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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 307 Documents
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Critical Care Management of Myasthenic Crisis: A Case Report Liliriawati Ananta Kahar
Indonesian Journal of Rheumatology Vol. 13 No. 3: Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v13i3.263

Abstract

Background: The annual incidence of myasthenia gravis is 1-2 cases in 100,000 population. 30% of all cases will develop bulbar or respiratory muscle weakness. About 15-20% of myasthenia gravis patients will develop myasthenia crisis. Case presentation: An 18-year-old female patient complained of difficulty swallowing two days ago difficulty swallowing solid and liquid food, and this complaint caused the patient to cough and choke. Complaints were accompanied by difficulty opening the eyelids, especially in the afternoon. Complaints were also accompanied by double vision, especially when looking to the right. There was a nasal sound, and the patient had difficulty pronouncing vocal letters. The patient was admitted to ICU, In the ICU patient was intubated and given plasma exchange therapy. Conclusion: Myasthenic crisis is a neurological emergency that requires prompt diagnosis and treatment. Adequate intensive care, judicious weaning, and extubation decisions, along with specifically targeted therapy, will improve the outcome of myasthenia gravis.
Embryonal Rhabdomyosarcoma: Rare Case Reports with Middle Ear Location Runky Pebranka; Salmiah Agus; Yessy Setiawati
Indonesian Journal of Rheumatology Vol. 13 No. 3: Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v13i3.264

Abstract

Background: Patients with embryonal rhabdomyosarcoma (EMRS) are dominated by boys. The peak incidence occurs in the small age group from one year to 4 years. Approximately 35% of all pediatric RMS occur in the head and neck. Case presentation: A 3-year-old male patient came to the ear, nose, throat-head neck (ENT-HNS) polyclinic at Dr. M. Djamil General Hospital Padang on February 25th, 2021, with complaints of a lump appearing in his right ear canal for 4 months. The patient also complained of slanting on the right side of his face and pain in his right ear since 2 weeks ago. History of bleeding from the ear 1 week ago. On the examination of House-Brackmann, the patient obtained a category House-Brackmann V. Histopathological results, microscopically visible pieces of tissue with part of the surface covered with keratinized squamous epithelium, part of the surface not keratinized. There are dense groups consisting of a proliferation of cells with round, oval nuclei, small to medium size, little cytoplasm, some cells with pleomorphic nuclei, hyperchromatic, irregular nuclear membranes, lots of eosinophilic cytoplasms, with the appearance of "tadpole”, atypical mitoses may be found. The underlying tissue stroma appears myxoid. Among them, fibrotic connective tissue septa containing partially hyperemic capillaries are visible. Necrotic areas and clusters of PMN leukocytes and cellular debris were also seen. This description is consistent with EMRS. Conclusion: The patient was diagnosed with right middle ear EMRS stage III with right peripheral facial nerve paresis House-Brackmann V.
Correlation between Serum IL-17 Levels and 24-H Urinary Protein in Lupus Nephritis Patients at Ulin General Hospital Banjarmasin: A Cross-Sectional Study Hariyanto Salim, Felix
Indonesian Journal of Rheumatology Vol. 17 No. 1 (2025): IJR VOL 17 No 1
Publisher : Indonesian Rheumatology Associantion

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v17i1.11

Abstract

24-h urinary protein is a marker and predictor of kidney function in Lupus Nephritis (LN). IL-17 appears to contribute to LN. The aim of this study was to determine the correlation between serum IL-17 levels and 24-h urinary protein in LN patients.
5 Year Survival of Systemic Lupus Erythematosus (SLE) Patients at RSCM and Predispose Factors: A Retrospective Cohort Study Hidayat , Rudy
Indonesian Journal of Rheumatology Vol. 17 No. 1 (2025): IJR VOL 17 No 1
Publisher : Indonesian Rheumatology Associantion

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v17i1.12

Abstract

Background: Systemic Lupus Erythematosus (SLE) is an autoimmunerheumatic disease characterized by widespread inflammation involvingalmost all organ systems. This disease attacks young women with apeak incidence aged 15-40 years. The clinical manifestations of SLEvary depending on the organs involved. The risk of death in SLEpatients increases if it is not diagnosed and treated appropriately.Methods: This study is a retrospective cohort study using medicalrecord data from patients diagnosed with SLE for the first time in 20142019 at RSCM. Survival analysis was carried out on age, gender,hemolytic anemia, thrombocytopenia, NPSLE, high anti ds-DNA, lowC3 and C4, high dose glucocorticoids, lymphopenia, positive AntiCardiolipin Antibody (ACA), cardiovascular disease, and lupusnephritis. Multivariate analysis with cox regression was carried out.Results: There were 448 subjects studied. The five-year survival of SLEpatients at RSCM is 88%. Mean survival 56 months (95% CI : 55-57).In the multivariate analysis, it was found that NPSLE [p=0,000 ; HR3,595 (95%CI 1,932-6,688)], low C3 and C4 [p=0,004 ; HR 2,501(95%CI 1,330-4,701)], cardiovascular disease [p=0,018 ; HR 2,851(95%CI 1,198-6,787)], and hemolytic anemia [p=0,023 ; HR 2,106(95%CI 1,008-4,404)] had a significant effect on patient survival.Conclusion: The 5-year survival of SLE patients was 88% withneuropsychiatric lupus (NPSLE), low C3 dan C4, cardiovasculardisease, dan hemolytic anemia have a significant effect on the SLEsurvival patients at RSCM.
Efficacy and Safety of Low-Dose Cyclophosphamide vs Mycophenolatemofetil in Patients with Lupus Nephritis: A Systemic Review andMeta-Analysis Raka Widhiarta, Putu
Indonesian Journal of Rheumatology Vol. 17 No. 1 (2025): IJR VOL 17 No 1
Publisher : Indonesian Rheumatology Associantion

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v17i1.14

Abstract

Background: Lupus Nephritis is still the most leading cause of morbidityand mortality in SLE (Systemic Lupus Erythematosus). Low-dose CYC(Cyclophosphamide) regimen was effective and had a higher safety profilethan standard CYC regimen. MMF (Mycophenolate Mofetil), a selectivelymphocyte antiproliferative agent, has been shown in several studies to bea safe and effective substitute to full dose CYC. The objective of this metaanalysis was to compare the efficacy and safety of these low-dose CYC vsMMF subjects with LN (Lupus Nephritis). Methods: The authorssystematically searched CENTRAL, PubMed, and ScienceDirect from 2009to early 2024. Studies enrolled RCT (Randomized Controlled Trial), in whichpatients diagnosed with lupus nephritis were treated with low-doseintravenous CYC or oral MMF. Results: A total of 6 trials, including 787patients, were included in this meta-analysis. The analysis showed there isno different between low dose-CYC MMF and MMF. (RR 0.96 95% CI [0.96,1.27], p = 0.76, Tau2 = 0.00, Chi2 = 0.07, df =1 and I2 = 0%, p = 0.79).Conclusion: No significant difference was observed between the twotreatment regimens. Oral MMF was associated in increasing vomiting andalopecia rather than low-dose CYC. Both agents demonstrated modestefficacy. However, further research is required to definitively assess therelative effectiveness and safety in a large patient cohort. 
Risk Factor Associated with Carotid Intima-Media Thickness inPatients with Systemic Lupus Erythematosus Vismita Indramila Duarsa, Made Dyah
Indonesian Journal of Rheumatology Vol. 17 No. 1 (2025): IJR VOL 17 No 1
Publisher : Indonesian Rheumatology Associantion

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v17i1.15

Abstract

Background: Cardiovascular complications, including atherosclerosis, arethe highest causes of mortality in systemic lupus erythematosus (SLE)patients. The carotid artery intima-media thickness (cIMT) can effectivelyindicate the condition of atherosclerosis in patients. This study wasconducted to determine the associated risk factors for cIMT in patientswith SLE. Methods: This research was conducted as a cross-sectionalstudy at Prof. I.G.N.G. Ngoerah Hospital, Denpasar. From January 2023to June 2023, all SLE patients aged 18-55 for men and 18-65 for women,without infections, cancer, asthma, stage 5 chronic kidney disease, stroke,coronary heart disease, peripheral artery disease, or smoking history, wereincluded. Measurement of cIMT was performed using Dopplerultrasonography. Statistical analysis was conducted using descriptivestatistics and Fisher exact test to assess the association between variables.Results: 52 patients (51 women and 1 man) met the inclusion criteria wereincluded. The mean age was 33.67 ± 10.51 years, the duration of SLE bythe time of diagnose was 50.37 ± 40.39 months, and the disease activityscored by MEX SLEDAI was 2.58 ± 3.24. Moreover, the bivariate analysisshowed a significant association between hypertension and cIMT in SLEpatients (p = 0.001) with an Odd Ratio (OR) of 28.77. The age at diagnosiswas also found to be significantly associated independently with cIMT (p =0.003, OR = 14.93). This is associated with dysregulation of lectin -likeoxidized-LDL (ox-LDL) receptor-1 (LOX-1), leading to an increased risk ofatherosclerotic plaque formation. Conclusion: There is a notableassociation between the occurrence of hypertension and age at diagnosisto the elevated cIMT in SLE patients. 
Early Detection Of Thalassemia Carrier In Patients With SystemicLupus Erythematous: The Use of Shine and Lal Index Sahiratmadja , Edhyana
Indonesian Journal of Rheumatology Vol. 17 No. 1 (2025): IJR VOL 17 No 1
Publisher : Indonesian Rheumatology Associantion

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v17i1.16

Abstract

Background: Anemia in systemic lupus erythematous (SLE) is common due toimpaired erythropoietin response and the presence of antibodies that attackerythropoietin. Various anemia in SLE include autoimmune hemolytic anemia (AIHA),anemia of chronic disease (ACD), or iron deficiency anemia (IDA). Interestingly,Indonesia lies in thalassemia belt area and it is estimated to harboring around 6-10%thalassemia carrier in its population. Therefore, anemia in SLE patients should befurther examined for its possibility for thalassemia carrier. This study aimed todetermine whether a simple erythrocyte index could be used for thalassemia carrierearly detection of SLE patients living in Indonesia. Methods: This study had aretrospective and cross-sectional design, collecting hematology data of SLE patientsregistered at Dr. Hasan Sadikin General Hospital. Erythrocyte indices, includingMentzer index (MCV/RBC) and Shine & Lal index (MCV.MCH.MCH/100), wereassessed to determine IDA or thalassemia carrier. Results: Of 259 hematology datafrom SLE patients included, predominantly female (95.8%), aged 34 years old (median;range 17-65 years) and single (27%), of whom 45.2% had anemia. However, most ofthem were anemia normocytic or normochromic. Interestingly, Mentzer index (<13) wasfound in 2.7% and Shine & Lal index (<1530) in 10% patients, suggesting considerthalassemia carrier. Conclusion: Although Shine & Lal index has lower sensitivitycompared with Mentzer index, Shine & Lal Index might serve a broader screening toolas an early detection for thalassemia carrier.  
New Onset Systemic Sclerosis-Polymyositis Overlap Syndrome FollowingSecond Dose of COVID-19 Vaccine – A Case Report Raga Ginting , Andi
Indonesian Journal of Rheumatology Vol. 17 No. 1 (2025): IJR VOL 17 No 1
Publisher : Indonesian Rheumatology Associantion

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v17i1.17

Abstract

Background: Coronavirus 2019 has been declared as a global emergency by theWorld Health Organization. Vaccination has been shown to be crucial during theCOVID-19 pandemic. However, as global vaccination programs are implemented,a number of COVID-19 vaccine-related side effects have lately been recorded,including new-onset autoimmune disease. Overlap syndrome is a medicaldisorder in which a patient has symptoms of at least two or more autoimmuneconnective tissue diseases that meet the clinical criteria. Case Presentation: A33-years-old woman with history of Graves’ disease presented with myalgia,proximal superior and inferior extremities muscle weakness, skin thickening inface and both superior and inferior extremities following the second dose ofinactivated whole virus COVID-19 vaccine. ANA test was found to be positive withno specific antibody related to disease and there was an increase in muscleenzyme. The patient was treated with combination of mycophenolic acid,methylprednisolone, nifedipine, vit D3 and curcuma. After 4 months of treatment,patient showed clinical improvement and decrease in muscle enzymes.Conclusion: Systemic Sclerosis-Polymyositis overlap syndrome is anautoimmune connective tissue disease that is frequently encountered inconjunction with myositis. The causes of autoimmune disease are multifaceted,involving genetic, environmental factors, and overstimulation of the immuneresponses. The relationship between COVID-19 vaccination and autoimmunedisease, especially systemic sclerosis-polymyositis overlap syndrome, stillrequires further study due to lack of reported evidence. 
Patients with Sjogren's Syndrome and Depression Who Got MenometrorraghiaAfter Receiving Antidepressant Damayanti Octaviani, Ines
Indonesian Journal of Rheumatology Vol. 17 No. 1 (2025): IJR VOL 17 No 1
Publisher : Indonesian Rheumatology Associantion

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v17i1.18

Abstract

Background: Sjogren's Syndrome (SS) is a systemic autoimmune diseasethat attacks the mucous glands and other organs of the body. SS can alsomanifest in neuropsychiatric forms such as fatigue, depression, andanxiety. Case presentation: Whether the menometrorrhagia that occurs inSS patients who has depression is caused by the disease or caused by theadministration of antidepressant and which antidepressant is appropriatefor patient. The method is by searching for scientific evidence throughtrusted databases, such as PubMEd, Cochrane, Scholar, Springer andMedscape using The Boolean Operator method using keywords with filtersfor journal publications in the last 15 years, human research subjects andEnglish language. There were 6 studies that matched the clinical question.Conclusion: There is an evidence that meno/metrorrhagia in SS patientscan be caused by the disease itself and the antidepressant that were taking.It preferable to be substituted the antidepressants with less bleedingincidence such as Clomipramine, Fluvoxamine, and Mirtazapine. 
Is There Any Correlation between Anti-Ro 52 Antibody Level with HematologicalAbnormalities in Systemic Lupus Erythematosus? Oehadian , Amaylia
Indonesian Journal of Rheumatology Vol. 14 No. 1 (2022): IJR VOL 14 No 1
Publisher : Indonesian Rheumatology Associantion

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/IJR.v14i1.186

Abstract

Background: Systemic lupus erythematosus (SLE) is a complexautoimmune disease with various clinical and serological manifestations.Previous studies have shown conflicting results about the association of antiRo 52 autoantibodies with hematological abnormalities in SLE. Weinvestigated the correlation between anti Ro 52 autoantibody with anemia,leucopenia, and thrombocytopenia in patients with SLE. Methods: Sixty-twobio archives serum of an SLE patient at the Division of Rheumatology,Department of Internal Medicine, Hasan Sadikin General Hospital,Bandung, Indonesia from 2017 to 2019 were enrolled in the study. Anti-Ro52 levels were examined using the ELISA method. The clinical data,treatment, and hematology paparametersere were analyzed retrospectively.Results: Among 62 bio-archive serum, four subjects were excluded becauseof incomplete data. Fifty-eight patients, all females were enrolled. Weidentified 57 (98.3%) subjects corticosteroid, 31 (53.4%) azathioprine and 28(48.3%) chloroquine. A correlation coefficient of anti-Ro 52 levels andhemoglobin, leukocyte and platelets were -0.037 (p = 0.391), 0.065 (p =0.315) and 0.092 (p = 0.246), respectively. Conclusion: No correlation wasfound between anti Ro 52 antibody levels with haematological abnormalitiesin patients with SLE. Further studies need to evaluate whether otherantibodies play important role in haematological abnormalities in SLE. 

Page 26 of 31 | Total Record : 307

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