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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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Pathogenesis, Clinical Presentations and Diagnosis of IgG4-related Disease: A Review Perdana Aditya Rahman; Cesarius Singgih Wahono; Fajar Maulana Raharjo; Handono Kalim; Mokhamad Fahmi Rizki Syaban
Indonesian Journal of Rheumatology Vol. 13 No. 2 (2021): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v13i2.189

Abstract

IgG4-Related Disease (IgG4RD) was identified by the International Classification of Diseases (ICD) in 2012. Numerous diseases, including Mikulicz’s disease, Kuttner’s tumor, Riedel’s thyroiditis, and Ormond’s disease, are pathologically associated with IgG4. Here, we present a review of the clinical presentation and pathogenesis of IgG4-associated disease. IgG4-RD term has been used to refer to a group of diseases involving multiple organs in which there is an abundant IgG4-positive lymphoplasmacytic infiltration, storiform fibrosis, obliterative phlebitis, and mild to moderate tissue eosinophilia, all of which show clinically as a tumefactive lesion, usually in more than one organ. IgG4 exhibits a unique property called an unstable disulfide bond between its heavy chain, as described by Fab-arm exchange which enables the recombination of a single IgG4 heavy chain with other IgG4 heavy chains, resulting in a bispecific antibody incapable of cross-linking and thus of forming an immune complex. IgG4-RD pathomechanism that causes serum IgG4 increase and tissue IgG4-plasma-cell deposition that is pathogenic, rather than the IgG4 itself. Genetic predisposition, autoimmunity, T-cell dysregulation, infection, and dysbiosis are just a few of the underlying pathomechanisms. Clinical symptoms are also frequently complex and may involve many organs. Confirmation of a diagnosis required a comprehensive anamnesis and examination.
Adult-Onset Still's Disease (AOSD): A Case Report Muhammad Reagan; Radiyati Umi Partan
Indonesian Journal of Rheumatology Vol. 14 No. 1 (2022): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v14i1.196

Abstract

Background: Adult-Onset Still's Disease (AOSD) is a rare multisystemic autoinflammatory disorder with an unknown etiology, and the diagnosis is difficult due to various differential diagnoses. AOSD diagnosis is getting better because medical developments and therapeutic strategies from various studies have benefited from advances in understanding autoinflammatory and autoimmune diseases. Case presentation. A woman patient has a complaint of periodic high fever with joint pain for more than 1 month and reddish spots on the skin, fatigue, and menstrual disorders. Patients had been treated several times and performed a blood transfusion, but complaints still occur frequently. The patient is diagnosed with Adult-Onset Still’s Disease with secondary amenorrhoea. Conclusion: This case is rarely found, so it requires quite difficult therapy and diagnostics. Therefore, this case was presented as a case report in order to get better therapy.
Sarcoidosis Manifested as Recurrent Pericardial Effusion with Signs of Impending Tamponade Christine Elizabeth Suryajaya; Susantina Prodjosoewojo; Arto Y. Soeroto; Nuraini Yasmin Kusumawardhani; Rudi Supriyadi; Laniyati Hamijoyo
Indonesian Journal of Rheumatology Vol. 13 No. 2 (2021): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v13i2.200

Abstract

Pericardial effusion is a fatal and life-threatening condition. If it is not addressed thoroughly, complications such as constrictive pericarditis may occur. Etiologies of pericardial effusion varied and one of the most common etiologies is tuberculosis. Other etiologies include inflammation, malignancy or other autoimmune disorder such as sarcoidosis. Sarcoidosis is a diagnosis of exclusion and is confirmed by biopsy result that showed non-caseating epitheloid-cell granuloma, with no other organism or particles. Epidemiology of sarcoidosis in Japan is 1-2 case per 100.000 patients, with the peak incidence between the age of 20 to 39 years old. We reported a case of 37 years old woman presented to our emergency department with shortness of breath and signs of pericardial tamponade. She was previously healthy with no other significant past medical. She was first treated as a case of extrapulmonary tuberculosis and shown no improvement with anti-tuberculosis medications. Several work ups were then done in search of other etiologies of her pericardial effusion. A biopsy form one of her abdominal lymph nodes was performed, which pathologically revealed sarcoidosis. She was placed on corticosteroid and methotrexate with improvement of symptoms. One month followed up showed complete resolution of her pericardial effusion.
Factors Related to Infection in Systemic Lupus Erythematosus Patients Admitted to the Hospital Arie Taufik; Rachmat Gunadi Wachjudi; Laniyati Hamijoyo
Indonesian Journal of Rheumatology Vol. 14 No. 1 (2022): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v14i1.201

Abstract

Background: One of the causes of the increase in hospitalized SLE patients is infection, and it is an important factor in morbidity and mortality, so it is necessary to conduct a research to identify factors related to infection and the type of infection caused in hospitalized SLE patients. Methods: This study is a retrospective, categorical descriptive study utilizing medical records of SLE patients diagnosed with and treated for infection both on admission and during their stay in Hasan Sadikin General Hospital between January 2016 to June 2018. Results: Seventy- four patients were involved into this study. Female were 70 (94.6%), aged <40 years were 69 (93.2%) patients, and all 74 (100%) were entirely in an active disease condition with a mean Mexican systemic lupus erythematosus disease activity (Mex-SLEDAI) score of 9 ± 5.2. Fifty-three (71.6%) subjects experienced major infections. Mucocutaneous and kidney were the most organs involvement found in SLE patients during infection, 63 (85.1%) and 57 (77.0%) respectively. Sixty-two (83.7%) subjects had received corticosteroids before the onset of infection, while pneumonia was the most common infection found in 33 patients (44.6%). This study also noted 12 (16.2%) patients deceased related to infection with most causes were respiratory failure (66.7%). Conclusion: Age less than 40-year-old, mucocutaneous and kidney involvement and previously on corticosteroids were found higher among in hospitalized SLE patients. Most experienced major infections and pneumonia is the most common type of infection.
A Systemic Lupus Erythematosus Accompanied with Myelodysplastic Syndrome, Grave’s Disease, and Sub-Acute Subdural Hemorrhage: A Case Report I Nyoman Suarjana; Anggrada K. Utomo
Indonesian Journal of Rheumatology Vol. 14 No. 1 (2022): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v14i1.202

Abstract

Background: The systemic lupus erythematosus (SLE) is a disease of autoimmune etiology affecting multiple systems, involving most commonly females of the reproductive age group and different clinical manifestations in each individual. Case presentation: A 23-year-old female patient with systemic lupus erythematosus (SLE) presented with myelodysplastic syndrome (MDS), Grave’s disease, and sub-acute subdural hemorrhage (SDH). She had chief complaints of severe headache and gum bleeding. Three weeks earlier, the patient experienced a head injury. SLE was diagnosed on biological and immunological clinical ACR criteria and the patient never had a therapy before. Bone marrow aspiration (BMA) test was performed with MDS result. Thyroid function test was performed with the result of decreased Thyroid Stimulating Hormone (TSH) and increased FT4 with diffused enlargement of thyroid gland. Brain CT Scan resulted in sub-acute SDH with midline shift of 1.13 cm to the left. The patient underwent subdural drainage with local anesthesia and received steroid, azathioprine, thiamazole and non- selective beta-blocker. She was hospitalized for 21 days and was discharged with good condition. Conclusion: Further investigation of the patient is needed to fully understand the correlation between MDS, Subdural Hemorrhage and Grave’s Disease in associated with SLE.
Single Case Experience of Immunosuppressant Administration to Systemic Sclerosis-ILD Patients with Aspergilloma Wilujeng Anggraini; Perdana Aditya Rahman
Indonesian Journal of Rheumatology Vol. 14 No. 1 (2022): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v14i1.197

Abstract

Background: Systemic sclerosis (SSc) is a chronic autoimmune disease that still poses a great challenge to clinicians. SSc is characterized by immune dysregulation and progressive fibrosis that typically affects variable internal organ involvement such as lungs. Interstitial lung disease (ILD) is a common manifestation of SSc and a leading cause of death. The immunosuppressive drug is the main treatment to suppress the inflammation process in SSc. Case presentation: In this case we report a 40-year-old female to suffer ILD-SSc. According to High-Resolution Computed Tomography (HRCT) thorax, we found that it was interstitial lung disease with aspergilloma. She got methylprednisolone 3x8 mg and azathioprine 2x50 mg. At the end of the treatment, the patient showed improvement in her clinical condition and showed no worsening condition in the HRCT evaluation for her fungal aspergilloma. Conclusion: Systemic sclerosis (SSc) is a rare autoimmune disease involving the skin and internal organs. The immunosuppressive agent is still the drug of choice for most autoimmune diseases. Immunosuppressive may promote fungal growth and have been associated with increased risk in most serious fungal diseases including aspergilloma.
The Relationship between Anti-dsDNA Antibody Levels and Clinical Manifestation in Systemic Lupus Erythematosus Patients Noviantoro Sunarko; Ayu Paramaiswari; Deddy Nur Wachid Achadiyono
Indonesian Journal of Rheumatology Vol. 14 No. 2 (2022): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v14i2.166

Abstract

Background: Anti-double-stranded deoxyribonucleic acid (anti-dsDNA) antibodies have been long known as specific autoantibodies in systemic lupus erythematosus (SLE) patients. Their central role in the pathogenesis of SLE also had been proposed for a long time. But many studies have failed to show a consistent association between anti-dsDNA levels and clinical manifestation in SLE patients. This phenomenon raised controversies about anti-dsDNA’s role in the development of the disease. This study aimed to give more description of the relationship between anti-dsDNA antibodies level and clinical manifestation of SLE. Methods: This study took place in Dr. Sardjito General Hospital, Yogyakarta, Indonesia, from July 2017 to July 2020. This study is a descriptive-analytic study with a cross-sectional design. Sixty-three females with new cases of SLE were included in this study. We used Alegria® ORGENTEC ORG204S kits to measure anti-dsDNA antibody levels in those patients. All organ involvement and anti-dsDNA level data were collected from the subject’s medical record. We categorized the patient into two groups, one group with a high level of anti-dsDNA antibodies and the other with the normal one. The statistical analysis was conducted by using the chi-square test to associate the anti-dsDNA antibodies level with the clinical manifestation of SLE that developed in those patients. Results: The haematological manifestation was the most prevalent clinical manifestation of SLE (69.8%), followed by cutaneous (66.7%) and musculoskeletal manifestation (63.5%), respectively. Thirty subjects had a high level of anti-dsDNA, and 33 subjects had the normal one. Anti-dsDNA antibody levels were only significantly associated with the development of haematological manifestation (p=0.026). Conclusion: Haematological manifestation tends to develop in SLE patients with high anti-dsDNA antibody levels.
The Effect of Polyunsaturated Fatty Acids Omega-3 Supplementation on the Components of Rheumatoid Arthritis Disease Activity: A Systematic Literature Review Nadia Hidayat; Awalia Awalia; Betty Agustina Tambunan; Hermina Novida
Indonesian Journal of Rheumatology Vol. 14 No. 2 (2022): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v14i2.191

Abstract

Background: Rheumatoid arthritis (AR) is a chronic disease that causes deformity in most productive age and can lead to death as disease activity increases. Omega-3 polyunsaturated fatty acids (PUFAs) have the potential to complement available therapies in reducing disease activity. Currently, the effect of omega-3 PUFAs on disease activity components is still unclear. This study aimed to determine the effect of omega-3 PUFAs’ supplementation on the components of RA disease activity. Methods: This research is a systematic study with PRISMA guidelines. Literature identification using Pubmed, MDPI, and clinicaltrials.gov. The inclusion criteria used were: giving omega-3 PUFAs, free full-text, RCT, in English or Indonesian, and assessing disease activity and its components; while the exclusion criteria were: unpublished, comparisons were inappropriate. Assessment of literature quality with the Cochrane Collaboration tool. Results: The study included six studies from 1994 to 2017. The effect of omega-3 PUFAs is diversity in changes of disease activity in 4 of 5 studies. Another effect is a significant reduction in the number of joint pains in the literature by daily doses above 2.9 grams or at lower doses taking longer, and swollen joints in 2 studies that were only affected in doses above 2.9 grams. Another change is a significant reduction in pain severity in the studies. Change increases with higher doses. There are variable LED and CRP changes with minimal study resources. Conclusion: Omega-3 PUFAs depend on their dose and administration duration and can, directly and indirectly, affect disease activity through the influence of most of its components, namely: the number of joints affected, the degree of pain, but the results of the ESR and CRP examinations are not sufficient.
B-Cell Activating Factor Profile and Quality of Life in Systemic Lupus Erythematosus Patients Andri Reza Rahmadi; Habib Burahman; Nadia Gita Ghassani; Rachmat Gunadi Wachjudi; Laniyati Hamijoyo
Indonesian Journal of Rheumatology Vol. 14 No. 2 (2022): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v14i2.204

Abstract

Background: B-Cell Activating Factor (BAFF) is a cytokine that plays a role in systemic lupus erythematosus (SLE) pathogenesis. BAFF increases B cell function, which will affect disease activity. In addition to decreasing disease activity, good quality of life (QoL) is one of the goals to be achieved in SLE therapy, which is also affected by disease activity. The purpose of this study is to know the correlation of the BAFF profile with the QoL of SLE patients. Methods: This was a cross-sectional study using secondary data from a previous study. The subjects of this study were SLE patients who had visited the rheumatology outpatient clinic or were hospitalized in Hasan Sadikin Hospital Bandung from September 2016 until February 2017. Subjects were asked to complete the Short Form-36 and measure their BAFF level in serum. Demographic data were collected, and disease activity data were assessed by Mexican Systemic Lupus Erythematosus Disease Activity Index (MEX-SLEDAI). The statistical analysis used in this study was the Spearman test. Results: There was a positive correlation between BAFF and MEX-SLEDAI (r 0.238, p-value 0.038). There was also a negative correlation between MEX-SLEDAI and PCS, as well as the MCS score (r -0.392 and -0.371, p-value <0.05). Conclusion: BAFF levels will increase in higher disease activity which will affect a poorer quality of life.
The Prevalence and Factors Associated with Metabolic Syndrome in Rheumatoid Arthritis Patients Rudy Hidayat; Ricky; Dicky L. Tahapary; Hamzah Shatri; RM. Suryo Anggoro; Anna Ariane; Sumariyono
Indonesian Journal of Rheumatology Vol. 14 No. 2 (2022): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v14i2.206

Abstract

Background: Rheumatoid arthritis (RA) is an independent risk factor of cardiovascular disease (CVD), causing 30-50% mortality in RA patients. Metabolic syndrome is a combination of metabolic disorders that can be manifested as central obesity, impaired blood pressure, or abnormalities of carbohydrate and lipid metabolism, which is closely associated with CVD in RA patients. The prevalence and factors associated with the incidence of metabolic syndrome in RA patients vary in previous studies. This study aimed to determine the prevalence and factors associated with the incidence of metabolic syndrome in RA patients at Cipto Mangunkusumo National Central General Hospital, Jakarta. Methods: A total of 145 RA patients at the Rheumatology Clinic of Cipto Mangunkusumo National Central General Hospital from October to December 2021 were included as research subjects by consecutive sampling method. History taking about the disease and demographic data, physical and anthropometric examination, and laboratory tests were done on the patients. The prevalence of the metabolic syndrome was determined using harmonization criteria. Statistical analysis was performed to determine the association of the variables of age, smoking habit, disease activity, duration of disease, glucocorticoid treatment, and methotrexate treatment with metabolic syndrome in RA patients. Results: The prevalence of metabolic syndrome was 19.3% in RA patients with a mean age of 49.8 ± 11.6 years. The variables of gender, age, deformity, physical activity, extraarticular manifestation, smoking habit, disease activity, disease duration, glucocorticoid treatment, and methotrexate treatment were not statistically significant to the incidence of metabolic syndrome in RA patients. Conclusion: The prevalence of metabolic syndrome in RA patients in this study was 19.3%, and no variable was associated with the prevalence of metabolic syndrome.

Page 24 of 26 | Total Record : 252

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