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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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Correlation between serum leptin concentration and disease activity in normal body mass index premenopausal women with systemic lupus erythematosus Suarjana, I Nyoman; Kasjmir, Yoga I; Isbagio, Harry; Soegondo, S
Indonesian Journal of Rheumatology Vol 1, No 1 (2009)
Publisher : Indonesian Rheumatology Association

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Abstract

Background. Leptin is recognized as a cytokine-like hormone with pleiotropic actions in modulating immune responses. The role of leptin in pathogenesis of systemiclupus erythematosus (SLE) was not fully understood yet. Previous study did not fi nd the correlation between serum leptin concentration and disease activity in patients with SLE, but selection of the subjects wasn’t based on the classifi cation of body mass index (BMI) and menopausal status.Objective. To determine correlation between serum leptin concentration and the disease activity in normal BMI premenopausal women with SLE.Methods. Serum leptin concentration was measured by enzyme-linked immunosorbent assay and disease activity was scored using Mexican SLE disease activity index (Mex-SLEDAI). Spearman’s correlation coeffi cient test was used for evaluating the strength of association between leptin level and Mex-SLEDAI score.Results. Seventy normal BMI premenopausal women with SLE were included in this study. The median of serum leptin concentration was 13.4 (0.6 – 45.9) ng/ml.The median serum leptin concentration in patients with active disease was 12.4 (0.6 – 41.6) ng/dl, whereas in patients with inactive disease was 15.2 (3.9 – 45.9) ng/dl.No signifi cant different was found between serum leptin concentration in active and inactive disease (p = 0.14). A weak negative correlation was observed between leptinconcentration and Mex-SLEDAI score, but not statistically signifi cant (r = -0.22; p = 0.07).Conclusion. No correlation was found between serum leptin concentration and disease activity in normal BMI premenopausal women with SLE. Prednisone doses anddisease duration might interfere.
Association Between Adiponectin Levels with Markers of Atherosclerosis In Patients with Rheumatoid Arthritis Meriza, Tanggo; Isbagio, Harry; Mulyadi, Rahmad; Abdullah, Murdani
Indonesian Journal of Rheumatology Vol 5, No 1 (2014)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: Several studies have shown that atherosclerosis underlying processes of Cardiovascular disease (CVD), increased in rheumatoid arthritis (RA) and occurred early (premature). The cause of accelerated atherosclerosis in RA are still unknown.Adipokines have known that the adipokines play a role in the pathophysiology of RA and CVD. Accumulation of visceral fat associated with dysregulation of adipokinesthat influence the development of the atherosclerotic and disruption plaque. Obesity and pathological changes in fat mass and fat dysfunction as well as a change inthe pattern of secretion of proinflammatory adipokines, may have a correlation between heart disease and rheumatic diseases. Adiponectin is one of the mostwidely-studied adipokines. In RA, adiponectin is involved in the pathophysiology of RA that produces of various proinflammatory and prodestructive molecules. So far, adiponectin has been known to provide antiatherosclerotic effects in patients with non-RA. But, several recent studies in RA patients get opposite results in which increased levels of adiponectin are associated with increased prevalence of atherosclerosis. The effect of adiponectin on atherosclerosis in patient with RA is still unknown.Objective: to determine the relationship of adiponectin with atherosclerosis in patients with rheumatoid arthritis. Methods: This is a cross-sectional study conducted on outpatients of the  rheumatology clinic at Cipto Mangunkusumo General Hospital from January untilApril, 2013. Subjects consisted of 50 patients were diagnosed based on ACR 1987/EULAR 2010 criteria. The collection of data obtained by consecutive sampling and evaluated the patients’ medical data that included age, long-suffering of RA, body mass index (BMI), lipid profile, rheumatoid factor levels, levels of anti-cyclic citrullinated peptide (anti-CCP), C-reactive protein (CRP), erythrocyte sedimentation rates (ESR), blood pressure, fasting blood glucose, 2 hour post prandial blood glucose, ECG, examination of serum adiponectin levels and bilateral carotid ultrasound to measure the carotid artery intima media thickness.Results: From the results of the 50 patients studied, obtained 28 (56%) of patients had increased levels of adiponectin. Atherosclerosis was found in 13 (26%) subjects. The median value was 9.46 μg / ml with the lowest levels of 4 μg/ml and the highestlevels of 24μg/ml. The Spearman’s test showed no significant correlation between adiponectin serum and atherosclerosis in patients with RA (p = 0706 and r = 0.055). The analysis results of the correlation of adiponectin with atherosclerosis based on age, disease duration, ESR, rheumatoid factor, DAS 28, CRP, BMI, dyslipidemia showed no significant correlation.Conclusion : From this study, researchers found no statistically significant correlation between adiponectin levels with marker of atherosclerosis (CIMT) in patients with rheumatoid arthritisKeywords : Adiponectin, Atherosclerosis
Risk of cardiovascular disease in rheumatoid arthritis patients Utari, A P; Hidayat, Rudy; Setiyohadi, Bambang
Indonesian Journal of Rheumatology Vol 3, No 1 (2011)
Publisher : Indonesian Rheumatology Association

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Abstract

Despite rheumatoid arthritis (RA) therapy development has been in advance level today, its mortality remains increasing in general population. The mortality is mainly caused by early-manifested atherosclerosis and other cardiovascular complications. Available evidences showthis condition appears in early stage of the disease. Thus, early detection and management of cardiovascular risk, followed by control of these factors are necessaryto reduce morbidity and mortality of RA patients
Most Frequent Musculoskeletal Manifestation of Systemic Lupus Erythematosus Patients in Dr. Hasan Sadikin General Hospital Bandung Sutrisno, Rahadian Nugi; Rahmadi, Andri Reza; Novita, Nita; Hamijoyo, Laniyati
Indonesian Journal of Rheumatology Vol 9, No 2 (2017)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: Systemic Lupus Erythematosus (SLE) is an autoimmune disease with wide range of clinical symptoms. The patients frequently complain musculoskeletal involvement during the active state of the disease. Musculoskeletal manifestation in SLE patients is an important sign in making early diagnosis and monitoring treatment response. This study aims to determine the presentation of musculoskeletal involvement of SLE patients in Dr. Hasan Sadikin General Hospital Bandung.Methods: a descriptive cross-sectional quantitative study done by interviewing SLE patients concerning musculoskeletal manifestation as the primary data and tracking their medical record as the secondary data. Study was conducted between September to November 2016 in Rheumatology Clinic Dr. Hasan Sadikin General Hospital Bandung.Result: Ninety-seven SLE patients, 91 females (93,81%) and 6 males (6,19%), were enrolled in this study with mean age 35.12 (±10.91) years. The three highest proportions of muskuloskeltal manifestations were arthritis of the knee (84,5%), myalgia of upper back(40,2%), and muscle weakness (15,5%). We did not find any Jaccoud’s Arthropathy (JA) and tendinitis manifestation. Osteoporosis were occured in 4 patients (4,12%), whereas gout arthritis, spondytlitis, osteoarthritis, rotator cuff syndrome, and rhupus wereonly occured in one patient (1,03%), respectively.Conclusion: The common musculoskeletal manifestation in SLE patients were arthritis of knee, myalgia of upper back, and muscle weakness. Only small portion of patients suffered from osteoporosis, gout arthritis, spondytlitis, osteoarthritis, rotator cuff syndrome, and rhupus.Keyword: musculoskeletal manifestation, musculoskletal involment, SLE
Correlation between osteoarthritis grading in femoropatella joint and patella malalignment with pain and disability using WOMAC score Kiswati, S; Suntoko, Bantar; Sukmaningtyas, H
Indonesian Journal of Rheumatology Vol 8, No 1 (2016)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: Osteoarthritis (OA) in femoropatella often causes pain and disabilities in the lower extremities. In 2011 found a significance association between knee pain with osteophytes in femoropatella joints compared with osteophytes in femorotibia joints. Niu J et al. found knee joint with lateral patellar malalignment and lateral patellar tilt had increased prevalence of femoropatella OA, similar study in Caucasian and African Americans patients found an association between patellar malalignment with severe knee pain and diseaseprogressivity. In this study, researchers correlate grading OA genu with pain and disability using WOMAC scores and malalignment correlate with pain and disability with WOMAC scores without assessing the progression of the disease. In this study, using cross-sectional at one time whereas previous studies using multi-center cohort were evaluated 3 to 5 years later to assess the progression of the disease. Objective of this study is to establish a correlation between OA grading in femoropatella joint and patellar malalignmentwith pain and disability using WOMAC Score.Method: Observational analytic study with crosssectional and consecutive sampling was performed in this study. In the WOMAC correlation with KellgrenLawrence grading on the WOMAC OA genu and grading narrowing between joints using the Rank Spearmanwhile the different test WOMAC with malalignment using T test Results: WOMAC OA genu of the grading (AP/LAT/Skyline) r = 0.488; p = 0.003, WOMAC OA genu of the grading (AP/LAT) r = 0.452 ; p = 0.006, WOMAC OA genu of the grading (AP/Skyline) r = 0.362 ; p = 0.033, WOMAC towards narrowing between joints gradingfemoropatella r = 0.370 ; p = 0.026, no differences between patellar malalignment with WOMAC score, with malalignment (p = 0.711) without malalignment(p = 0.751).Conclusion: In AP/LAT/Skyline, AP/LAT, AP/Skyline position and grading narrowing femoropatella joint space was found a significant positive correlation between OA knee’s grading and WOMAC score. No differences in T test between patella malalignment with pain and disability using WOMAC score.Keywords: femoropatella osteoarthritis, patellar malalignment, WOMAC score.
Role of interleukin-17 in the pathogenesis of rheumatoid arthritis Ongkowijaya, Jeffrey A; Setiyohadi, Bambang; Sumariyono, Sumariyono; Kasjmir, Yoga I
Indonesian Journal of Rheumatology Vol 2, No 2 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Rheumatoid arthritis (RA) is a systemic autoimmune disorder with an unknown etiology. It typically affects the peripheral synovial joints symmetrically. The roles of T and B cells, macrophages, plasmocytes, host tissue cells (synoviocytes, chondrocytes), and osteoclastsin RA are more defi ned. In RA, cytokines secreted by cells implicated in adaptive and natural immunity have important roles in causing infl ammation, articular destruction, and other comorbid diseases related to RA. Other than the clear roles of interleukin (IL)-1 and tumor necrosis factor α, there are other cytokines that are suspected of having roles in the pathogenesis of RA, IL-17 for instance. Interleukin-17 is a proinfl ammatory cytokine,  produced by Th17 cells, and has pleiotropic effects on various cells contributing to the pathogenic condition of RA. Several studies showed that this cytokine maintains the infl ammation and causes more destruction of joint cartilage. Advances in the understanding of the role of IL-17 elicits the idea to modulate IL-17 and/or Th17 cells as the potential targetsof therapy in RA
Correlation Of Clinical Disease Activity Index And Disease Activity Score-28 in Indonesian Rheumatoid Arthritis Patients Pasha, Mochamad; Isbagio, Harry; Albar, Zuljasri; Rumende, Cleopas Martin
Indonesian Journal of Rheumatology Vol 9, No 1 (2017)
Publisher : Indonesian Rheumatology Association

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Abstract

Background:Clinical Disease Activity Index (CDAI) stands out amongst other methods in measuring disease activity of rheumatoid arthritis (RA) patient. CDAI is considered to be more practical and cost-effective in daily practice because it requires no laboratoryexamination. Previous studies conducted overseas revealed that CDAI has good correlation compared to other scoring index in measuring RA disease activity. However, those studies only included pure RA patients without any comorbidity diseases. Indonesian RA patients have distinct clinical profile, in terms of comorbidity conditions, and genetic predisposition which affect the fenotype of the disease.Objectives: Analyze correlation between CDAI compared to Disease Activity Score 28 CRP (DAS28- CRP) in measuring RA disease activity of RA patients in Indonesia.Methods: We conducted a cross sectional study to RA patients who visited rheumatology clinic at Cipto Mangunkusumo general hospital from April to May 2016. Data collected included history of illness, physical examination, and recent laboratory results. All data were documented in reseach’s form. Both CDAI and DAS28- CRP were measured in each patient by two observers. Correlation analysis between two numeric datas fromCDAI and DAS28-CRP were measured with Spearman’s Rho. Overall performance was analyzed as additional results using R2 index.Result: A total of 119 subjects were included in this study. All subjects were RA patients with comorbidities and were representing quite numbers of Indonesian races characteristic profile. Spearman’s Rho = 0,918 and R2 index =0,831 (83,1%).Conclusion: There is positive correlation result between outcome of CDAI and outcome of DAS28-CRP in assesing disease activity of Indonesian RA patients.Key Word: rheumatoid arthritis, Indonesia, correlation,Clinical Disease Activity Index.
Correlation of sCD40L Level with Force Vital Capacity Value in Restrictive Lung Disease of Systemic Sclerosis Patients Salim, Susanto; Wachjudi, Rachmat Gunadi; Dewi, Sumartini
Indonesian Journal of Rheumatology Vol 10, No 1 (2018)
Publisher : Indonesian Rheumatology Association

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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
Vitamin D and inflammation Albar, Zuljasri
Indonesian Journal of Rheumatology Vol 2, No 1 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

The discovery that most body cells and tissues have vitamin D receptors and that some of them have the enzymatic machinery to convert the circulating form of vitamin D (25-hydroxyvitamin D) into the active form (1,25- dihydroxyvitamin D/1,25(OH)2D3 ) gave a new insight about the function of this vitamin. In the course of time, more and more evidences showed that a low vitamin D level leads to the occurrence or recurrenceof cardiovascular diseases, type II diabetes mellitus (DM), cell dedifferentiation (oncogenesis), and immune derangement (autoimmune diseases such as lupus, typeI DM, rheumatoid arthritis, and multiple sclerosis). Most researchers have agreed that a minimum 25(OH)D3 serum level of about 30 ng/ml or more is necessary for favorable calcium absorption and good health. Until proven otherwise, the balance of the research clearly indicates that oral supplementation in the range of 1,000 IU/day for infants, 2,000 IU/day for children, and 4,000 IU/day for adults is safe and reasonable to meetphysiologic requirements, to promote optimal health, and to reduce the risk of several serious diseases.
Avascular necrosis of the right femoral head in female patient with Systemic Lupus Erythematosus Sinaga, A; Nufus, H; Setiyohadi, Bambang
Indonesian Journal of Rheumatology Vol 5, No 1 (2014)
Publisher : Indonesian Rheumatology Association

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Abstract

Avascular necrosis (also known as osteonecrosis, aseptic necrosis, or ischemic necrosis) represents collection of pathologic conditions from various etiologies causing impairment of blood supply to particular bone resulting in bone cellular death.Avascular necrosis remains a significant cause of morbidity in patients with systemic lupus erythematosus (SLE).1 It often involves multiple joints in SLE, in which the femoral head is involvedin most of these patients. Corticosteroids use is known as a major risk factor in the development of this complication.2-3 We report this case due to its quite common occurrence in SLE patients. The early recognition of avascular necrosis is essentialto prevent morbidity

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