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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 302 Documents
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Effect of Vitamin D Supplementation on Regulatory T Cells of Systemic LupusErythematosus: A Systematic Review Yuniza , Yuniza
Indonesian Journal of Rheumatology Vol. 15 No. 2 (2023): IJR VOL 15 No 2
Publisher : Indonesian Rheumatology Associantion

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Abstract

Background. Systemic lupus erythematosus (SLE) is associated with aglobal reduction in regulatory T cells (Tregs). Vitamin D supplementationthat is efficacious, safe, and reasonably priced has the potential to reducemorbidity in SLE. This study was aimed to systematically assess the efficacyof vitamin D supplementation in enhancing Tregs concentration or Tregsrelated marker. Methods. A systematic review of the literature for clinicalstudies was performed on Pubmed, Proquest, and Google Scholar. Studieswere assessed for risk of bias using Newcastle Ottawa Scale. All clinicalstudies that investigated the effects of vitamin D supplementation on Tregsin SLE patients were included. Key evidence was analyzed and qualitativelysynthesized. Results. Three relevant studies were included. All studies wereof high-quality. Vitamin D supplementation consistently increased Tregsconcentration across all included studies. Conclusion. The current studysupports the evidence that vitamin D supplementation enhanced Tregsconcentration in SLE patients. 
Characteristics and Treatment Responses of Rheumatoid Arthritis Patients at Dr.Cipto Mangunkusumo National General Hospital Hidayat , Rudy
Indonesian Journal of Rheumatology Vol. 15 No. 2 (2023): IJR VOL 15 No 2
Publisher : Indonesian Rheumatology Associantion

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Abstract

Introduction. Rheumatoid arthritis (RA) is a chronic progressiveautoimmune rheumatic disease that primarily affects the joints. The goal ofRA treatment is to achieve remission or low disease activity, using a treatto-target approach. This study aims to explore the characteristics of RApatients and evaluate their treatment responses in Dr. CiptoMangunkusumo National General Hospital (RSCM). Methods. This crosssectionalstudyisconductedbycollectingdemographicandclinicaldata,as wellasinterviewingadultpatientsthathavebeendiagnosedwithRAatthe Rheumatology Clinic of RSCM and have been on disease-modifyingantirheumatic drugs (DMARD) treatment for a minimum of 6 months.Results. A total of 94 patients were included in this study. Subjects werepredominantly female (93.6%) and had no formal jobs (64.9%). A majority ofRA patients exhibited moderate disease activity (48.9%, based on DiseaseActivity Score-28 with erythrocyte sedimentation rate [DAS-28 ESR]), with arelatively high level of steroid use (86.2%). Notably, most patients startedDMARD treatment more than 2 years after the onset of symptoms (45.7%).The proportion of patients achieving therapy target (remission to low diseaseactivity) was 41.5%, with 13.8% attaining remission. Furthermore, HealthAssessment Quality (HAQ) scores were found to be significantly lower amongthe target-achieving group, indicating better quality of life. Conclusion.Therapy target was achieved in 41.5% of RA patients in RSCM, with 13.8%achieving remission. Further research can be conducted to evaluate factorswhich may affect treatment response among RA patients.   
Acute Lupus Pneumonitis with Cytomegalovirus Co-infection in Patients withLupus Nephritis Wijaya , Hadi Kurniawan
Indonesian Journal of Rheumatology Vol. 16 No. 1 (2024): IJR VOL 16 No 1
Publisher : Indonesian Rheumatology Associantion

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Abstract

Introduction: Most patients with systemic lupus erythematosus (SLE) showsigns of pulmonary involvement. The clinical manifestations of LupusPneumonitis are the similar to those of acute interstitial pneumonia. The useof cyclophosphamide in lupus nephritis (LN) is associated with high CMVtiters. Ganciclovir is the main choice of therapy for CMV pneumoniainfection. Case presentation: A 19-year-old female with previous history oflupus nephritis presented with worsening dyspnea, productive cough withyellowish sputum and hemoptysis. Following physical, laboratory andradiological examinations, the patient was diagnosed with acute lupuspneumonitis, with a differential diagnosis of pneumonia infection. Duringtreatment in the intensive care unit (ICU), she was put on ventilator andreceived routine hemodialysis due to pulmonary edema. She was givenintravenous antibiotics before the culture results came out, but there wasno clinical improvement. Once the culture results returned negative, theantibiotics were discontinued and IV pulse methylprednisolone was started.There was significant clinical, radiological, and laboratory improvements.After discharge, the patient experienced hemoptysis again due to CMVpneumonia infection and was given ganciclovir therapy with satisfactoryresults. Conclusion: In patients with advanced LN and pulmonaryinvolvement, distinguishing between infection and SLE flares may bechallenging, which can cause dilemma in diagnosis and treatment decisions.Adequate oxygenation with ventilator, hemodialysis, and administration ofganciclovir and mycophenolic acid provides significant improvements inpatient care. 
Perfect Timing for Canakinumab Use in Gout Wijaya , Hadi Kurniawan
Indonesian Journal of Rheumatology Vol. 16 No. 1 (2024): IJR VOL 16 No 1
Publisher : Indonesian Rheumatology Associantion

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Abstract

Gout is an inflammatory disease caused by the deposition of monosodiumurate (MSU) crystals. Recently, the American College of Rheumatology (ACR)has recommended the usage of interleukin (IL)-1 inhibitor in gout patientswho are refractory to typical anti-inflammatory drugs. An example of IL-1inhibitor is canakinumab. Not much is known regarding the usage ofcanakinumab in gout arthritis. Thus, we decided to conduct a narrativereview that summarizes the efficacy and safety of canakinumab in goutpatients. In this review, we found that canakinumab is superior to nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids in treatingacute gout flares. In addition, canakinumab may also be considered as apreventive therapy for gout flares in patients receiving urate-loweringtherapy. Overall, canakinumab has mild side effects but may occasionallycause serious infections. Canakinumab is also generally safe for use duringpregnancy. Due to the lack of studies, the safety of canakinumab in lactatingwomen, geriatric patients, and patients with hepatic or renal impairment isstill unknown. 
Initial Clinical Presentation of Systematic Lupus Erythematosus (SLE) Patientsin Cipto Mangunkusumo Hospital Isabela , Teresa
Indonesian Journal of Rheumatology Vol. 16 No. 1 (2024): IJR VOL 16 No 1
Publisher : Indonesian Rheumatology Associantion

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Abstract

Background. Systemic Lupus Erythematosus (SLE) is a systemicautoimmune disease characterized by highly diverse and nonspecificsymptoms with clinical presentations involving more than one organ systemwhich often leads to delayed diagnosis and poor prognosis. This study aimsto understand patients’ initial clinical presentation in order to enhance earlydetection and establish an early diagnosis. Methods. This descriptive crosssectionalquantitativestudy included patients who commenced their visitsto the Rheumatology Clinic at RSCM from May 2021-December 2022. Aconsecutive sampling method was used, and data were analyzed for age,gender, symptom onset, as well as patients' initial clinical presentations(SPSS 25.0). Results. Out of 231 subjects, 96.1% were females. A total of38.1% of the patients belonged to the 21-30 age group, and symptom onsetwas most commonly observed in the 0-1 year age group, accounting for67.5%. Approximately 24.2% of the patients exhibited constitutionalmanifestations with involvement of other organs, including musculoskeletal(87.4%), mucocutaneous (84%), hematologic (3.,5%), renal (33.3%), andneuropsychiatric (8.7%) systems. Lungs, heart, blood vessels, gastrointestinal and hepatic systems, eyes, obstetric, and endocrineinvolvements were not found in this study. Among the 231 subjects, 44.2%of them had simultaneous involvement of two organs, which emerged as theirinitial clinical presentation. Conclusion. Musculoskeletal andmucocutaneous involvement were most commonly observed as th e initialclinical presentation of SLE patients at RSCM, followed by hematologic,renal, and neuropsychiatric involvement. 
The The Role of 25-Hydroxy Vitamin D and Cartilage Oligomeric Matrix Protein(COMP) Serum in Knee Osteoarthritis Putra , Khoriun Mukhsinin
Indonesian Journal of Rheumatology Vol. 16 No. 1 (2024): IJR VOL 16 No 1
Publisher : Indonesian Rheumatology Associantion

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Abstract

Background. Osteoarthritis (OA) is a prevalent disease of themusculoskeletal system that affects over 528 million individuals worldwide,with 73% of those diagnosed being aged 55 or older. The knee joint is mostcommonly affected, along with the hip and hand joints. Vitamin D isessential for maintaining bone and cartilage metabolism. In chondrocytes,the presence of the vitamin D receptor (VDR) regulates the expression ofmetalloproteinase. The purpose of this investigation is to examine thecorrelation between vitamin D (25(OH)D) and cartilage oligomeric matrixprotein (COMP) serum in knee osteoarthritis. Methods. The cross-sectionalstudy was conducted by the Rheumatology Division at RSMH Palembang.Patients diagnosed with knee osteoarthritis based on the 1990 ACR criteriawere included.  The chemoluminescent immunoassay and the HumanCartilage Oligometric Matrix Protein ELISA Reagent were used to measurethe levels of vitamin D (25(OH)D) and COMP serum. Results. Thirtyparticipants took part in this study from July to December 2022. Accordingto this study, 33% had insufficiency and 67% had a deficiency of vitamin D.Spearman's Rho test shows that there is a strong negative correlationbetween vitamin D (25(OH)D) and COMP serum. Conclusion. Vitamin D(25(OH)D) and COMP serum levels were significantly correlated in kneeosteoathritis. 
Correlation between sCTLA-4 and sCD86 Levels with Disease Activity of SystemicLupus Erythematosus (SLE) Patients Based on SLEDAI Score Eldatarina , Helsa
Indonesian Journal of Rheumatology Vol. 16 No. 1 (2024): IJR VOL 16 No 1
Publisher : Indonesian Rheumatology Associantion

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Abstract

Background. Systemic Lupus Erythematosus (SLE) is an autoimmunedisease with multisystem involvement which arises from multifactorialcauses. Continuous exposure to autoantigens and chronic activation of theimmune system, especially memory T lymphocytes, contribute to prematureimmunosenescence. sCTLA-4 and sCD86 are soluble costimulatorymolecules of CTLA-4 and CD86, which play a role in the occurrence ofimmunosenescence in SLE. The presence of immunosenescence will causehigher morbidity and mortality. This research was conducted to establishthe correlation between the increased levels of sCTLA-4 and sCD86 and theseverity of SLE, as measured by the SLE Disease Activity Index (SLEDAI)score. Methods. This analytical observational research utilized a crosssectional approach involving 35 female SLE patients diagnosed according to the SLICC 2012 criteria. SLE disease activity was measured using SLEDAI score. Serum sCTLA-4 and sCD86 levels were measured using the ELISA method. Statistical analysis was conducted using the Mann-Whitney test for comparisons and the Spearman test for correlation analysis, with a significance level of p<0.05. Results. sCTLA-4 levels were higher and significantly different in patients with moderate SLE (p=<0.001; p<0.05), and there was no significant difference in sCD86 levels (p=0.915; p>0.05).Increased sCTLA-4 levels were positively correlated with the severity of SLE(r =0.361, p=0.033), while no significant correlation was observed in sCD86levels (r=-0.094, p=0.591). Conclusion. Elevated sCTLA-4 levels werepositively correlated with increased severity of SLE based on the SLEDAIscore. 
Relationship between Knowledge Level and Preventive Behavior of SepticArthritis in Student Batch 2019-2020, Faculty of Medicine, University of NorthSumatra Silalahi, Christine
Indonesian Journal of Rheumatology Vol. 16 No. 1 (2024): IJR VOL 16 No 1
Publisher : Indonesian Rheumatology Associantion

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Abstract

Background: Septic arthritis is an infectious disease that severely damagesthe joints with clinical manifestations such as swelling, erythema andwarmth of the affected joint. The most common cause of this disease is theresult of hematogenous spread of microorganisms. Some of the risk factorsinclude injection drug use, prosthetic joints and skin infection. The incidenceof septic arthritis is 5 to 8 per 100,000 population per year with 5-10%mortality rate, therefore preventive behavior is needed to minimize theincidence of septic arthritis. Methods: This study is an observationalanalytic study with a cross-sectional approach. The research populationconsisted of students from batch 2019-2020 of the Faculty of Medicine,University of North Sumatra and the sample was determined using stratifiedrandom sampling method. Primary data were obtained directly from researchsubjects using questionnaires via Google Forms. Results: The univariateresearch analysis found that the knowledge level of the majority ofrespondents was in the good category, with 45 subjects (53.6%). The mostpredominant behavior observed in the respondents was negative behavior,with 49 subjects (58.3%). Bivariate analysis found that there was nosignificant relationship between knowledge level and septic arthritisprevention behavior with p value = 0.809. Conclusion: Students from batch2019-2020 of the Faculty of Medicine, University of North Sumatra, onaverage have a good level of knowledge and negative behavior on theprevention of septic arthritis. There is no relationship between the level ofknowledge with septic arthritis prevention behavior.  
Massive Pericardial Effusion – An Uncommon Initial Presentation in aMale Patient With Systemic Lupus Erythematosus Kumar , Vivek
Indonesian Journal of Rheumatology Vol. 16 No. 2 (2024): IJR VOL 16 No 2
Publisher : Indonesian Rheumatology Associantion

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Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease whichhas predilection for female gender. Usually, it manifests as myriad ofclinical signs and symptoms which can involve any organ system of thebody, however cardiovascular involvement solely as an initialpresentation is uncommon. Here we present a case of a male patientwho initially presented with a large pericardial effusion. Later, onextensive workup he was diagnosed with SLE with lupus nephritis. 
Factors Contributed to a Difficult-To-Treat Juvenile IdiopathicArthritis: A Systematic Review and Meta Analysis Wirya , Louis Edwin
Indonesian Journal of Rheumatology Vol. 16 No. 2 (2024): IJR VOL 16 No 2
Publisher : Indonesian Rheumatology Associantion

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Abstract

Background: Juvenile Idiopathic Arthritis is the foremost commonunremitting rheumatic illness in childhood, with a global prevalence rangingfrom 16 to 150 per 100.000 population. However, in some cases, clinicianmay face a difficult-to-treat Juvenile Idiopathic Arthritis (D-JIA), whichindicate to a group of patients who have not affected by administration ofstandard anti-rheumatic drugs. This study aims to identify factors thatcorrelate to D-JIA. Methods: We conducted a systematic review and metaanalysis, collecting studies from PubMed, Scopus, Embase, Cochrane, andGoogle Scholar. Eligible Studies were trials that analyze factors that maycontribute to D-JIA. Results: Six studies were included, enrolling 1.177patients. Female composes 70.9% (835) of the population (OR 1.04, CI 95%0.83-1.31, p=0.72). Median of age and duration of disease respectively were5.79 years and 11.06 months. Some factors correlate with occurancy of DJIA including Caucasian race (OR 0.96, CI 95% 0.44-2.07, p=0.91), ANAnegative (OR 1.77, CI 95% 1.42-2.22, p<0.00001), HLA B27 positive (OR1.86, CI 95% 0.85-4.08, p=0.12), prescence of atypical skin lesion (OR 8.5,CI 95% 1.6-72.4, p=0.022), and spesific subtype of JIA such as Oligoarthritis(OR 0.86, CI 95% 0.70-1.07, p=0.17), Poliarthritis (OR 1.77, CI 95% 1.422.22, p<0.00001), Systemic-type (OR1.22, CI 95% 0.60-2.49, p=0.58),Psoriatic (OR1.61, CI 95% 0.69-3.78, p=0.27), Enteritis-related (OR 1.33, CI95% 0.68-2.59, p=0.40), and Undiffrentiated (OR 1.46, CI 95% 0.55-3.83,p=0.45). Conclusion: Eventhough many factors identified, but only ANAnegativity, presence of atypical skin lesion, and Poliarthritis subtype thathave been statistically proved related in the development of D-JIA. Thisfinding may be due to the study's limitations and remaining differences insubsequent results. Future studies are needed for further analysis regardingthis issue.  

Page 29 of 31 | Total Record : 302

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