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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 of serum level of interleukin-6 and disease activity with bone-resorption activity in premenopausal rheumatoid arthritis patients Akil, Natsir; Isbagio, H; Sumariyono, Sumariyono
Indonesian Journal of Rheumatology Vol 4, No 1 (2013)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: Rheumatoid arthritis (RA) is a chronic, systemic disease characterized by inflammation and cellular proliferation in the synovial lining of joints that can ultimately result in cartilage and bone destruction.Patients with RA are at increased risk of osteoporotic fractures in both axial and appendicular bones. Several cytokines are involved in the pathogenesis of osteoporotic RA patients, including tumor necrosis factor α, interleukin (IL)-1, IL-6, and IL-17. Among these cytokines, IL-6 has a pivotal role in the pathogenesis of increased bone resorption in postmenopausal RA patients. There are currently scarce data concerning this process in premenopausal RA patients.Objective: To determine the correlation of serum level IL-6 and disease activity with bone-resorption activity in premenopausal RA patients. Methods: This is a cross-sectional study with consecutive sampling method conducted at the Division of Rheumatology, Cipto Mangunkusumo General Hospital from June until August 2010. Bone-resorption activity was quantified using serum C-terminal crosslinking telopeptide of type I collagen (CTx-I) level, while disease activity was assessed using the 28-joint disease activity (DAS28) score. Statistical analysis was performed to investigate the correlation of serum IL-6 level and disease activity with serum CTx-I level.Results: There were 38 patients enrolled in this study. Mean serum level of IL-6 was 10.99 pg/mL (SD 16.06). Mean serum level of CTx-I was 405.37 pg/mL (SD 199.32). There was no significant correlation (p = 0.252) between serum IL-6 level with serum CTx-I level;however, a significant correlation existed (r = 0.389, p = 0.033) among seropositive patients. There was no significant correlation (p = 0.257) between the DAS28score with serum CTx-I level.Conclusion: There were no significant correlation either of serum IL-6 level or disease activity with serum CTx-I level among patients in this study
Risk factors of osteoarthritis that reduce the Steinbrocker’s functional capacity of patients with osteoarthritis of the knee Setiyohadi, Bambang; Nasution, A R; Isbagio, H
Indonesian Journal of Rheumatology Vol 1, No 1 (2009)
Publisher : Indonesian Rheumatology Association

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Abstract

Objective. This study was implemented to determine the risk factors of osteoarthrosis which potentially could reduce the Steinbrocker’s functional capacity (SFC) of patients with osteoarthrosis of the knee.Method. In this cross sectional study, the cases were taken consecutively from the ambulatory patient with the osteoarthrosis of the knee who visited the rheumatologyclinic, Cipto Mangunkusumo Hospital. Subjects was interviewed to record the existing and severity risk factors using a structured questionnaire regarding their age, gender, duration of the illness pattern of smoking history of diabetes mellitus, menopause, body mass index (BMI), knee joint deformity, 15 meters walking time and KellgrenLawrence radiologic index.Results. One hundred thirteen cases of osteoarthrosis of the knee were assigned to the study between July to December 1992, 24 patients were male and 89 werefemale. Eighteen patients were designated to SFC I, 77 patients to SFC II, 14 patients to SFC III and 4 patients to SFC IV. With the logistic regression analysis, it was found that the signifi cant risk factors of developing SFC II, III and IV from patients of SFC I were being female and smoking. In the second logistic regression analysis we found that the signifi cant risk factors for developing SFC III and IV from patients of SFC I and II were age and BMI.Conclusion. In this study we have found that age, smoking, female genders, and BMI were the risk factors which potentially could reduce the SFC of patients withosteoarthrosis of the knee.
Septic arthritis in malignancy Setiyohadi, Bambang; Santosa, D; Titis, Titis; Abdullah, A A
Indonesian Journal of Rheumatology Vol 3, No 1 (2011)
Publisher : Indonesian Rheumatology Association

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Abstract

Septic arthritis is an infection of a joint, which canbe caused by bacteria, viruses, fungi, or parasites. The infection may happen in distant sites of the body, which then spread hematogenously, or it could also result from open wounds, surgery, or unsterile injections.1 Septic arthritis is a serious condition that, if left undiagnosed and untreated, can cause joint destruction and an irreversible loss of joint function.2,3 Based on epidemiological data, the incidence of septic arthritis in general population is 2–10 cases in 100,000 people annually and is increased in those who have risk factors for septic arthritis, such as rheumatoid arthritis (RA) and joint prosthesis. In those with RA, the incidence of septic arthritis rises up to 30–70 cases in 100,000 people annually, and in those with prosthesis the figure is around 40–68 cases in 100,000 people annually.4,5 Septic arthritis can affect all age groups, but it is more prevalence in the elderly and in children under 5 years old, in which the prevalence is 8.4 and 5 cases, respectively, in 100,000 people annually.5 Septic arthritis is usually monoarticular, whereas polyarticular involvement occurs in only 10–15% of cases. The knee is involved in around 50% of cases.Septic arthritis is still a challenge for cliniciansince there has not been a significant decline in both morbidity and mortality in the last two decades.2 Late recognition and therapy can cause permanent joint dysfunction and even death; thus, early diagnosis and prompt therapy is expected to decrease the morbidity and mortality rate in septic arthritis.6 In this case report we would like to present a case of a woman suffering from septic arthritis with an underlying immunocompromised condition of malignancy
Role of diacerein in pain intensity and functional status in patients with knee osteoarthritis Kasjmir, Yoga I; Imelda, F; Erawati, L
Indonesian Journal of Rheumatology Vol 2, No 3 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: Infl ammation is an important mechanism in the pathogenesis of osteoarthritis (OA). Proinfl ammatory mediators, especially interleukin-1β (IL-1β), play a signifi cant role in the occurrence of joint infl ammation, which lead to pain and limitation of daily activities. As an anti–IL-1β, diacerein is therefore have potency to reduce pain and improve functional status of OA patients.Objective: To evaluate the role of diacerein in pain intensity and functional status of knee OA patients. Methods: This is a pre-post study without control group using consecutive sampling conducted at rheumatology outpatient clinic at the Cipto Mangunkusumo General Hospital, Jakarta from January until May 2006. At the fi rst visit, all patients underwentassessment of pain intensity (using visual analog scale (VAS)) and functional status (Lequesne algofunctional index) to obtain baseline data. We also performed kneeradiograph examination to evaluate joint damage basedon the Kellgren-Lawrence classifi cation. Measurement of IL-1β level in synovial fl uid was performed using enzyme-linked immunosorbent assay, with a minimum detectable value of 3.9 pg/mL. Diacerein wasadministered with a dose of 50 mg, given orally twice a day for 2 months. Follow-ups were done in the fi rst, second, and eighth week after the administration of diacerein. In the eighth week we repeated the measurement of IL-1β level.Results: Thirty three patients were enrolled in this study, most (78.8%) of them were female. The majority (81.8%) belong to the 50- to 70-year-old age group. More than half of the patients (54.5%) had detectable IL-1β level. The median baseline VAS score was 65.00 (range 25–100) while the median baseline Lequesne score was 11.00 (range 1.5–21.0). The statistical analysis showed a signifi cant decrease in VAS at the fi rst (p = 0.000), second(p = 0.000), and eighth week (p = 0.000). Lequesne index score was also decrease signifi cantly at the fi rst (p =0.000), second (p = 0.000), and eighth week (p = 0.000)of treatment. We found no signifi cant correlation of IL-1β level with VAS and Lequesne algofunctional index scores.Conclusions: Among the patients in this study, there were signifi cant decrease in pain intensity and disabilityafter the administration of diacerein.
Erosive osteoarthritis Ongkowijaya, Jeffrey A; Setiyohadi, Bambang; Sumariyono, Sumariyono
Indonesian Journal of Rheumatology Vol 2, No 2 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Osteoarthritis (OA) is a degenerative joint disease characterized by the erosion of cartilage joints, hypertrophy of the marginal bone, subchondral sclerosis, and the morphological and biochemical changes of synovial membrane and joint capsule.This clinical syndrome is characterized by joint pain caused by degeneration of the joints. It is the most common joint disease to afflict the elderly and it occurs more often with age.1–3 Erosive osteoarthritis is a subset of OA in which there is a destruction of the joints as a result of inflammation.3,4 Changes mainly occur on the distal interphalangeal (DIP) joints, proximal interphalangeal (PIP) joints, carpometacarpal (CMC) joints, and very rarely occur on other joints of hand or of other body parts.3–5 The diagnosis is in accordance with the criteria of American College of Rheumatology (ACR) for OA and is supported by the existence of bone erosion on the radiological image. The management of this disease is merely for palliative purpose.
The Pattern of Joints Involvement in Patients with Rheumatoid Arthritis in Rheumatology Clinic Dr. Hasan Sadikin General Hospital Bandung Pratama, Muhammad Kevin; Atik, Nur; Hamijoyo, Laniyati
Indonesian Journal of Rheumatology Vol 9, No 2 (2017)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease with primary manifestation in the joints. Early management of RA will prevent further joint damage. The joint damages, result of uncontrolled disease activity, will decrease patient’s quality of life.RA should be diagnosed earlier and followed by early treatment initiation, in order to prevent further damages. This study aimed to determine the pattern of joint involvement in RA in order to made earlier diagnosis and treatment initiation.Method: This research was conducted using descriptive study design. Data were obtained using interview of RA patients who coming to Rheumatology Clinic of Dr. Hasan Sadikin General Hospital from August 2016 to October 2016. Collected data included number of joints involvement, duration of therapy, and duration of illness after diagnosed according to the criteria of ACR / EULAR 2010.Result: Ninety-seven RA patients were involved in this study. Subjects were dominantly women (87%), the highest age group was 45-49 years old (17.53%), duration of the disease <5 years (90.72%), and duration of therapy > 3 months (86%). Joint that frequently involved at the time when the diagnosis made was first proximal interphalangeal (49.50%), overall findings during the course of RA was the wrist joint (90.72%).There were different tendency of joint involvement between the gender, knee joints occured in 53,84% male subjects, while PIP joints were accounted for 52,38% infemale subjects.Conclusion: The first PIP was the most common joint involved in RA patients when the diagnosis made. The wrist joint involvement was dominantly found in overall course of RA. Knee joint involvement was majorly found in male RA patients, whereas female RA patients would suffer mostly from PIP joint involvement.Keywords: involvement pattern, joints, rheumatoid arthritis
Chronic polyarthritis mimicking rheumatoid arthritis in a patient with leprosy Haribowo, A S; Suryana, Bagus Putu Putra; Handono, Kusworini
Indonesian Journal of Rheumatology Vol 2, No 1 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Currently leprosy is now still a global threat in the world even after the introduction of multidrug therapy (MDT), including in Indonesia.1 World Health Organization (WHO) data revealed that in 2002 there were 597,000 cases worldwide and the prevalence is only less than 1 every 10,000 populations.2 Nevertheless, the latest data showedthat 83% of leprosy cases concentrated in only 6 countries: Indonesia, India, Brazil, Madagascar, Myanmar, and Nepal.3 The most common manifestations of leprosyare cutaneous and neuritic manifestation. Rheumatologic manifestation is another common manifestation of leprosy.4-7 Prevalence of rheumatologic manifestation of leprosy is range from 1% to 77% of all leprosy patients.4-11 Study conducted by Mandal et al in India revealed that the prevalence of rheumatologic manifestation was 5.9%, in Brazil,6 another study by Pereira revealed the prevalence of 9.1%.5 Hadi, in Indonesia,showed the prevalence of arthritic manifestation was 7.5%.8 Rheumatologic  manifestations that can be found in leprosy are polyarthritis or oligoarthritis, soft tissue rheumatism, noninflammatory arthritis, and also enthesitis.4-7 We report a patient presenting with polyarthritis as the primary manifestation of leprosy.
Effect of vitamin D supplementation on disease activity (SLEDAI) and fatigue in Systemic Lupus Erythematosus patients with hipovitamin D: An Open Clinical Trial Rifa’i, Achmad; Kalim, Handono; Kusworini, Kusworini; Wahono, Cesarius Singgih
Indonesian Journal of Rheumatology Vol 8, No 2 (2016)
Publisher : Indonesian Rheumatology Association

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Abstract

Background : Low level of vitamin D impact the disease activity and the degree of fatigue in SLE patients. This study aims to determine the effect of vitamin D supplementation on disease activity and fatigue condition in Systemic Lupus Erythematosus (SLE) patients with hipovitamin D.Methods: We performed an open clinical trial. Subjects were randomized into two different groups (supplementation or placebo) using simple random sampling. The treatment group got vitamin D3 softgel/ cholecalciferol 1200 IU/day or 30 mg/day, while the control group gotplacebo for 3 months. SLEDAI scores and FSS scores were calculated at pre and posttreatment.Results: There were 20 subjectsfor supplementation group and 19 subjects in the placebo group. From this study, before and after treatment, we found a significant difference of mean level of vitamin D in supplementation group (p=0.000), and no significant difference inpatients with placebo (p=0.427). Moreover, from the SLEDAI score analysis, observed a significant difference bothin the supplemented group (p=0.000) and the placebo group (p=0.006). FSS scores significantly different in the supplemented group (p=0.000). Incorrelation test,there was a negative correlation (r=-0763) between vitamin D level and disease activity (SLEDAI), and both showing stastistical significance between thepre supplementation (p=0.000) and post supplementation (r=-0846; p=0.000). Similarly to theFSS scores, there was a meaningfulnegative correlation (r=-0.931, p=0.000) between the level of vitamin D with FSS scores pre and post supplementation (r=-0.911; p= 0.000). Furthermore, there was a significant correlation between disease activity (SLEDAI) pre supplementation with fatigue condition pre supplementation (r=0.846; p = 0.000) and postsupplementation (r=0.913; p= 0.000).Conclusion: The supplementation of vitamin D 1200 IU per day in patients with SLE improve disease activity and degree of fatigue. Keywords: vitamin D, disease activity, fatigue, SLE
Proportion and Factors that Associate with Incidence of Hepatotoxicity in Rheumatoid Arthritis Patients Treated with Methotrexate in RSCM Year 2013−2015 Prathitasari, Rahma Anindya; Isbagio, Harry
Indonesian Journal of Rheumatology Vol 10, No 1 (2018)
Publisher : Indonesian Rheumatology Association

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Abstract

Background Rheumatoid arhtirtis (RA) is a chronic autoimmune disease that mainly attacks joints. It may causes joint deformities which leads to lower quality of life of RA patients. RA is treated with metothrexate (MTX) which inhibiting disease progression. MTX is known for its hepatotoxicity side effect, which is described by an elevation of aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) beyond the upper normal limit. Factors that may enhance hepatotoxicity are gender, age, cummulative dose of MTX, and duration therapy of MTX. Prevalence of hepatotoxicity caused by MTX therapy in RA patients in Indonesia is still unknown. The objective of this research is to know the proportion of hepatotoxicity and its associations with the factors that may enhance hepatotoxicity caused by MTX therapy in RA patients in RSCM.Method Data about gender, age, cummulative dose and duration therapy of MTX are obtained from 115 RA patients medical records.Result Proportion of hepatotoxicity in RA patients treated with MTX in RSCM is 42.60%. Gender, age, cummulative dose and duration therapy of MTX do not significantly enhance hepatotoxicity (p>0.05).Conclusion In conclusion gender, age, cummulative dose and duration therapy of MTX do not have association with hepatotoxicity in RA patients treated with MTX. Keywords: Rheumatoid Arthritis, Methotrexate, Hepatotoxicity
Systemic sclerosis in two generations family: a mother and offspring Nilasari, D; Hamijoyo, Laniyati; Kasjmir, Yoga I; Setiyohadi, Bambang
Indonesian Journal of Rheumatology Vol 1, No 1 (2009)
Publisher : Indonesian Rheumatology Association

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Abstract

Systemic sclerosis (SSc) is uncommon connective tissue disease characterized by a pathological thickening and tethering of the skin and involvement of internal organ (i.e gastrointestinal tract, heart, lungs, and kidneys). Systemic sclerosis seems to result from a multifactorial process (alteration of the immune system, genetic, and  environmental factors) but its pathogenesis remains unclear. A familial history of SSc represents an important risk factor for developing the disease.1 We describe two generations family who developed SSc.

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