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INDONESIA
Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
Published by Perhimpunan Dokter Spesialis Patologi Klinik Indonesia
ISSN : 08544263     EISSN : 24774685     DOI : https://dx.doi.org/10.24293
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience
Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) is a journal published by “Association of Clinical Pathologist” professional association. This journal displays articles in the Clinical Pathology and Medical Laboratory scope. Clinical Pathology has a couple of subdivisions, namely: Clinical Chemistry, Hematology, Immunology and Serology, Microbiology and Infectious Disease, Hepatology, Cardiovascular, Endocrinology, Blood Transfusion, Nephrology, and Molecular Biology. Scientific articles of these topics, mainly emphasize on the laboratory examinations, pathophysiology, and pathogenesis in a disease.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 23 Documents
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Search results for , issue "Vol 26, No 2 (2020)" : 23 Documents clear
Gestational Trophoblastic Neoplasia with Hyperthyroidism Devi Rahmadhona; Betty Agustina Tambunan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1428

Abstract

Gestational Trophoblastic Neoplasia (GTN) is a malignant lesion arising from placental villous and extra-villoustrophoblastand occurs in 1:40,000 pregnancies. Invasive mole and choriocarcinoma are the vast majority of GTN whichproduce substantial amounts of Human Chorionic Gonadotropin (hCG). Hyperthyroidism in GTN is due to the stimulation ofthe thyroid gland by hCG which has a similar structure with Thyroid-Stimulating Hormone (TSH). A 28-year-old female,suspected with choriocarcinoma and anemia, had a history of recurrent vaginal bleeding for eight months, accompaniedwith loss of appetite, weight loss, palpitation, and tremor. Physical examination such as pulse rate of 114x/minutes, the0 respiration rate of 26x/minutes, temperature 38 C, conjunctival anemia, and dyspnea were reported. In addition, laboratoryfindings such as anemia, leukocytosis, hypoalbuminemia, hypokalemia, increase of LDH, increase of hCG >1,500,000mIU/mL, T4 levels of 14.1 ug/dL (4.40-10.90 ug/dL), FT4 levels of 1.95 ng/dL (0.89-1.76 ng/dL), and decrease of TSH were alsoreported. Abdominal CT Scan suggested uterine mass suspected as malignancy infiltrating to the rectum with metastaticfeatures in the liver, base of left lung, spleen and left kidney. Increased CA-125, and metastatic features of lung rightparacardial and left suprahilar from Chest X-ray were found. Diagnostic criteria for gestational trophoblastic neoplasia are asfollows: increased hCG 4 x tests; increased hCG three weekly tests; histology diagnosis of choriocarcinoma; increased hCG> 20,000 more than four weeks post evacuation and the presence of metastasis. Hyperthyroidism in GTN is potentiallylife-threatening because of heart failure and thyroid storm. Hyperthyroidism increases morbidity and mortality in GTNpatient; therefore, periodic thyroid tests is essential to prevent further complication of hyperthyroidism.
Profile of Rapid Molecular Test of Tuberculosis Using Xpert MTB/RIF Faigah Aprilia Sy Faraid; Irda Handayani; Tenri Esa
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1425

Abstract

Tuberculosis (TB) ranked the 10th highest cause of death in the world in 2016 according to the World Health Organization (WHO). To date, TB remains a top priority and is one of the goals in Sustainability Development Goals (SDGs), suggesting an urgent need of rapid detection methods for proper diagnosis and treatment. Rapid molecular test using Xpert MTB/RIF is one of the detection methods for TB diagnosis and it is expected to be able to early detect TB cases and anti-tuberculosis drug resistance. The purpose of this study was to determine the profile of rapid molecular test of tuberculosis using Xpert MTB/RIF device in the period of September 2017-August 2018 at Dr. Wahidin Sudirohusodo Hospital, Makassar. This study was retrospective research with a cross-sectional method using secondary data of rapid molecular test of Xpert MTB/RIF in the period of September 2017-August 2018. Data were statistically analyzed using SPSS version 22 and Chi-Square test with a significance value of 0.05. From 527 sputum samples, 96.8% adult TB was predominantly found. The "MTB not detected", “MTB detected”, and “MTB detected with Rif resistance” result was predominantly found in the 74.6% TB non-HIV group; 42.4% TB-HIV group, and 3.8% Non-HIV TB group. There were remarkably higher number of “MTB not detected” results of rapid molecular tests using Xpert MTB/RIF device in the group of pediatric and adult TB. The proportion of "MTB not detected" was higher in the TB-Non-HIV group; while the "MTB detected, Rif-sensitive" was higher in the TB-HIV group and the "MTB detected, Rif-resistance" was higher in the TB-Non-HIV group. It was recommended to carry out further research by performing diagnostic tests consisting of Acid-Fast Bacilli, rapid molecular test with Xpert MTB/RIF, and MTB culture.
Infection of Cytomegalovirus in Cholestasis Infant with Biliary Atresia Lasmauli Situmorang; Bagus Setyoboedi; Sjamsul Arief; Gondo Mastutik
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1496

Abstract

Biliary Atresia (BA) is extrahepatic cholestasis that results in death within the first two years if the diagnosis andintervention are delayed. The etiology and pathogenesis of BA are still undetermined. Viral infections, includingCytomegalovirus (CMV), are presumed to be one of the causes. Cytomegalovirus infection is more common in intrahepaticthan extrahepatic cholestasis such as BA. There are limited data about Cytomegalovirus infection in cholestatic infants withBA. This study compared the incidence of CMV infection in cholestatic infants with biliary atresia and non-biliary atresia.A cross-sectional study was performed in December 2017 - August 2018 in cholestatic infants aged 1-6 months. Liverbiopsy, histopathological examination followed by PCR CMV examination were performed on cholestatic infants. Theresults of the PCR examination were compared between BA and non-BA infants. Statistical analysis of Chi-Square, t-testindependent and Mann-Whitney U resulting in p<0.05 were stated as significant. Thirty-seven children were obtainedduring the study period, consisting of sixteen children with BA and twenty-one children with non-BA. Biliary atresia waspredominantly found in female than male children, despite no differences were found between the groups (p=0.163). Therewere differences in body weight (p=0.002) age (p=0.009), birth weight (p=0.02) and gestational age (p=0.03) betweenchildren with BA and non-BA. There was no significant difference in the incidence of CMV infection in cholestatic infants withBA and non-BA (p=0.338). Cytomegalovirus infection in cholestatic infants with BA was less than non-BA cholestatic infants.
Diagnostic Value of Encode TB IgG and IgM Rapid Test to Support Pulmonary Tuberculosis Diagnosis Notrisia Rachmayanti; Aryati Aryati; Tutik Kusmiati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1524

Abstract

Diagnosis of tuberculosis can be established through the detection of antigens by Acid Fast Bacilli (AFB), microscopy,culture, and Polymerase Chain Reaction (PCR). The World Health Organization (WHO) 2012 issued a recommendation not touse antibody detection in the diagnosis of tuberculosis. However, there is high demand from clinicians to detectanti-tuberculosis antibody in patients who are challenging to do a bacteriological examination. The purpose of this researchwas to determine the diagnostic value of anti-M.tuberculosis IgG and IgM Encode TB to support lung tuberculosis diagnosis.This study was a cross-sectional by using consecutively sampling, which was performed in the Dr. Soetomo Hospital,Surabaya, Indonesia, from November 2017 until May 2018. A total of 52 patients were included and evaluated for clinical orbacteriological examination using AFB microscopy or PCR (Gene Xpert) as the gold standard and tested theanti-M.tuberculosis IgG and IgM with immunochromatography. Encode Tuberculosis (TB) IgG was positive in 12 patientsfrom the tuberculosis group and one false-positive in the non-tuberculosis group. The diagnostic sensitivity, specificity,positive predictive value, negative predictive value, and accuracy of Encode TB IgG dan IgM were 35%, 94%, 92%, 43% and55.7%, respectively. The specificity was high that the positive result was considered as TB; the sensitivity was low that thenegative results were not excluded from TB. Encode TB IgG/IgM rapid test was not recommended to use as a singlediagnostic test and must be combined with other diagnostic tests to increase the sensitivity.
Diagnostic Value of Plasmotec Malaria-3 Antigen Detection on Gold Standard Microscopy Trieva Verawaty Butarbutar; Puspa Wardhani; Aryati Aryati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1529

Abstract

Plasmotec Malaria-3 is a rapid malaria diagnostic test that uses four-line tests and targets three malaria proteins,namely Plasmodium falciparum specific protein (HRP-2), Plasmodium vivax-specific LDH (Pv-LDH) and non-specificPlasmodium LDH (pLDH). Microscopy as a gold standard has many disadvantages and the availability of malaria RapidDiagnostic Tests (RDTs) in detecting three proteins is still very limited. This study aimed to determine the diagnostic value of® ® Plasmotec Malaria-3 against gold standard microscopy, comparing the Plasmotec Malaria-3 and microscopy antigen® species detection, determining the Parasitemia Index (PI) cut-off using Plasmotec Malaria-3. This study was across-sectional study with 105 whole blood samples obtained from the Merauke Papua General Hospital which fulfilled theinclusion and exclusion criteria. Samples were examined by thick and thin drops and then examined with Plasmotec®® Malaria-3. Diagnostic values of Plasmotec Malaria-3 against the microscopy were Sn 100%, Sp 98.04%, PPV 98.18%, NPV® 100%, LR + 51, LR-0, diagnostic accuracy of 99.05%. Comparison of Plasmodium species between Plasmotec Malaria-3 and® microscopy was not significantly different, p-value = 0.172. The cut-off of PI in P.falciparum and P.vivax in PlasmotecMalaria-3 based on the Receiver Operating Characteristic (ROC) curve could not be determined with AUC=0.577,p-value=0.385 and AUC=0.423, p-value=0.385, respectively. This study concluded that the comparison of Plasmodium® species between Plasmotec Malaria-3, and microscopy was not significantly different. This study suggested that further® research is needed to find the diagnostic value of non-falciparum and non-vivax Plasmodium against Plasmotec Malaria-3.
Analysis of Liver Fibrosis Degree with APRI Score and FIB-4 Index on Patients with Non-Alcoholic Fatty Liver Disease Gillian Elvira Seipalla; Nurahmi Nurahmi; Ibrahim Abd Samad
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1414

Abstract

Liver fibrosis is the accumulation of Extracellular Matrix Protein (EMP) scar tissue after acute or chronic liver injury. Liverbiopsy is the gold standard test for evaluating liver fibrosis in patients with Non-Alcoholic Fatty Liver Disease (NAFLD). Thisdiagnostic method is invasive, painful, and complicated in rare cases; thus the noninvasive methods such as laboratory testsand radiology had been proposed to assess liver fibrosis in NAFLD and are expected to overcome the limitations of liverbiopsy. This method consists of aspartate Aminotransferase to the Platelet Ratio Index (APRI) and fibrosis-4 (FIB-4).Thisresearch was retrospective cross-sectional performed at Dr. Wahidin Sudirohusodo Hospital Makassar involving 63 subjectsfrom January to June 2018. The correlated variables were presented in categorical and numerical data and the Pearsoncorrelation test was used to determine the compatibility of APRI score and FIB-4 index with Fibroscan result in patientswith NAFLD. A highly significant positive correlation (p <0.001) was found between APRI score and Fibroscan (correlationvalue = 45.8%), APRI score and FIB-4 index (correlation value = 91.8%), FIB-4 index and Fibroscan (correlationvalue = 47.6%). The score of Aminotransferase to platelet ratio index score and FIB-4 index could be an alternative methodinstead of a liver biopsy to predict the degree of fibrosis in patients with NAFLD.
Evaluation of the Progressivity Parameters of Chronic Kidney Disease after Branched-Chain Amino Acid Supplementation in Children Esthy Poespitaningtyas; Roedi Irawan; Ninik Asmaningsih Soemyarso; Jusak Nugraha
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1467

Abstract

Chronic Kidney Disease (CKD) is not an uncommon issuein children. Chronic kidney disease is the abnormality ofstructure or function of the kidney that occurs for more than three months. The presence of a longitudinal decline inGlomerulus Filtration Rate (GFR), proteinuria, and hypertension Are the characteristics of CKD. One of the recommendationsof nutritional supplementation as the prevention of CKD is by the administration of oral Branched-Chain Amino Acid (BCAA).To date, there has been no research to analyze the effects of the BCAA on children with stage 2-4CKD. This study aimed toanalyze the effect of BCAA in inhibiting the progressivity of stage 2-4 CKD in children and improving nutritional status.Astudy with randomized pre-post test controlled trial design was performed in the Outpatient Clinic of Pediatric Nephrologyin Dr. Soetomo Hospital with stage 2-4CKD. The subjects were divided into two groups, such as the BCAA and placebo, andwere monitored for eight weeks to be evaluated the GFR, albumin, proteinuria, blood pressure, and nutritional status.Sixteen children with stage 2-4 CKD dominated by 71.4% of male patients were enrolled in this study. The mean age was 12.5(SD 2.90) years. Approximately 50% (p=0.767) stage 2 chronic kidney, 50% (p=1.000) moderate malnutrition, and 64.28%(p=1.000) short stature were found, with nephrotic syndrome as the most common underlying cause of CKD (p=0.149). InBCAA group, decrease of GFR -5.08±7.13 (p=0.055), increase of serum albumin 0.20±0.23 (p=0.062), decrease of deltasystole -11.57±15.08 (p=0.565) and diastole -4.85±16.25 (p=0.708), weight loss -0.07±1.01 (p=0.828), an increase of height0.14±0.24 (p=0.771), and a decrease in BMI -0.03±0.74 (p=0.389) were reported. It was concluded that branched-chainamino acid (leucine, isoleucine, and valine) supplementation did not provide a significant effect to inhibit progressivity ofstage 2-4CKD in children and improvement of nutritional status.
Differences of Bone Marrow Features and BCR-ABL Variants in Chronic Granulocytic Leukemia Post Tyrosine Kinase Inhibitor Therapy Wivina Riza Devi; M Darwin Prenggono; Purwanto AP; Imam B
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1457

Abstract

Chronic Granulocytic Leukemia (CGL) occurs due to chromosomal translocation (9;22) known as Philadelphiachromosome. p210 BCR-ABL1 oncogenes are classified into b2a2 and b3a2 transcripts which possibly lead to differentclinical manifestations and response to therapy. This study was aimed to prove that there is a difference in bone marrowfeatures and BCR-ABL between remissive and resistant CGL after Tyrosine Kinase Inhibitor (TKI) therapy. This research wasan observational study with a cross-sectional design carried out at Ulin Hospital Banjarmasin on 32 subjects. BCR ABL wasdetected by using PCR and bone marrow features were assessed by using bone marrow aspiration technique. The differencebetween bone marrow features and BCR-ABL variants was analyzed by using the T-test (p < 0.005) and Chi-Square(p < 0.005), respectively. There was a difference of BCR-ABL variants with p=0.091 and characterized by M:E ratio (p=0.124),myeloblast count (p=0.063), and eosinophil count (p=0.055). Also, there was a difference of bone marrow cellularity(p=0.000) and basophil count (p=0.016) between remissive CGL and resistant CGL patients. There was no difference in BCRABL variants, myeloblast count and eosinophil count between remissive CGL and resistant CGL patients. However, there wasdifferent of bone marrow cellularity and basophil count between remissive CGL and resistant CGL patients.
Analysis of Hematologic Parameters and Serum Bilirubin Levels in Complicated and Uncomplicated Acute Appendicitis Patients Rini Rahman; Ani Kartini; Yuyun Widaningsih; Agus Alim Abdullah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1536

Abstract

  Acute appendicitis is inflammation of the vermiformis appendix due to lumen obstruction followed by bacterial infection. Acute appendicitis is classified into two types of disease, namely complicated and uncomplicated. Acute inflammation of the appendix requires immediate surgical action to prevent complications; therefore, a further laboratory test is required. This study was retrospective research which analyzed several hematologic parameters (WBC, Neutrophils, NLR, RDW, PLTMPV, PDW) and serum bilirubin levels. Data were statistically analyzed using Independent-t and Mann-Whitney test. Univariate logistic regression test was used to evaluate the correlation of hematologic parameters and significant serum bilirubin levels with the diagnosis of complicated and uncomplicated appendicitis. The cut-off value and diagnosis value were measured using Receiver Operating Characteristic (ROC) curve analysis. This study involved 173 subjects categorized into 67 complicated and 106 uncomplicated acute appendicitis patients. Whole blood count and neutrophil counts were significantly higher in complicated acute appendicitis (p <0.05). Similarly, NLR and PLT were significantly higher in complicated acute appendicitis (p <0.001), p > 0.05 was obtained in RDW-CV, MPV and PDW values. The higher serum bilirubin levels were reported in patients with complicated acute appendicitis compared to uncomplicated acute appendicitis (p <0.001). Logistic regression test results showed significant PLT parameters with p <0.001, while there was no significance of hematologic parameters such as WBC, neutrophil, NLR, RDW-CV, MPV, PDW and bilirubin levels. Area under curve results on the ROC curve showed 74.4% PLT with sensitivity and specificity of 97.17% and 40.29%, respectively. From the analysis of hematologic parameters and measurement of serum bilirubin levels, only the PLT parameter can be used as one of the parameters for the diagnosis of complicated appendicitis with high sensitivity but low specificity. It was recommended to perform prospective studies with more subjects.
Comparison of the Profile and TSH Levels from Several Types of Blood Collection Tubes Putra, Gunawan Eka; Sukartini, Ninik; Immanuel, Suzanna; Henrika, Fify; Indrasari, Nuri Dyah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1475

Abstract

Thyroid-Stimulating Hormone (TSH) is an important parameter in diagnosing thyroid disease which uses serumaccording to the World Health Organization's (WHO) recommendations. The use of plasma can help improve the TurnAround Time (TAT); however, the discrepancy with serum is unknown. A cross-sectional study using 89 blood samples wasperformed to compare TSH levels using serum tubes with clot activator (Tube I), plasma tubes with heparin (Tube II), andplasma tubes with heparin-gel separator (Tube III); and to overview of TSH levels according to gender and age. The medianof TSH levels in Tubes I, II, and III were 1.380 (0.032-7.420) μIU/mL, 1.380 (0.030-7.480) μIU/mL, and 1.360 (0.030-7.460)μIU/mL, respectively. There were no statistically significant differences in TSH levels of the three tubes. The median TSHlevels differences of Tubes II and III compared to the tube I were -0.9% (-7.2-2.2) and -1.7% (-8.0-1.6), respectively.Measurement bias observed in this study was following the specified desirable bias according to Ricos. The median TSHlevels of the male and female groups were 1.500 (0.032-4.250) μIU/mL and 1.345 (0.058-7.420) μIU/mL, respectively. MedianTSH levels of 31-40 years old age group and >61 years old age group were 1.190 (0.609-3.240) μIU/mL and 1.730 (0.088-5.760) μIU/mL, respectively. Specimens from three tubes could be used to examine TSH levels. Measurement of TSH levelsshowed a higher median in the male and older group.

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