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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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The effect of disease duration on the incidence of peripheral arterial disease in young adults with systemic lupus erythematosus Merlyn, M; Setyohadi, Bambang; Soebardi, S; Harimurti, K
Indonesian Journal of Rheumatology Vol 4, No 1 (2013)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: Peripheral arterial disease is a chronic complication that affects morbidity and mortality in SLE patient. However, there were only a few of researches studying the relationship of disease duration and  peripheral arterial disease event overseas and it hasnever been studied in Indonesia.Objectives: To obtain information about the increased event of peripheral arterial disease in women of 40 years old or younger with SLE’s duration of five years or longer compared with less than five years.Methods: This was a case control study conducted between June - August 2012 at Cipto Mangunkusumo hospital, Jakarta. Subjects were women of 40 years old or younger with SLE who visited Rheumatolgy and Allergy-Immunlogy outpatient clinic. They were assignedto case and control groups and traced retrospectively using interview and medical record. The relationship between disease duration and peripheral arterial disease was estimated using OR and the role of confounding factors was analysed using logistic regression one byone, resulted in fully adjusted OR.Results: A total of 90 subjects were recruited, 18 subjects in case group and 72 subjects in control group.Traditional risk factors were similiar in both groups. In multivariat analysis, there was a relationship between disease duration 5 years or longer and peripheral arterialdisease with fully adjusted OR 1,9 (95%CI 0,575-6,543). Older age and steroid therapy were the confounding factors.Conclusion: There was an increased event of peripheral arterial disease in women of 40 years old or younger with SLE’s duration five years or longer compared withsubjects having the disease duration less than five years, but this increase was not statistically significant.Keywords: Peripheral arterial disease, lupus erythematosus systemic, disease duration
Experience with cyclophosphamide in the treatment of a young woman with refractory dermatomyositis Setiyohadi, Bambang; Sinto, R
Indonesian Journal of Rheumatology Vol 3, No 1 (2011)
Publisher : Indonesian Rheumatology Association

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Abstract

Dermatomyositis is an idiopathic inflammatory myopathy characterized by the presence of rash and moderate-to-severe muscle weakness secondary to inflammation of the muscle. It can be a difficult condition to treat. Systemic corticosteroids are the first choice of treatment. However, about a quarter of patients either fail to respond to steroids or develop steroid-related toxicity. Second-line agents such as azathioprine and methotrexate are then added either alone, or in combination with corticosteroids. Failure of the disease to respond tosecond-line agents can then be a problem and this is often referred to as “refractory dermatomyositis”. Unfortunately, there is neither agreement nor wellestablished guidelines on the best regimen or combination of immunosuppressive agents in the case of refractory dermatomyositis.
Diagnosis and management of osteomyelitis Gunawan, Gunawan; Setiyohadi, Bambang
Indonesian Journal of Rheumatology Vol 2, No 3 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Osteomyelitis is an infection of the bone that causes bone destruction and formation of new bone as the result of the infl ammatory process. Proper diagnosis in osteomyelitis is important since it determines the decision-making in the management of the disease: whether to perform aggressive treatments or administration of long-term antibiotic treatment. Imaging techniques play an important role in the diagnosis of osteomyelitis, but their results should be interpreted with care as they have a wide range of sensitivity and specifi city. A combination of imagingtechniques could improve their sensitivity and specifi city. Conventional radiography is an affordable and widely available technique, and has been proven to be useful in diagnosing and excluding the differential diagnosesof osteomyelitis. Surgical intervention to remove necrotic tissues and administration of antibiotics to eradicate pathogens are necessary in the anagementof osteomyelitis. Several antibiotics such as quinolones,rifampin, and clindamycin have been proven to havegood penetration into bone.
Myelopathy caused by Ossification of Thoracic Ligamentum Flavum Yudoyono, Farid; Dahlan, Rully Hanafi; Ompusunggu, Sevline Esthetia; Hamijoyo, Laniyati; Arifin, Muhammad Zafrullah
Indonesian Journal of Rheumatology Vol 8, No 1 (2016)
Publisher : Indonesian Rheumatology Association

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Abstract

Hypertrophy of the posterior spinal elements leading to compromise of the spinal canal and its neural elements is a well-recognized pathological entity affecting the lumbar or cervical spine. Such stenosis of the thoracic spine in the absence of a generalized rheumatological,metabolic, or orthopedic disorder, or a history of trauma is generally considered to be rare. Spinal ligaments, such as the ligamentum flavum (LF), are prone to degeneration and can lead to back pain and nerve dysfunction. Ossification of ligamentum flavum (OLF) is a pathological condition that cause neurological symptoms and usually occurs in the thoracic spine and less frequently in the cervical spine. However the disease is now being increasingly recognized as acause of thoracic myelopathy. We report a rare case of thoracic myelopathy caused by OLF. A 48-year-old male presented with a chief complaint of weakness of bilateral lower extremities. Neurological examination revealed sensory deficit at Th 11 level below. Magnetic resonance imaging and computed tomography demonstrated OLF at the right T9–11 level. Thoracicmyelopathy caused by OLF was consider and surgical intervention was performed. Posterior decompression and laminoplasty has been performed for this patient. Keywords: ossification of ligamentum flavum, thoracic myelopathy, laminoplasty
Arthritis in leprosy without specific skin lesion Dewi, Sumartini; Setiyohadi, Bambang
Indonesian Journal of Rheumatology Vol 2, No 2 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Leprosy patients could display a great variability of signs and symptoms. An overabundance of rheumatic manifestations, occuring alone or in varying combinations, are associated with leprosy, particularly with lepra reactions A study involving seventy cases of leprosy found that rheumatic manifestations were seen in 61.42% of cases: arthritis in 54.28% and soft tissue rheumatism in 17.14%. Enthesitis was seen in 2.84% of cases. Rheumatic manifestations may be the primary complaint, thus delaying accurate diagnosis. Musculoskeletal involvement in leprosy is the third most frequent manifestation after dermatological and neurological involvements. It can occur at anytime during the infection. Articular inflammation in leprosy, which closely mimics other rheumatic disorders, usually occurs in reactive states, particularly erythema nodosum leprosum (ENL).1 About 1–5% of leprosy patients are reported of developing arthritis (synovial inflammation) at some stage of the disease but this rate increases to over 50% during lepra reactions.2 Here we report a case of arthritis in leprosywithout any typical skin lesion thus causing a delay in diagnosis.
Memory Performance in Patient with Systemic Lupus Erythematosus Using MoCA-Ina in Hasan Sadikin Genneral Hospital Bandung Anjalia, Safira; Ong, Paulus Anam; Atik, Nur; Hamijoyo, Laniyati
Indonesian Journal of Rheumatology Vol 9, No 1 (2017)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: The involvement of neuropsychiatry is reported in 6% to 91% of Systemic Lupus Erythematosus (SLE) patients. It can cause fatal morbidity and mortality. Memory impairment is one of the most common symptoms of neuropsychiatry involvement. This study aims to find out the performance of memory test in SLE patients using Indonesian version of Montreal Cognitive Assessment (MoCA-Ina).Method: This cross sectional study recruited 30 SLE patients. Cognitive abilities and patient’s memory were examined using Indonesian version of Montreal Cognitive Assessment (MoCA-Ina). Cognitive impairment was determined when total MoCA-Ina score was below 26. For memory evaluation, immediate recall or delayed recall impairment was determined when the patient failed in each memory subtests.Results: The mean of total MoCA-Ina score was 24.97 (SD±3.14). Fifty percent of the SLE patients had cognitive impairment, with the domain involved being delayed recall (86.67%), attention (60%), language (56.67%), abstraction (53.33%), and visuo-spatial/ executive function (36.67%). Most patients (86.67%) could completely repeat immediate recall. Whileonly 4 (13.33%) subjects could repeat delayed recall completely without any clue. Of the 26 SLE patients who failed to recall completely, 24 (92.3%) of them succeeded to recall completely after getting clue(s).Conclusion: Memory impairment is the most frequent cognitive impairment in SLE patients, especially in delayed recall. By using the memory subtests of MoCAIna, more than four fifth of patients with SLE was detected having delayed recall memory impairment and almost all of them could recalled completely after getting clue(s). This findings indicated that the finalstep of memory process retrieval in SLE was interrupted while being encoded, but retention pathway were stillintact.Keywords: Systemic Lupus Erythematous, Memory, MoCA-Ina
Osteoarticular tuberculosis of the right foot: a diagnostic delayed Akil, Natsir; Setiyohadi, Bambang; Lubis, A MT; Fawziah, A
Indonesian Journal of Rheumatology Vol 2, No 1 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Extrapulmonary tuberculosis (TB) involving the musculoskeletal system occurs in approximately 1% to 3% of patients with extrapulmonary TB. Concurrent pulmonary or intrathoracic TB is present in less than 50% of cases.1 Spine is the most frequent site of osseous tuberculous involvement. Other affected sites include the hip, knee, foot, elbow, hand, and bursal sheaths.2 Tuberculosis of the foot and ankle remains anuncommon site of the infection, present in 8% to 10% of osteoarticular infection. The diagnosis of osteoarticular tuberculosis is often delayed due to a lack of familiarity with the disease.3 We describe a patient with foot pain and swelling without any respiratory symptom as initial presentation of pulmonary and osteoarticular tuberculosis
Correlations between osteoartritis grading in femorotibial joint (kellgren lawrence) with cartilage defects grading Permatasari, Yuliati; Zulqarnain, Nasirun; Sukmaningtyas, Hermina; Suntoko, Bantar
Indonesian Journal of Rheumatology Vol 8, No 2 (2016)
Publisher : Indonesian Rheumatology Association

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Abstract

Background : Osteoarthritis (OA) is the most common chronic rheumatic diseases that causing pain and disability. The imaging of knee OA were found in 15,5%  men and 12,7% women of Indonesia population. Radiography is still used as a standard modalities in assesing OA progression, and Kellgren-Lawrence scale (KL) is the most common measurement used byclinicians. Superficial cartilage degradation is the first sign of OA, the early detection of the superficial cartilage degradation is very important for diagnosis. Our study was established to assess the correlation between OA grading in femorotibial joint examined by standard Kellgren-Lawrence scale (KL) measurement with cartilage defects examined by ultrasound.Methods : Observational analytic study with cross sectional and consecutive sampling was performed. Rank Spearman test for correlation of OA grading, cartilage defect, BMI and joint malalignment. McNemar test for correspondence between the location of the narrowing of the femorotibial joint and location of cartilage defects.Result : Correlation of OA grading of femorotibial joints (KL) with cartilage defects grading on ultrasound resulted r =0.459, p<0.05; correlation of OA grading of femorotibial joints (KL) with BMI or joint malalignment resulted p>0,05; correlation of cartilage defect grading with BMI or joint malalignment also resulted p>0.05. McNemar test for location of the narrowing of thefemorotibial joint with location of cartilage defects on ultrasound resulted p = 1.00, k = 0.714. There was a significant positive correlation of OA grading of femorotibial joints (KL) with cartilage defects grading on ultrasound. There was no significant correlation between OA grading of femorotibial joints (KL) with BMI and joint malignment, and no significant correlationbetween cartilage defects grading with BMI and joint malalignment. There is a correspondence between the location of the narrowing of the femorotibial joint with location of cartilage defects on ultrasound.Conclusion: For assesing the grade of osteoartritis, cartilage defect grading and assesment by ultrasound can be used as an alternative to X-Ray KellgrenLawrence scale (KL) measurement.Keywords : femorotibial joint, cartilage defects grading, osteoartritis grading examination, BMI, joint malalignment.
Erosive polyarthritis in multicentric reticulohistiocytosis mimics rheumatoid arthritis Suryana, Bagus Putu Putra; Puspitasari, L; Wahono, Cesarius Singgih; Kalim, H
Indonesian Journal of Rheumatology Vol 4, No 1 (2013)
Publisher : Indonesian Rheumatology Association

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Abstract

Multicentric reticulohistiocytosis (MRH) is a very rare multisystemic syndrome.1,2 The first case of MRH was described by Goltz and Layman in 1954 and so far only less than 200 cases have been reported.3-5 It is characterized by the insidious onset of polyarthritis that often evolves into a severe erosive deforming arthritis and characteristic skin lesions composed of nodules and plaques containing lipid-laden (periodic acidSchiff-positive) histiocytes and multinucleated giant cells.6 It most commonly affects the handsand cervical spine.7 MRH is also known as lipoid dermatoarthritis, lipoid rheumatism, and giant cell reticulohistiocytosis.4 MRH is occured due to infiltration of multinucleated giant cells and histiocytes into various tissues. The typical pictures include skin nodules and destructive polyarthritis.3 This entity is frequently mistaken for rheumatoid arthritis (RA).3 MRH is often associated with systemic complication and various types ofmalignancy. Therefore, sometimes it is considered a paraneoplastic syndrome
Avascular necrosis of the right femoral head in a systemic lupus erythematosus patient Manuaba, Ida Ayu Ratih Wulansari; Setiyohadi, Bambang
Indonesian Journal of Rheumatology Vol 1, No 1 (2009)
Publisher : Indonesian Rheumatology Association

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Abstract

According to the 1993 Association Research Circulation Osseous, idiopathic avascular necrosis of the femoral head is defined as the presence of disease or other causes that result in ischemic osteonecrosis of the femoral head without the presence of trauma or sepsis. Based on the above defi nition, idiopathic avascular necrosis(AVN) includes those that are the result of steroid administration, systemic lupus erythematosus, alcoholic consumption, etc. The pathogenesis of AVN is still obscure; however, it is basically caused by vascular circulation disorder, cell death and decreased capability of bone repair.1,2 Systemic lupus erythematosus (SLE) is characterized by the presence of systemic immune dysregulation, autoantibody formation, immune complex in the circulation, and activation of the systemic complement. The pathology during recurrence of SLE, among others, is the presenceof vascular lesion in the form of infl ammation, thrombosis, endothelial injury in which the three of them are predispositions for atherosclerosis. The vascular lesion will cause microcirculation damage which is a risk factor for the occurrence of AVN in activation of SLE. Besides being caused by vascular lesion during activation of SLE, AVN is also triggered by fat deposition in SLE patients as a result of long term steroid therapy that causes abnormal blood fat level.1,2 Patients with SLE who have undergone pharmacologic treatment with systemic steroid either in oral or injection form will have 10 to 40 times the risk of having idiopathic AVN. High dose of systemic steroid treatment of more than 4000 mg of prednisone administered for more than three months or low dose of oral steroid administered for seven days can become a risk factor for AVN. The mechanism of AVN caused by steroid treatmentis associated with hypercoagulation, fi brinolysis disorder, and thrombosis of the bone vein.1,2,3 We report a case of AVN of the right femoral head in an SLE patient.

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