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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 252 Documents
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The effect of disease duration on the incidence of peripheral arterial disease in young adults with systemic lupus erythematosus M Merlyn; Bambang Setyohadi; S Soebardi; K Harimurti
Indonesian Journal of Rheumatology Vol. 4 No. 1 (2013): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (135.855 KB) | DOI: 10.37275/ijr.v4i1.85

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
A survey on the clinical diagnosis and management of gout among general practitioners in Bandung II Hidayat; L Hamijoyo; M A Moeliono
Indonesian Journal of Rheumatology Vol. 4 No. 1 (2013): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (152.64 KB) | DOI: 10.37275/ijr.v4i1.86

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 Natsir Akil; H Isbagio; Sumariyono Sumariyono
Indonesian Journal of Rheumatology Vol. 4 No. 1 (2013): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (155.737 KB) | DOI: 10.37275/ijr.v4i1.87

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 S Anggoro; B Setyohadi; L Sukrisman; S Setiati
Indonesian Journal of Rheumatology Vol. 4 No. 1 (2013): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (152.02 KB) | DOI: 10.37275/ijr.v4i1.88

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.
Systemic sclerosis and hyperthyroidism in pregnancy Awalia Awalia; Yuliasih Yuliasih; Joewono Soeroso
Indonesian Journal of Rheumatology Vol. 4 No. 1 (2013): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (216.305 KB) | DOI: 10.37275/ijr.v4i1.89

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.
Erosive polyarthritis in multicentric reticulohistiocytosis mimics rheumatoid arthritis Bagus Putu Putra Suryana; L Puspitasari; Cesarius Singgih Wahono; H Kalim
Indonesian Journal of Rheumatology Vol. 4 No. 1 (2013): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (428.563 KB) | DOI: 10.37275/ijr.v4i1.90

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
The Use of Tocilizumab in Combination with Methotrexate in Indonesian Rheumatoid Arthritis Patients (PICTURE INA Study) Bambang Setyohadi; Harry Isbagio; Rachmat Gunadi Wachjudi; Joewono Soeroso; Handono Kalim; Deddy Nur Wachid Achadiono
Indonesian Journal of Rheumatology Vol. 10 No. 1 (2018): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (577.723 KB) | DOI: 10.37275/ijr.v10i1.91

Abstract

Background Aim of this research is to assess the efficacy and safety of tocilizumab (TCZ) in combination with methotrexate (MTX) in Indonesian patients with moderate to severe active rheumatoid arthritis (RA) who have an inadequate response to non-biologic DMARDs.Methods This was a interventional, prospective, single arm, multicenter, study in  Indonesian male or female patients aged ≥ 18 years old, with a diagnosis of RA for > 6 months based on ACR 1987 revised criteria with moderate to severe disease activity (DAS28 score > 3.2) after ≥ 12 weeks of non-biologic DMARDs treatment. The treatment consisted of tocilizumab, 8 mg/kg, intravenous (IV), every 4 weeks for a total of 6 infusion in combination with oral MTX (10−25 mg) every week. Efficacy was assessed based on the percentage of patients achieving low disease activity state (DAS28 < 3.2), percentage of patients achieving reduction > 1.2 point of DAS28, percentage of patients achieving remission (DAS28 < 2.6), and percentage of patients with ACR20, ACR50, and ACR70 responses. Descriptive statistics will be used for presentation of results.Results 100% patients reached low disease activity (DAS28 ≤ 3.2) at last study visit (week 24) and clinically significant improvement (reduction at least 1.2 units) at every visit in DAS28, both for ITT or PP patients. Remission (DAS28 < 2.6) was observed in 82.1% (ITT patients) and 93.1 % (PP patients) on last study visit. ACR20, ACR50, and ACR70 were achieved in 20%, 34%, and 34% (ITT patients), and 7%, 24%, and 62% (PP patients) on week 24. There were 3 out of 39 patients (7.69%) with adverse events (AE) and serious adverse events (SAE) that resulted in discontinuation of TCZ treatment, consisting of 1 patient with SAE of sepsis ec acquired community pneumonia, 1 patient with SAE of pneumonia tuberculosis, and 1 patient with AE of candidiasis. Most common adverse events were hepatic dysfunction (30.7%), hypercholesterolemia (23.1%), followed by arthralgia (20.5%) Twelve percent of patients needed dose modification due to elevated liver enzyme (elevated ALT/SGPT level).Conclusion Tocilizumab seems to be efficacious and likely to have good safety profile in non- biologic DMARD nonresponsive RA patients of PICTURE INA study.   Keywords: Rheumatoid Arthritis, Tocilizumab, DMARD, DAS28
Proportion and Factors that Associate with Incidence of Hepatotoxicity in Rheumatoid Arthritis Patients Treated with Methotrexate in RSCM Year 2013-2015 Rahma Anindya Prathitasari; Harry Isbagio
Indonesian Journal of Rheumatology Vol. 10 No. 1 (2018): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (370.429 KB) | DOI: 10.37275/ijr.v10i1.92

Abstract

Background Rheumatoid arhtirtis (RA) is a chronic autoimmune disease that mainly attacks joints. It may causes joint deformities which leads to lower quality of life of RA patients. RA is treated with metothrexate (MTX) which inhibiting disease progression. MTX is known for its hepatotoxicity side effect, which is described by an elevation of aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) beyond the upper normal limit. Factors that may enhance hepatotoxicity are gender, age, cummulative dose of MTX, and duration therapy of MTX. Prevalence of hepatotoxicity caused by MTX therapy in RA patients in Indonesia is still unknown. The objective of this research is to know the proportion of hepatotoxicity and its associations with the factors that may enhance hepatotoxicity caused by MTX therapy in RA patients in RSCM. Method Data about gender, age, cummulative dose and duration therapy of MTX are obtained from 115 RA patients' medical records. Result Proportion of hepatotoxicity in RA patients treated with MTX in RSCM is 42.60%. Gender, age, cummulative dose and duration therapy of MTX do not significantly enhance hepatotoxicity (p>0.05). Conclusion In conclusion gender, age, cummulative dose and duration therapy of MTX do not have association with hepatotoxicity in RA patients treated with MTX.  Keywords: Rheumatoid Arthritis, Methotrexate, Hepatotoxicity
Clinical Manifestation and Laboratory Finding of Sclerosis Systemic Patient in Dr. Hasan Sadikin General Hospital Bandung : A Descriptive Quantitative Study Annisa Meivira Budiman; Sumartini Dewi; Marietta Shanti Prananta
Indonesian Journal of Rheumatology Vol. 10 No. 1 (2018): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (247.674 KB) | DOI: 10.37275/ijr.v10i1.93

Abstract

Background Systemic sclerosis is a chronic progressive multisystem autoimmune disease in connective tissue, characterized by its heterogeneous clinical manifestation. The purpose of this study is to give information regarding clinical manifestations and laboratory findings of systemic sclerosis patients to establish diagnosis of disease. Methods This study was conducted using descriptive quantitative design in September−October 2016. Data was collected from medical records of patients visiting Rheumatology Clinic Dr. Hasan Sadikin General Hospital from 1 July 2015−30 June 2016 using total sampling method. The collected data were expected to comprise patient’s clinical manifestation and laboratory finding. Results Most of patients had cutaneous 57 (100.0%) and musculoskeletal 40 (70.2%) involvement. Some of the disease manifestations were Raynaud’s phenomenon 38 (66.7%), fingertip lesion 33 (57.9%), stiffness in skin 34 (59.6%), and arthalgia 29 (50.9%). Gastrointestinal involvements were present in 29 (50.9%) patients. Renal involvement were determined from urinalysis result showed proteinuria 10 (17.5%) and hematuria 8 (14.0%), found in 24 (42.1%) patients, while pulmonary and cardiac involvements were found in 30 (52.6%) patients, acknowledged from clinical symptoms such as dyspnea 12 (21.1%). Identification of autoantibodies was found in 12 (21.1%) patients, with 10 (17.5%) patients had reactive ANA and 3 (3.5%) had positive anti-Scl70. Conclusion Most of systemic sclerosis patients had cutaneous involvement. Renal, pulmonary, and cardiac involvement were concluded based on laboratory findings. Keywords: Systemic sclerosis, clinical manifestation, laboratory finding
Correlation of sCD40L Level with Force Vital Capacity Value in Restrictive Lung Disease of Systemic Sclerosis Patients Susanto Salim; Rachmat Gunadi Wachjudi; Sumartini Dewi
Indonesian Journal of Rheumatology Vol. 10 No. 1 (2018): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (224.756 KB) | DOI: 10.37275/ijr.v10i1.94

Abstract

Background: Interstitial Lung Disease (ILD) is one of the major cause of morbidity and mortality in Systemic Sclerosis (SSc). The gold standard to diagnose ILD is using High Resolution Computed Tomography (HRCT) scan. HRCT scan need a lot of cost and not always available, so another diagnosing test is needed as an alternative modality to diagnose ILD. ILD is a restrictive lung disease caused by lung fibrosis which is proved by the decrease of Forced Vital Capacity (FVC) in spirometry, and followed by the increase of soluble CD40L (sCD40L) level in plasma. This sCD40L may become a potential biomarker to evaluate lung fibrosis in SSc patients. The aim of this study is to analyze the correlation of sCD40L levels with FVC score in SSc patients with restrictive lung disease.Method:This cross sectional study was enrolled by the SSc patient who has restrictive lung disease based on spirometry test, at Rheumatology outpatient clinic dr. Hasan Sadikin Hospital from May 2015 to May 2016. All subject took underwent history, physical examination, spirometry and blood test for sCD40L. Data were analyzed using Pearson correlation.Result:There were 38 subjects involved in this study, dominated bywoman (92.1%) with mean age 41(±11) years. Subjects consist of 22(57,9%) with limited SSc, 16(42,1%) with diffuse SSc patients and 33 subjects treated with DMARD. Mean sCD40L serum in this study was 6.690,3(±2.377,3) pg/mL, with no statistical difference between limited and diffuse type (p=0.154). Mean FVC score in this study was 58.2(±10,8). There was no significant correlation between sCD40L serum with FVC (r=0.058; p=0.366). There was weak correlation on DMARD naïve subject between sCD40L serum and FVC (r=0.058; p=0.366) but statistically insignificant. There was no significant correlation between sCD40L serum with mRSS (r=0,066; p=0,346).Conclusion: This study founds no correlation between sCD40L with FVC in SSc at dr. Hasan Sadikin Hospital. Keyword : sCD40L, Forced Vital Capacity, Restrictive Lung Disease, Systemic Sclerosis

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