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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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Is It Obesity or Metabolic Syndrome Which Has a Greater Prevalence ToCause Muscoloskeletal Complaints? A Cross Sectional Study in theCepokomulyo District, Malang Regency Rahman , Perdana Aditya
Indonesian Journal of Rheumatology Vol. 16 No. 2 (2024): IJR VOL 16 No 2
Publisher : Indonesian Rheumatology Associantion

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Abstract

Introduction: Musculoskeletal (MSK) complaints including pain,swelling, stiffness, or immobility of joints and muscles are among themost common health issues that biomechanical factors are one of therisk factors. Metabolic syndrome is a combination of several riskfactors including obesity, hypertension, low HDL-C levels,hypertriglyceridemia, and impaired glucose tolerance. These issues areknown to influence the incidence of metabolic inflammation associatedwith several MSK diseases, in which obesity is one of the mainbiomechanical factors. Aim: To compare the Prevalence Odd Ratio(POR) of MSK complaints associated with metabolic syndrome (MetS)and obesity. Conclusion: This study included 260 patients, with 49.6%(n=129) of them having metabolic syndrome. The most common MSKcomplaint region was the right knee (n=85). MSK complaints were mostcommon in the group of patients with MetS and obesity (n=109),compared to the group with MetS or obesity alone. Prevalence OddRatio (POR) results show that Group III (group of patients with obesityand without MetS) has the highest prevalence of MSK complaints whencompared to the other three groups.
Correlation Between sCD28 and sCD80 Levels with Disease Actiity of SystemicLupus Erythematosus (SLE) Patients Based on SLEDAI Score Ibad , Ahmad Harissul
Indonesian Journal of Rheumatology Vol. 16 No. 2 (2024): IJR VOL 16 No 2
Publisher : Indonesian Rheumatology Associantion

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Abstract

Background: Systemic Lupus Erythematosus (SLE) is an autoimmune diseasewith multisystem involvement that is caused by multifactorial. Prolongedexposure to autoantigens and sustained immune system activation, particularlyin memory T lymphocytes, can contribute to premature immunosenescence.Soluble costimulatory molecules such as sCTLA-4 and sCD86, originating fromCTLA-4 and CD86 respectively, contribute to the progression ofimmunosenescence in patients with SLE. This condition is associated with highermorbidity and mortality. This study aimed to investigate the relationshipbetween elevated levels of sCTLA-4 and sCD86 and the severity of SLE diseaseactivity, as assessed by the SLEDAI score. Methods: The study employed ananalytical observational design with a cross-sectional approach, involving 35female participants diagnosed with SLE according to the 2012 SLICC criteria. SLEdisease activity was assessed using the SLEDAI score, and serum levels of sCD28and sCD80 were measured using the ELISA method. The Mann-Whitney test wasused for group comparisons, while the Spearman test was conducted forcorrelation analysis, with statistical significance defined as p < 0.05. Results: SLEpatients had an average sCD28 and sCD80 level of 24.93 and 27.41, respectively.Spearman test results showed that sCD28 level had a significant correlation withSLEDAI score [R=0.364; p=0.031 (p<0.05)], while sCD80 level did not correlatesignificantly with SLEDAI score [R=0.048; p=0.786 (p<0.05)]. Conclusion: Therise in sCD28 levels showed a positively correlation with the SLE severity activity,as indicated by the SLEDAI score.
Plasmapheresis as a Promising Therapeutic Option to TreatMacrophage Activation Syndrome Varun , Bansal
Indonesian Journal of Rheumatology Vol. 16 No. 2 (2024): IJR VOL 16 No 2
Publisher : Indonesian Rheumatology Associantion

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Abstract

Macrophage activation syndrome (MAS) is a lethal complication ofautoimmune conditions. Its diagnosis and management remainschallenging till date in view of paucity of standard protocols.Plasmapheresis has shown promise if used early in the course ofdisease. We hereby describe a case report of a young male patient whopresented with multiorgan failure. He was diagnosed with MAStriggered by systemic lupus erythematosus (SLE). He was successfullytreated with steroids, cyclophosphamide and plasmapheresis.
Relationship Between Interleukin 6 (IL-6) and Organ Damage Based on SLICCDamage Index -SDI Score in Systemic Lupus Erythematosus Patients Sianturi , Yesanopa
Indonesian Journal of Rheumatology Vol. 16 No. 2 (2024): IJR VOL 16 No 2
Publisher : Indonesian Rheumatology Associantion

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Abstract

Background: Systemic Lupus Erythematosus (SLE) is a heterogeneousand complex chronic autoimmune disease. Interleukin 6 (IL-6) is acytokine known to be elevated in people with SLE. This research wasconducted to determine the relationship between IL-6 levels and organdamage based on the SLICC Damage Index-SDI Score in SLE patients.Method: The study was a retrospective cross-sectional study involving67 SLE patients conducted based on the SLICC 2012/ACR EULAR2019 criteria at least 6 months prior to their inclusion. They werepatients treated at the Rheumatology Clinic of  Adam Malik GeneralHospital in Medan from June to August 2023, who met the inclusionand exclusion criteria. Organ damage assessment was done using theSLICC Damage Index (SDI) score, while disease activity degree wasmeasured using the SLE Disease Activity Index (SLEDAI-2K) scoringsystem. Results: 94 % subject were women with a median SLEDAI-2Kscore of 6 (10 – 16) where the moderate degree of activity was themajority in this study (41.8%), followed by the mild degree (37.3%),severe (16, 4%), and remission (4.5%). The median IL-6 level was63.3932 pg/ml (8.88 – 5966.67) where a significant correlation wasfound between IL-6 levels and the SDI score (p=0.017) and the degreeof disease activity and the SDI score (P<0.001). Conclusion: Asignificant positive correlation was found between IL-6 levels and SDIscores in SLE patients (p=0.017). 
The The Correlation Between Serum Vitamin D Level and Quality of Life inSystemic Sclerosis Patients Dewi , Sumartini
Indonesian Journal of Rheumatology Vol. 16 No. 2 (2024): IJR VOL 16 No 2
Publisher : Indonesian Rheumatology Associantion

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Abstract

Background: Systemic sclerosis (SSc) is an autoimmune rheumatic disease that is associated with disability and a reduced quality of life. Patients with SSc have lower levels of vitamin D than healthy people. Vitamin D influences the pathological mechanisms of SSc such as autoimmunity, vasculopathy, and fibrosis. The aim of this study was to know the correlation between serum vitamin D levels and the quality of life in SSc patients. Methods: This study was a cross-sectional study. Data were taken from the SSc patient registry at the Rheumatology Clinic of Dr. Hasan Sadikin General Hospital Bandung from September to November 2023. Vitamin D level were assessed by measuring serum 25-hydroxyvitamin D levels. The quality of life was measured using the Indonesian version of the Short Form (SF-36), which was divided into physical component summary (PCS) and mental component summary (MCS). Statistical analysis was performed using the Rank-Spearman test. Results: There were 81 SSc patients enrolled in this study. Vitamin D levels were found low in 44 subjects (54.3%), which were divided into 23 subjects deficiency and 21 subjects insufficiency. Thirty seven subjects (46.7%) had normal vitamin D levels.  The results of this study showed that there was a significant weak positive correlation between serum vitamin D levels and PCS SF-36 (r=0.222, p=0.023) and MCS SF-36 (r=0.209, p=0.031) quality of life in SSc patients.  Conclusion: Serum vitamin D levels of SSc patients had a significant weak positive correlation with physical and mental quality of life component.
Evidence Based Case Report: Secukinumab versus golimumab for Ankylosing Spondylitis Patients Prayogo, Yosafat Sebastian
Indonesian Journal of Rheumatology Vol. 17 No. 2 (2025): IJR VOL 17 No 2
Publisher : Indonesian Rheumatology Associantion

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Abstract

Background: Ankylosing spondylitis is a chronic inflammation of the axial spine and joints that can lead to a wide spectrum of clinical manifestations, with chronic back pain and progressive vertebrae stiffness being two hallmark symptoms. The choice of medication for ankylosing spondylitis depends on both efficacy and cost. This study aims to compare Secukinumab, the cheapest and only available anti-interleukin-17, against Golimumab, a TNF-alpha inhibitor, in terms of efficacy and cost. Methods: A systematic search was conducted until October 30th, 2023, using keywords such as ankylosing spondylitis, secukinumab, golimumab, ASAS20, and their synonyms on databases including PubMed, Embase, SCOPUS, and Cochrane to find relevant studies. Critical appraisal of included studies was performed using the Oxford Center of Evidence-based Medicine (CEBM) tools for harm scenarios. Results: Three eligible articles were collected, observing both Secukinumab and Golimumab with different doses and administration routes. Chen et al.'s comparative analysis between secukinumab 150 mg and golimumab 50 mg revealed an odds ratio (OR) (95% confidence interval (CI)) of 1.19 (0.03-8.94), while secukinumab 150 mg against golimumab 100 mg presented an OR of 1.45 (0.03- 11.98). Zhang et al.'s comparison results between golimumab and secukinumab yielded an OR of 0.62 (0.20-1.89). Finally, Deodhar et al. analyzed different doses of secukinumab and golimumab with an OR range of 1.04-1.15 (0.4-3.11). Conclusion: Both secukinumab and golimumab showed comparable results in ASAS20, exhibiting insignificant differences in the superiority of ASAS20 improvement. However, the cost-effectiveness and personal drug choice need to be evaluated to add further considerations to the medication choice.
Behcet Disease: When Laryngeal Tuberculosis Unforeseably Strikes Zeroual, Chaïmaâ
Indonesian Journal of Rheumatology Vol. 17 No. 2 (2025): IJR VOL 17 No 2
Publisher : Indonesian Rheumatology Associantion

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Abstract

Behçet disease (BD) is a chronic vasculitis that can affect all organs, particularly the skin, mucous membranes, eyes and joints. It can lead to severe complications requiring immunosuppressive therapy (IS). Although the prescription of IS is indisputable and life-saving, they carry a significant risk of opportunistic infections. Tuberculosis is an infectious disease primarily caused by the bacterium Mycobacterium tuberculosis, also known as Koch's bacillus. It predominantly affects the lungs due to airborne transmission and favorable conditions for the bacillus's survival in this area; however, it can also affect other sites to a lesser extent, such as the brain, bones, skin and « ear, nose and throat » (ENT) regions. Laryngeal tuberculosis (LT) is a rare and underdiagnosed localization that often occurs in immunocompromised patients. This article reports the case of a patient with BD under IS who developed LT secondary to subclinical pulmonary tuberculosis. The outcome after discontinuing azathioprine and initiating antituberculous treatment was favorable. The case report aims to shed light on the rare and underrecognized presentation of tuberculosis in BD and in case of immune vulnerability, unraveling the intricate interplay between immunosuppression and opportunistic infections. Its significance lies in underscoring the critical need for heightened clinical vigilance, as LT can masquerade as BD-related manifestations, posing diagnostic dilemmas.
Indonesian Rheumatology Association (IRA) Recommendations for Diagnosis and Management of Systemic Sclerosis Dewi, Sumartini
Indonesian Journal of Rheumatology Vol. 17 No. 2 (2025): IJR VOL 17 No 2
Publisher : Indonesian Rheumatology Associantion

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Abstract

Background: Systemic Sclerosis (SSc) or Scleroderma is a systemic autoimmune rheumatic disease characterized by dysregulation of the immune system, fibrosis of the skin and visceral organs and vasculopathy. The global prevalence of SSc reaches 17.6 per 100,000 population and the incidence reaches 1.4 per 100,000 people per year. The prevalence and incidence of SSc in Asia reaches 6.8 per 100,000 and 0.9 per 100,000, which is lower than other continents. Women have a prevalence and incidence of SSc five times higher than men. The prevalence and incidence of SSc depends greatly on the results of the study. There has not been much research on the epidemiological studies of SSc in Indonesia. Methods: Twelve selected rheumatologists from the Indonesian Rheumatologist Association (IRA) made recommendations based on key questions formed by a steering committee from IRA. These recommendation materials were taken from several online databases such as PubMed, Science Direct, and Google Scholar. Level of evidence and grades of recommendation were then assigned, and every member of the panelist team will assign a score for level of agreement. Results: A total of 50 recommendations that discussed the diagnosis, pharmacological and non- pharmacological therapy, and prognosis for SSc were made. Conclusion: These recommendations can be used to help clinicians correctly diagnose and choose the most suitable therapy for SSc patients. All recommendation statements were created with the consideration of Indonesia’s clinical setting, facility, and drug availability.
Indonesian Rheumatology Association (IRA) Recommendations for Diagnosis and Management of Hyperuricemia and Gouty Arthritis Manuaba, Ida Ayu Ratih Wulansari
Indonesian Journal of Rheumatology Vol. 17 No. 2 (2025): IJR VOL 17 No 2
Publisher : Indonesian Rheumatology Associantion

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Abstract

Background: Gout is a progressive systemic disease caused by deposition of monosodium urate (MSU) crystals in various tissues such as joints, kidneys, and other connective tissues as a result of chronic hyperuricemia. If this condition is not adequately treated, it may progress to chronic gout, tophus formation, and even serious kidney function problems, which will lower quality of life. With the emergence of new treatment options in the last several years, a better understanding of diagnosis and management is required by every physician in Indonesia. Methods: A panel of eighteen selected rheumatologists from the Indonesian Rheumatologist Association (IRA) developed recommendations based on key questions formulated by a steering committee from IRA. These recommendation materials were taken from several online databases such as PubMed, Science Direct, and Google Scholar. Level of evidence and grades of recommendation were then assigned, and each member of the panellist team will assign a score to express their level of agreement. Results: A total of 16 recommendations discussing the diagnosis, non-pharmacological and pharmacological therapies, as well as monitoring for hyperuricemia and gouty arthritis were formulated. Conclusion: These recommendations can be used to help clinicians in accurately diagnosing hyperuricemia and gouty arthritis and choosing the most suitable therapy for their patients. All recommendation statements were tailored to the clinical setting, facility, and drug availability in Indonesia.
The Relationship between Disease Activity Level and the Incidence of Depression in Systemic Lupus Erythematosus Patients at Haji Adam Malik Hospital Medan Sagala, Yohansen Martunas
Indonesian Journal of Rheumatology Vol. 17 No. 2 (2025): IJR VOL 17 No 2
Publisher : Indonesian Rheumatology Associantion

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Abstract

Background: Systemic Lupus Erythematosus (SLE) is a autoimmune disease that affects many organs of the body. SLE is a disease that cannot be completely cured. Life is difficult with SLE because the symptoms may come and go and it is unpredictable what will happen next. This condition causes the SLE patients feel unhappy, frustrated, angry, and sad. If this happens for a long time, it can cause SLE patients to experience depression. Methods: This study used a cross sectional design of 63 respondents at H. Adam Malik General Hospital Medan. This research data was obtained through history taking using primary data in the form of MEX SLEDAI questionnaires and Patient Health Questionnaire 9 (PHQ 9) and secondary data in the form of patient medical records. Results: It was found that SLE patients at H. Adam Malik General Hospital were all female, most of them were in the late adolescent age group with an age range of 17-25 years (39.7%), the last high school education level (68.3%), not working (81%), Married (54%), duration of SLE disease 1-2 years (36.5%), most SLE patients had mild disease activity levels (49.2%), most SLE patients have a mild depression (34,9%). There is a significant relationship between the level of disease activity and the incidence of depression in SLE patients at H. Adam Malik General Hospital (p ≤ 0.05) with a strong and unidirectional relationship (ρ = 0.64). Conclusion: There is a significant relationship between the level of disease activity and the incidence of depression in SLE patients at H. Adam Malik Hospital Medan with a strong relationship.

Page 30 of 31 | Total Record : 302

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