CTx-I level among patients in this study
The characteristics of hemophilic patients with decreased bone density in Cipto Mangunkusumo Hospital Jakarta Anggoro, S; Setyohadi, B; Sukrisman, L; Setiati, S
Indonesian Journal of Rheumatology Vol 4, No 1 (2013)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: Hemophilia can cause musculoskeletal complications and decreased bone density is one of those complications. The profile of hemophilic patients with decreased bone density in Indonesia is still unknown.Objective: To estimate the proportion of decreased bone density hemophilia and to learn the characteristics of hemophilic patients with decreased bone density.Methods: This is a cross-sectional study done in June - November 2012. Subjects were adult hemophilic patients from 19-50 years old in Hematology- Oncology outpatient clinic Cipto Mangunkusumo Hospital. Estimated variables were bone density mass, age, bodymass index, physical activity, arthropathy, substitution therapy, HIV, and HCV infection.Result: 63 subjects were included in the study with median age of 26 years old. The proportion of decreased bone density in hemophilia was 6.3%. Subjects with decreased bone density were younger (19 years old vs 26 years old), have lower BMI (18,6 + 2,8 kg/m2 vs 21,5 + 3,8 kg/m2), used more substitution therapy (4047 IU/month vs 2000 IU/month), and have better clinical arthropathy score. HCV infection happened on 25% subjects with decreased bone density while HIV was on 1.6% of subjects.Conclusion: Decreased bone density was found in 6.3% of subjects with hemophilia. They were younger, have lower BMI, better joint score, lower infection caused by transfusion, and more bleeding compared with subjects with normal bone density.

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