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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 22 Documents
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Search results for , issue "Vol. 27 No. 1 (2020)" : 22 Documents clear
Analysis of Endocan Levels in Hypertensive Patients as Risk Factors of Chronic Kidney Disease Suryani Jamal; Uleng Bahrun; Ibrahim Abdul Samad; Fitriani Mangarengi; Hasyim Kasim; Ilham Jaya Patellongi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1571

Abstract

This study aimed to analyze endocan levels as a marker of endothelial dysfunction in the control group, patients with stage I hypertension, stage II hypertension, and patients with end-stage renal disease. Endocan levels were measured with ESM-1 (endocan) kit by Enzyme-Linked Immunosorbent Assay (ELISA) method. This study used a cross-sectional method and was conducted in Dr. Wahidin Sudirohusodo Hospital, Makassar and Hasanuddin University Hospital from September to October 2017. There were 83 samples in this study, consisting of 12 samples in the control group, 22 samples of stage I hypertension, 28 samples of stage II hypertension, and 21 samples of end-stage renal disease aged 20-90 years old. This study showed significantly higher endocan levels in patients with stage II hypertension and end-stage renal disease (p< 0.05). Endocan levels were significantly higher (p<0.05) in patients with end-stage renal disease compared with the control group and patients with stage I hypertension; but not significantly higher (p > 0.05) compared to patients with stage II hypertension. Also, the median of endocan levels in patients with the end-stage renal disease was higher (309,850 ng/L) compared to patients with stage II hypertension (273,050 ng/L).
Multiple Myeloma with Suspected Non-Secretory Type Annisa Ginar Indrarsi; Usi Sukorini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1575

Abstract

Multiple Myeloma (MM) is a hematological malignancy characterized by clonal plasma cell in bone marrow that produce abnormal globulin, which resulted in monoclonal gammopathy. Multiple Myeloma Non-Secretory (MMNS) is a very rare form of multiple myeloma with monoclonal plasmocytic proliferation in bone marrow supported by clinical manifestation and radiological findings. However, plasma cells fail to secrete immunoglobulin. A 44-year-old female came to Sardjito General Hospital with main complaints of weakness and back pain. General weakness and pale palpebral conjunctiva were 6 observed (+/+), liver and spleen were not palpable. Blood test results were as follows: Hb 3.0 g/dL, RBC 1.07 x 10 / μL, WBC 3 3 562 x 10 /μL, PLT 114 x 10 /μL, A/G ratio 1.07, BUN 51.5 mg/dL, creatinine 4.62 mg/dL, and calcium 3.1 mmol/L. Skeletal survey suggested a multiple osteolytic. Protein electrophoresis revealed hypogammaglobulinemia with no M-spike. There were 66% of plasma cells in bone marrow. Patient was diagnosed by MMNS. Diagnosis MMNS can be established if clonal plasmacytes is accompanied with renal insufficiency and hypercalcemia. However, monoclonal gammopathy was not found in serum protein electrophoresis. A case reported of 44-year-old female diagnosed as MMNS with 'punched out' multiple osteolytic, increased plasma cells in bone marrow without evidence of paraprotein in circulation proved by low A/G ratio and negative M-spike.
Clinical Gitelman Syndrome with Periodic Paralysis and Anemia Muhammad Saiful Rahman; Leonita Anniwati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1576

Abstract

Gitelman syndrome is a rare, autosomal recessive, renal tubular salt-wasting disorder characterized by hypokalemia and metabolic alkalosis combined with hypomagnesemia and hypocalciuria. A 13-year-old male patient came with acute flaccid paralysis, pain, and weakness in limb muscles. Laboratory results showed hypokalemia, hypocalcemia, hypomagnesemia, and metabolic alkalosis accompanied by anemia and elevated serum transaminases. An electrocardiogram test showed a prolonged QT wave. Physical examination showed blood pressure 118/68 mmHg; heart rate 95x/minute; respiration rate 26 2 x/minute; temperature 37.6⁰C, weight 80 kg, height 160 cm, and BMI 31.25 kg/M. Neurological examination weakness in the lower limb, negative pathological reflex. Hematology examination showed Hb 9.8 g/dL, MCV 82.3 fL, MCH 26.8 pg, MCHC 32.5 g/dl, WBC 16.87x10³/μL, platelets 320 x10 / μL, serum iron 47 mg/dL, TIBC 229 mg/dL, ferritin 38.45 ng/mL. Peripheral blood smear showed hypochromic microcytic anemia. Blood gas pH 7.47; pCO2 39 mmHg; pO2 44 mmHg; HCO3- 28.4 mmol/l; Beecf 4.7 mmol/l; SO2 83%; AaDO2 114; thus supporting metabolic alkalosis. Cortisol level was 11.39 ug/dL, ANA test result was positive at 17.2 IU/mL, the complement level was normal, dsDNA antigen was negative. Due to hypokalemia, hypocalcemia, hypomagnesemia, and metabolic alkalosis, this patient was diagnosed with Gitelman syndrome with anemia. The diagnosis should be confirmed by molecular DNA diagnostic studies to identify mutations of the gene encoding the thiazide-sensitive Na-Cl-cotransporter.
Analysis of Serum Uric Acid Level in Patients with and without Diabetic Nephropathy Erika Rosaria Simbolon; Suci Aprianti; Nurahmi Nurahmi; Liong Boy Kuniawan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1594

Abstract

Diabetic nephropathy is one of the microvascular complications in type 2 Diabetes Mellitus (DM). Diagnosis of diabetic nephropathy is based on any history of DM, a decrease in Glomerular Estimation Filtrate Rate (eGFR) using the CKD-Epi formula, and albuminuria. The role of serum uric acid level in diabetic nephropathy remains an ongoing debate. Serum uric acid levels may be the cause or the result of diabetic nephropathy. This study aimed to analyze serum uric acid levels in patients with and without diabetic nephropathy and determine its correlation with diabetic nephropathy. This study was performed at Dr. Wahidin Sudirohusodo Hospital, Makassar, by taking the data from the medical record of type 2 DM patients from January to April 2018. Fifty-nine patients with diabetic nephropathy and 150 patients without diabetic nephropathy participated in this study. An independent T-test and Pearson's correlation test were used for statistical analysis. There was a significant difference in uric acid level between patients with and without diabetic nephropathy (9.57±3.42 mg/dL vs. 6.41±2.86 mg/dL, p < 0.001). There was significant correlation between uric acid serum levels with urea (p < 0.001, r=0.585), creatinine (p<0.001, r=0.413) and eGFR (p < 0.001, r=-0.525) in patients with diabetic nephropathy. Uric acid levels in patients with diabetic nephropathy were higher than patients without diabetic nephropathy. Higher levels of urea and the serum creatinine led to higher levels of serum uric acid. Contrastingly, a lower eGFR rate led to higher levels of uric acid.
Diagnostic Performance of Serum (1,3) β-D Glucan to Detect Fungal Infection in Acute Leukemia Patients with Chemotherapy Dian Ariani Wirastuti; B. Rina A Sidharta; Yuwono Hadi Suparto; Leli Saptawati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1598

Abstract

Chemotherapy is a predisposing factor for infection in patients with malignancy, while culture, as the gold standard, limits the diagnosis of fungal infections. (1,3) β-D glucans, the most abundant polysaccharide component of the fungal wall, are increased in patients with Invasive Fungal Infections (IFI). This research was an analytical observational study with a cross-sectional approach involving 60 acute leukemia patients who received chemotherapy with suspicion of fungal infection at the General Hospital of Dr. Moewardi, Surakarta, from September to October 2019. Fungal blood cultures andserum (1,3) β-D glucan levels by the enzyme-linked immunoassay method were examined. Diagnostic tests were performed to determine sensitivity, specificity, Positive Predict Value (PPV), Negative Predict Value (NPV), Positive Likehood Ratio (PLR), Negative Likehood Ratio (NLR), and the serum's accuracy value (1,3) β-D glucan levels to fungal culture. Most (88.3%) of patients were diagnosed with Acute Lymphocytic Leukemia (ALL), maintenance chemotherapy phase (51.3%), risk factors for neutropenia (50%), and intravenous (IV) line use (56.7%). Serum (1,3) β-D glucan levels in patients with positive fungal cultures (4) in blood samples had a median of 482.87 (476.13-640.56) pg/mL, while patients with negative fungal cultures (56) had a mean±SD 298,68±114,39 pg/mL. Diagnostic test with a cut-off of 471,717 pg/mL showed sensitivity of 100.0%, specificity of 96.4%, NPV of 100%, PLR of 28.00, and NLR of 0.00 with an Area Under Curve (AUC) value of 0.982 and Coefficient Interval (CI) 95% (0.950-1.014). The measurement of serum (1,3) β-D glucan at a cut-off value of 471,717 pg/mL showed good performance as a biomarker for diagnosing and screening IFIs.  
Correlation between Serum Dehydroepiandrosterone Sulfate and LDL Cholesterol in Patients with Polycystic Ovarian Syndrome Hantoro Gunawan; Irvan Ipandi; Jusak Nugraha; Ashon Sa'adi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1600

Abstract

Polycystic Ovary Syndrome (PCOS) is the most prevalent endocrine disorder in female of childbearing age. PCOS patients also have metabolic and cardiovascular disorder risks. One of the factors that can affect those disorders is androgen hormone level. Dehydroepiandrosterone, is produced by the adrenal gland, and its metabolite dehydroepiandrosterone sulphate (DHEAS) has a different effect than testosterone. DHEA and DHEAS might have a protective effect to dyslipidemia and cardiovascular disorder. LDL cholesterol is an important parameter for dyslipidemia therapy guide according to The National Cholesterol Education Program Adult Treatment Panel. The aim of this study was to analyze the correlation between DHEAS and LDL cholesterol. This research was a cross sectional observational study. DHEAS and LDL cholesterol were examined in 25 research subjects by chemiluminescent immunoassay (Immulite®, Siemens) and colorimetric enzymatic (Dimension EXL®, Siemens). These subjects were divided into 3 groups according to 2003 Rotterdam's criteria. Spearman and Pearson's correlation statistical analysis were done, with a significance of p-value less than 0.05 This study showed a moderate negative correlation between DHEAS and LDL cholesterol (r= -0.441, p = 0.027). Group D PCOS (non-hyperandrogenic) had a strong negative correlation between DHEAS and LDL cholesterol (r=-0.717, p= 0.001). DHEA, in some literatures was shown to activate Peroxisome Proliferator Activated Response γ (PPAR γ) receptors and thereby increasing LDL-cholesterol receptors in adipose tissue and LDL-cholesterol uptake from serum. The rise in DHEAS might indicate a better prognosis for PCOS patients in terms of cardiovascular complications, especially in group D PCOS.
The Suitability of Compatibility Test Results with Gel Method between Diagnostic Grifols Gel Coombs and Diamed-Identification Tigor Pandapotan Sianturi; Betty Agustina Tambunan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1605

Abstract

A compatibility test as part of a pre-transfusion test is mandatory to ensure blood compatibility between patients and donors. Diamed-ID as the first gel-based product is commonly used as a reference for the compatibility test. The presence of new products such as DG Gel Coombs encourages research to compare them with reference methods. This study aimed to analyze the suitability of DG Gel Coombs to Diamed-ID in the compatibility test with the same sample. This cross-sectional analytic observational study was conducted during November 2017-February 2018 at the Blood Transfusion Unit Dr. Soetomo Hospital, Surabaya using blood samples (n=40), which met the inclusion and exclusion criteria. Simultaneous testing of the two products was according to the manufacturing requirements of each product (using different LISS reagents for red blood cell suspensions and centrifugation arrangements). The suitability of results was tested with Cohen's kappa and significant differences with McNemar. There was a minimum suitability of DG Gel Coombs to Diamed-ID for major compatibility tests, κ 0.307 (95% CI: -0.029-0.643), significance 0.007 (p < 0.05) and moderate for minor, κ 0,678 (95% CI: 0.454-0.903), significance <0.0001 (p < 0.05). McNemar's significance was 0.016 (p < 0.05) for major compatibility test and 0.031 (p < 0.05) for minor. Referring to Diamed-ID's results, false negatives were found on DG Gel Coombs for major compatibility tests (n=7) and minor (n=6). The suitability of results from DG Gel Coombs and Diamed-ID is not strong for compatibility testing.
IL-4 Level in Rifampicin-Sensitive and Rifampicin-Resistant Lung Tuberculosis Patients Joko Susanto; Jusak Nugraha; Soedarsono Soedarsono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1606

Abstract

Tuberculosis remains a global health burden. Mycobacterium tuberculosis infection causes humoral and cellular responses. Macrophages of patients with pulmonary tuberculosis evolve M1 polarization that blocks infection or immunosuppressive M2, promoting tissue repair mediated by IL-4, IL-10, and IL-13. Previous research showed a decrease of IL-4R and IL-10 expression in lung macrophages of anti-TB drug resistance. A molecular test can detect rifampicin- resistance. There has been no study, which showed the difference in serum IL-4 levels in rifampicin-sensitive and rifampicin-resistant tuberculosis patients. This study aimed to determine the difference between circulating IL-4 levels in rifampicin-sensitive and rifampicin-resistant pulmonary tuberculosis patients. This cross-sectional observational study consecutively recruited subjects based on positive molecular and acid-fast bacilli microscopic examination from MDR-TB Clinic of the Dr. Soetomo Hospital between December 2018 to March 2019. Subjects were classified into a rifampicin-sensitive and rifampicin-resistant group. On ELISA measurement, IL-4 data were analyzed with SPSS version 17. Mann-Whitney U test and ROC analysis tests were performed, and p < 0.05 was significant for α=0.05 (95% CI). There was significant difference between rifampicin-sensitive group (420±281 pg/mL) and rifampicin-resistant group (253±279 pg/mL) (p=0.014). Receiver operating characteristics analysis showed AUC 0.70, the sensitivity of 81.5%, the specificity of 63.6%, and the cut-off value of 235.6 pg/mL. There was a significantly higher level of circulating IL-4 in the rifampicin-sensitive group than the rifampicin-resistant group. IL-4 level in healthy subjects should be measured as the normal value in the population. Immunology and metabolic parameters should be performed to increase sample homogeneity. Further study was also needed to understand the IL-4 role in rifampicin resistance of lung tuberculosis patients in the Indonesia population.
The Thyroid Stimulating Hormone and Free Thyroxine Levels in Correlation with Serum Bilirubin in Neonatal Jaundice Elvira Dwijayanti; MI. Diah Pramudianti; Dian Ariningrum
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1607

Abstract

Congenital hypothyroidism is known to cause prolonged hyperbilirubinemia in neonates. It also correlates with delayed maturation of the activity of the uridine diphosphate glucoronosyltransferase (UDPG-T) enzyme. Thus, this study was performed to analyze the correlation of TSH and FT4 levels with serum bilirubin in neonatal jaundice. This observational analytical study with a cross-sectional approach was conducted on 64 neonatal patients with jaundice in Dr. Moewardi General Hospital, Surakarta during September-November 2019. The data comparison and correlation were analyzed with Mann-Whitney and the Spearman test. A p-value of < 0.05 was considered significant with 95% Confidence Interval (CI). The study variables comprised of total bilirubin of 12.7 (6.28-23.5) mg/dL, direct bilirubin of 0.8 (0.30-6.61) mg/dL, indirect bilirubin of 11.87 (3.16-22.94) mg/dL, TSH of 4.4 (0.40-0.06) uIU/L, and FT4 of 22.85±7.4 pmol/L. The TSH and FT4 were moderately correlated with total bilirubin r=-0.444; p=0.001 and r= -0.467; p=0.001), with indirect bilirubin (r= -0.3362; p=0.03 and r=-0.411; p=0.001) and with direct bilirubin (r= -0.257; p=0.040 and r=0.232; p=0.065), respectively. A moderate correlation of TSH and FT4 with total and indirect bilirubin, as well as a weak correlation between TSH and direct bilirubin were found, while no correlation was found between FT4 and with direct bilirubin. Thyroid function screening is recommended in neonates with jaundice, due to the importance of thyroid hormones in the function and formation of organs.                                       
Immature Platelet Fraction as A Potential Marker To Differentiate Types of Acute Coronary Syndrome Endah Indriastuti; Yetti Hernaningsih; Yulia Nadar Indrasari; Andrianto Andrianto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1609

Abstract

Acute Coronary Syndrome (ACS) includes ST-Elevation Myocardial Infarction (STEMI), non-ST Elevation Myocardial Infarction (NSTEMI), and Unstable Angina (UA). Platelet plays an essential role in ACS pathogenesis. Immature Platelet Fraction (IPF) and platelet indices can predict platelet activations. Platelet indices consist of platelet count, Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), plateletcrit (Pct). This study aimed to analyze the differences of IPF and platelet indices among ACS patients. This study was an observational analytical cross-sectional study conducted in Dr. Soetomo Hospital during May-September 2019. The subjects consisted of 30-STEMI, 25-NSTEMI, and 24-UA patients. The EDTA-samples were measured for platelet indices and IPF using Sysmex XN-1000. The differences between IPF and platelet indices among STEMI, NSTEMI, and UA patients were analyzed using Kruskal-Wallis and Mann-Whitney test. The IPF values were significantly higher in STEMI patients than NSTEMI and UA patients. The IPF values of NSTEMI patients were higher than UA patients. The MPV, PDW, and P-LCR were significantly higher in STEMI and NSTEMI compared to UA. The MPV, PDW, and P-LCR values of NSTEMI patients were significantly higher than UA patients. The significant differences between STEMI and NSTEMI toward UA might be caused by the more severe thrombotic conditions in myocardial infarction patients than UA. The IPF values were significantly different among each type of ACS patients gave an opportunity using this parameter to differentiate the ACS types. The MPV, PDW, and P-LCR were significantly higher in myocardial infarction patients than UA patients, which also allowed them to use those parameters to differentiate both conditions.

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