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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 18 Documents
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Search results for , issue "Vol. 25 No. 2 (2019)" : 18 Documents clear
DIFFERENTIATION T LYMPHOCYTE CELLS EXPRESSING INTERLEUKIN-17 PERCENTAGE ON HEALTHY PERSON AND ADULT ACUTE MYELOID LEUKEMIA PATIENT Elvan Dwi Widyadi; Yetti Hernaningsih; Endang Retnowati; Ugroseno Ugroseno; Ryzky Widi Atmaja
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 25 No. 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1383

Abstract

Acute Mieloid Leukemia (AML) is a hematologic cause of cancer deaths of 1.2% including a relatively rare disease but by the end of the decade there is an increase in the number of new cases. The immune system in AML is caused by gene mutations giving immunosuppressive effects so that the immune system will be inhibited in eliminating leukemia cells. The immune response of tumors is important to determine the prognosis, development of new cancer immunotherapy as well. One of the subset of lymphocytes T is  gdT lymphocyte cell with innate nature, but until now no information is required about gdT cell profile in AML patients. gdT cells have properties as antitumors played by Interferon production g (INF g), and the nature of protumor by interleukin 17 (IL-17). The percentage of lymphocyte T (CD3 +) of AML patients and healthy people did not differ (p = 0.528), indicating, not being activated for proliferation. gdT Lymphocyte cells percentage in healthy people by race, genetic and exposure to the surrounding environment such as infection. Percentage of gdT lymphocyte of AML patients and healthy people was not different from (p = 0.694), showed an immune response by gdT cells Unefected to proliferate. The percentage of gdT llimfocytes expressing the interleukin 17 (gdT17 cells)in patients AML and healthy people did not differ significantly (p = 0.436), this indicates inhibited proliferation.
ANALYSIS OF MEAN PLATELET VOLUME, PLATELET DISTRIBUTION WIDTH, AND PLATELET COUNT IN HEMORRHAGIC AND NON-HEMORRHAGIC STROKE Gita Medita Sunusi; Darwati Muhadi; Mansyur Arif
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 25 No. 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1392

Abstract

Stroke is a sudden and acute focal or global cerebral functional disorder lasting more than 24 hours due to cerebral blood flow impairment. Platelets play an essential role in the pathophysiology of non-hemorrhagic stroke by causing thrombus formation in blood vessels after erosion or rupture of atherosclerotic plaques. Mean platelet volume, PDW and platelet counts are hematological parameters that can be measured on routine blood tests that can describe platelet function and activity and are standard tests carried out in hospitals. The aim of this study was to analyze the differences in MPV, PDW and platelet count between non-hemorrhagic strokes and hemorrhagic strokes. This was a retrospective cross-sectional study conducted in the Dr. Wahidin Sudirohusodo General Hospital of Makassar. A total of 375 Non-Hemorrhagic Stroke (NHS) and 221 Hemorrhagic Stroke (HS) patients were included in this study. Mean platelet volume, PDW and platelet counts were obtained from complete blood count at the time of admission. There was a significant difference in platelet count between NHS and HS patients (p=0.01). Nevertheless, there were no significant differences between MPV and PDW between NHS and HS patients (p=0.19 and p=0.54, respectively). The results of this study indicated that there were significant differences in platelet counts in HS and NHS with increased platelet counts being a risk factor for NHS and a decrease in platelet counts as a risk factor for HS. However, there were no significant differences in the values of MPV and PDW in NHS and HS patients. It is recommended  to study using a better sample selection method so that it can eliminate the occurrence of bias with other diseases, which can also cause a decrease and increase in MPV values, PDW and platelet counts.       
CORRELATION OF TOTAL LYMPHOCYTE COUNT WITH CD4 COUNT IN HIV/TB COINFECTED PATIENTS Herniaty Rampo; Uleng Bahrun; Mansyur Arif
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 25 No. 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1393

Abstract

HIV-TB co-infection is a global challenge in the healthcare world. HIV infection causes CD4  to decrease which has a role in TB immunity. CD4 as a marker for HIV progression have expensive cost and not available in all healthcare facilities, so WHO recommended TLC as a substitute for CD4. This study aims to determine the correlation of TLC and CD4 in HIV-TB co-infection patients.This was a retrospective study using medical records of hospitalized patients with HIV-TB co-infection in Dr.Wahidin Sudirohusodo Hospital. The correlation was analyzed by Spearman test. CD4 data were divided into two groups: CD4 < 200 cells/mm3 and CD4 ≥ 200 cells/mm3 and Mann-Whitney test was performed. Data were also analyzed by ROC curve.In total 172 data with diagnosis of HIV-TB co-infection, Spearman test showed a positive correlation between TLC and CD4  with moderate correlation strength (p <0.001 and r = 0.56). Mann-Whitney test showed  a significant difference between CD4 < 200 cells/mm3 and CD4 ≥ 200 cells/mm3 (p < 0.001). ROC curve analysis showed that TLC has a good accuracy value for predicting CD4 in CD4 < 200 cells/mm3 (AUC = 0.911). Sensitivity  88.9% with specificity 84.7% was found in TLC 1154.9 cells/mm3 which predicted CD4  < 200 cells/mm3.There was a positive correlation between TLC and CD4 with moderate correlation strength. TLC can predict CD4 in CD4 <200 cells/mm3. We suggest further studies on patients who receive drug therapy.
CHRONIC MYELOGENEOUS LEUKEMIA TRANSFORMATION INTO ACUTE LYMPHOBLASTIC LEUKEMIA Endah Indriastuti; Arifoel Hajat
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 25 No. 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1395

Abstract

Chronic Myelogenous Leukemia (CML) is a myeloproliferative neoplasm that can progress into various conditions. Transformation of CML into Acute Lymphoblastic Leukemia (ALL) is rare. A 22-year-old male with a history of CML since 2014 and positive BCR-ABL p210 in 2017 came with the complaint of weakness. Physical examination showed hepatosplenomegaly. Complete Blood Count (CBC) showed Hb 7.1 g/dL, WBC 290,620 /uL, platelet 434,000 /uL.Blood Smear Evaluation (BSE) suggested CML blastic crisis with DD of AML-M5. Patient’s condition got worse and the CBC result showed WBC 96,770/uL and platelet 7,000/uL in 2 weeks. Blood smear evaluation was dominated by mononuclear cells with scanty blue cytoplasm, no granules, no Auer rods, loose chromatin, and indistinct nucleoli, suggesting lymphoblasts with a proportion of 60%. The BMA result was dominated by lymphoblast, consistent with ALL. The immunophenotyping result was CD10+, CD34+(0.99%), CD79a+, HLA-DR+, and CD20+. Molecular examination showed positive RUNX1 and NRAS while FLT3, NPM1 and del(5q) was negative.  BCR-ABL gene can be found both in CML and ALL. CML transformation into ALL had been reported to be related with deletion of a transcription gene. Diagnosis of ALL can be established by BMA and immunophenotyping. CD34+ expression of lymphoblast in ALL can be varied and found to be minimal in this case. Patient with history of CML showed an ALL picture based on BSE, BMA, and immunophenotyping suggesting CML transformation into ALL although CD34+ expression was minimal.    
RAPID PROGRESSION OF CLAVICULAR SOLITARY PLASMACYTOMA TO MULTIPLE MYELOMA Hantoro Gunawan; Paulus Budiono Notopuro
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 25 No. 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1398

Abstract

Solitary plasmacytoma is a monoclonal plasma cell malignancy restricted to one tumor. Fifty percent of cases can progress to Multiple Myeloma (MM). The median time to progression is 19 months. A case about plasmacytoma advancing rapidly to MM within two months from the initial diagnosis is described. A 45-year-old male attended the Surgery Outpatient Clinic with a chief complaint of progressive swelling on the left neck for two months. Physical examination revealed a fixed, solid, 8x8 cm mass on the left supraclavicular. Fine Needle Aspiration Biopsy (FNAB) showed plasmacytoma. Surgical biopsy and immunohistochemistry confirmed the diagnosis of plasmacytoma. Ki67 index was 80%. There was no abnormality in the laboratory examination. Two months later he was admitted to the Internal Ward with anemia and kidney disorder. Serum protein electrophoresis revealed an M-spike. Bone Marrow Aspiration (BMA) showed plasma cell proliferation of 78%, which confirmed the diagnosis of MM. Solitary plasmacytoma can occur on any bone, mostly on axial bones. Solitary plasmacytoma on the clavicle is very rare, with a prevalence of 0.45% of all primary bone tumors. Diagnosis of solitary plasmacytoma relies on tissue biopsy, laboratory, radiology and bone marrow aspiration. Progression of plasmacytoma to MM can be detected from CBC and clinical chemistry results. Serum protein electrophoresis and bone marrow aspiration results confirmed the diagnosis of MM. The high proliferation index (Ki67>8%) and tumor size (>5cm) were the risk factors for the rapid progression of plasmacytoma. Early detection of systemic symptoms is critical in the management of solitary plasmacytoma.  
DIAGNOSTIC VALUE OF NEUTROPHIL-LYMPHOCYTE RATIO TO DIFFERENTIATE ISCHEMIC AND HEMORRHAGIC STROKE Martina Rentauli; Liong Boy Kurniawan; Darwati Muhadi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 25 No. 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1446

Abstract

Stroke is a neurologic emergency disease and the main cause of high mortality. The inflammatory process in stroke due to cell and tissue damage causes an increase of leucocyte prominently neutrophil. Neutrophil Lymphocyte Ratio (NLR) is an easy-to-measure inflammatory marker. There is only a few data of NLR in Indonesia. This study aimed to know the difference in NLR values among ischemic and hemorrhagic stroke and to find out the diagnostic NLR to differentiate ischemic and hemorrhagic stroke patients. This study was a retrospective cross-sectional study using secondary data from Medical Record of Wahidin Sudirohusodo Hospital, Makassar. Leucocyte, neutrophil, and lymphocyte first data from adult stroke diagnosed patients were taken. Data statistically analyzed and diagnostic value of  NLR was determined by Receiver Operating Curve (ROC) analysis. Total of 402 patients was enrolled, 214 (54.72%) with ischemic stroke and 182 (46.8) with hemorrhagic stroke. There was a significant NLR difference between ischemic stroke (median 7.23) and hemorrhagic stroke (median 3.65) (p<0.001). Using cut-off 5.18, ROC curve showed of (AUC) 0.730 which had a weak performance to differentiate ischemic and hemorrhagic stroke with sensitivity 67.8% and specificity 68.6%. The neutrophil-lymphocyte ratio in hemorrhagic stroke is higher than ischemic stroke. Further studies with larger and more evenly distributed samples and consideration of sampling time are a suggestion.
THE CORRELATION OF ANEMIA AND HEPCIDIN SERUM LEVELS IN REGULAR HEMODIALYSIS PATIENTS WITH CHRONIC HEPATITIS C IN HAJI ADAM MALIK HOSPITAL MEDAN Wingsar Indrawanto; Adi Koesoema Aman; Alwi Thamrin
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 25 No. 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1464

Abstract

End-Stage Renal Disease (ESRD) patients who undergo hemodialysis therapy are high-risk populations infected by the hepatitis C virus. Some studies have reported that hepcidin levels were decreased in patients with chronic hepatitis C. Hepcidin serum concentrations were also reported to increase in patients with renal failure in the line with increased severity of renal failure, which can cause the accumulation of hepcidin culminating in anemia due to iron deficiency. This study was to analyze the correlation of anemia and hepcidin serum levels in ESRD patients who underwent regular hemodialysis with chronic hepatitis C. This was an analytical observational study with cross-sectional design, conducted on 24 ESRD patients with chronic hepatitis C and 24 patients with ESRD without hepatitis who were undergoing regular hemodialysis therapy in the Adam Malik Hospital, Medan during July – September 2016. All study subjects were examined for full blood count and hepcidin serum levels. The result of the iron status was recorded from the patient’s medical record. In this study, the mean hemoglobin was 8.15±1.44 g/dL, mean hematocrit 25.42±4.53%, median hepcidin levels 29.75 (4.92-359.49) in the ESRD patients with chronic hepatitis C and mean hemoglobin 8.21±1.50 g/dL, mean hematocrit 25.25±4.37%, median hepcidin levels 30.33 (11.65-141.53) in the ESRD patients without hepatitis. The Spearman’s rho test showed a positive correlation that was significant between hepcidin and hemoglobin (r = 0.439, p=0.032), hepcidin and hematocrit (r = 0.021; p=0.024) in ESRD patients with chronic hepatitis C. This study showed a positive correlation between anemia and hepcidin serum levels in ESRD patients with chronic hepatitis C who underwent regular hemodialysis.
DIFFERENCE IN HbA1c LEVEL BETWEEN BORONATE AFFINITY AND ION EXCHANGE-HIGH PERFORMANCE LIQUID CHROMATOGRAPHY METHOD IN DIABETIC PATIENT Tuti Asryani; Ellyza Nasrul; Rikarni Rikarni; Tutty Prihandani
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 25 No. 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1466

Abstract

Glycated Hb (HbA1c) test is needed to control glycemic in high prevalence type 2 Diabetes Mellitus (DM) patients. Hemoglobin fraction separated and chemical reaction is two main concepts in the HbA1c test. Ion exchange-high performance liquid chromatography (HPLC) and boronate affinity use the first concept. Ion exchange-HPLC is a reference method in most of the clinical laboratory. Point of care testing (POCT) with boronate affinity method that has been standardized by the international institution is available. This study aimed to compare the boronate affinity POCT method and ion exchange-HPLC method. This cross-sectional study was conducted to 22 types 2 DM patients those fulfilled inclusion and exclusion criteria in January 2017 to February 2018. Level of HbA1c was assayed with boronate affinity POCT and ion exchange-HPLC method. A t-test was used to analyze data and no significant difference if p>0.005. Subjects of this study are females (59.1%) more than males (40.9%) with age mean 59.23 years old (8.1). Uncontrolled type 2 DM (77.3%) more than controlled type 2 DM (22.7%).Mean of HbA1 level was 8.0% (1.7) in boronate affinity POCT and 8.3% (1.8) in ion exchange-HPLC. T-test showed no significant difference between those two HbA1C assay methods (p>0.005). There was no difference HbA1c level between boronate affinity POCT method and ion exchange-HPLC method.

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