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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 21 Documents
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Search results for , issue "Vol. 27 No. 3 (2021)" : 21 Documents clear
Correlation between Serum hs-CRP and Magnesium Ion with Osteocalcin in Acute Leukemia Patients Nuniek Luthy Naftali; MI. Diah Pramudianti; Yuwono Hadisuparto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1700

Abstract

Acute leukemia is a proliferation of immature cells in the bone marrow that affects peripheral blood or other organs. Inflammation has a vital role in cancer pathophysiology. Inflammation in leukemia occurs through two mechanisms: intrinsic and extrinsic. Magnesium deficiency leads to inflammation in acute leukemia patients. Manifestation of inflammation in acute leukemia are abnormalities in musculoskeletal systems such as osteopenia, osteoporosis, osteonecrosis, and pathological fractures. Increased inflammation in the bone remodeling process increases osteoclast (OC) regulation and decreases osteoblast (OB) activity resulting in reduced osteocalcin (OCN) production. Osteocalcin, also known as gamma-carboxy glutamic acid-containing protein or bone Gla-protein, is a small, non-collagen protein associated with the bone matrix. Osteocalcin is known as bone formation. This study aimed to analyze the correlation between hs-CRP, ion Mg and serum OCN levels in acute leukemia. A cross-sectional observational analytic study in acute leukemia subjects was conducted at Clinical Pathology Installation of Dr. Moewardi Hospital. Surakarta from August to September 2020. Normality test of Shapiro-Wilk was used to determine data distribution, Pearson correlation test was used to analyze the correlation strength between variables. From a total of 35 subjects, there was a significant negative correlation between hs-CRP and serum OCN in acute leukemia (r= -0.46; p=0.06), but no correlation was found between Mg ion and serum OCN in acute leukemia patients (r=0.09; p=0.957). The mean of hs-CRP, Mg ion, and OCN was 2.95±4.95 mg/dL, 0.49±0.05 mmol/L, and 16.32±19.46 ng/mL, respectively. Advanced research with chronic leukemia population and other variants as needed.
The Association of CD4, CD8, and CD4/CD8 Ratio with Thyroid Dysfunction in HIV/AIDS Sri Mulyani; MI. Diah Pramudianti; Dian Ariningrum
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1701

Abstract

Incidence of thyroid dysfunction increases in HIV/AIDS patients. It can be a hypothyroid or hyperthyroid, with subclinical hypothyroid predomination. Thyroid dysfunction is associated with the progression of HIV and low CD4 counts. There has been controversy over how HIV affects thyroid function. Opportunistic infections and HBV/HCV co-infections might increase the probability of thyroid dysfunction. Medication of HIV is also an important factor of thyroid dysfunction. Research shows that the use of ART increases the probability of thyroid dysfunction. This study aimed to analyze the association between CD4 counts, CD8, CD4/CD8 ratio, and HIV RNA viral load with thyroid dysfunction in HIV/AIDS patients. An observational study with a cross-sectional design was conducted from August to September 2020 in Dr. Moewardi Hospital, Surakarta on 60 HIV/AIDS patients. All subjects were 18-60 years old. The research data were analyzed with a 2x2 test table to determine the Prevalence Ratio (PR) of each variable, then multivariate analysis with logistic regression was continued. The study showed 6.7% thyroid dysfunction in HIV/AIDS patients, 5% subclinical hyperthyroidism, and 1.7% subclinical hypothyroidism. The CD4 counts [PR 13.36 (95% CI: 1.53-116,65; p=0.017) and CD8 counts [PR 0.91 (95% CI: 3 0.02-0.51; p=0.032)] significantly associated with thyroid dysfunction in HIV/AIDS patients. CD4 counts < 200 cells/mm and 3 CD8 counts ≥500 cells/mm were associated with the incidence of thyroid dysfunction in HIV/AIDS patients, while CD4/CD8 ratio and HIV RNA viral load were not associated. CD4 count was not an independent predictor of thyroid dysfunction in HIV/AIDS patients.
Comparison between Neutrophil Lymphocyte Ratio and Derived Neutrophil Lymphocyte Ratio as the Risk Factor of COVID-19 Dwi Aryani; Dea Noviana Pramatik
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1706

Abstract

Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Respiratory disorders were the most common sign and symptom of COVID-19. Inflammation on SARS-CoV-2 infection is presumed to play a role in the pathogenesis of COVID-19. The Neutrophil Lymphocyte Ratio (NLR) is one of many biomarkers that has been widely used to assess the risk factors of COVID-19. The derived Neutrophil Lymphocyte Ratio (d-NLR) is a simple, inexpensive, and widely available inflammation biomarker. However, its usage for COVID-19 remains to be further studied. This study aimed to determine the NLR and d-NLR ratio as a risk factor of COVID-19. This study was a retrospective study with a study population of 84 subjects, consisting of 33 patients with positive COVID-19 and 51 patients with negative COVID-19. The result showed that the odds ratio of NLR to COVID-19 was 2.665 with the p-value of 0.047 and confidence interval of 95% 0.998-7.038 at cut-off ≥ 3.1. The odd ratio of d-NLR to COVID-19 was 2.808 with the p-value of 0.026 and confidence interval of 95% 1.129-7.038 at cut-off ≥ 2.0. In conclusion, despite a higher odd ratio of d-NLR compared to NLR, both NLR and d-NLR can be used as a biomarker for the risk factor of COVID-19.
Assessment of Systemic Immune Inflammation Index to Predict SARS-CoV-2 Infection Dea Noviana Pramantik; Dwi Aryani
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1707

Abstract

Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and has become a major health problem worldwide. Inflammation plays a vital role in the pathophysiology of COVID-19. Systemic Immune Inflammation Index (SII) is an index obtained from calculating the platelets counts, neutrophils, and lymphocytes, which can indicate the inflammation status and immunity. This study aimed to determine the potential of SII as a predictor of SARS-CoV-2 infection in suspected COVID-19 subjects. A retrospective study was carried out by obtaining medical record data in June 2020 at Sleman General Hospital. An unpaired T-test or the Mann-Whitney test was used to determine the statistical difference. A Receiver Operating Characteristic (ROC) curve was generated and used to get the cut-off values. Bivariate analysis was performed using Chi-Square. There were 84 subjects consisting of 46 (54.8%) males and 38 (45.2%) females with a mean age of 42.4±16.356 years. There was a significant difference in the neutrophils count (p=0.045), monocytes (p=0.001), and eosinophils (p=0.037) between subjects with positive and negative SARS-CoV-2 PCR. The median SII in the positive and negative SARS-CoV-2 PCR group was 780.12 (301.21-2178.90)x103/µL and 584.14 (117.79-1933.87)x103/µL (p=0.045), respectively. Bivariate analysis showed significant results at SII > 705 x103/µL in suspected COVID-19 patients to obtain a positive SARS-CoV-2 PCR result with Odds Ratio (OR) of 4.00 (95% CI 1.580-10.127), p=0.003. Patients with suspected SARS-CoV-2 infection with high SII levels had a greater risk of a positive SARS-CoV-2 in PCR test
Hairy Cell Leukemia (Morphologic and Immunophenotypic Profile) Anindita Novia Damayanti; Arifoel Hajat
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1712

Abstract

Hairy Cell Leukemia (HCL) is a lymphoproliferative B cell abnormality dominated by mature lymphocytes with cytoplasmic projections and often misunderstood as Chronic Lymphocytic Leukemia (CLL). Misdiagnosis can be caused by errors in the preparation of peripheral Blood Smear Evaluation (BSE). Immunophenotyping is an option to differentiate HCL from CLL. A 56-year-old female presented with complaints of weakness. Physical examination showed conjunctival anemia 3 3 and hepatosplenomegaly. Hematological test results were as follows: Hb 7.4 g/dL; WBC 131.24x10 /uL; and Plt 61x10 /uL. BSE And Bone Marrow Aspiration (BMA) showed predominantly mature lymphocytes with cytoplasmic projections and suspected CLL with HCL as the differential diagnosis. Immunophenotyping with peripheral blood samples showed CD19+, CD20+, CD79a+, HLA-DR+, CD5-, and CD7- suggesting an increasing mature lymphocytes population (74.16%) that expressed B lymphoid lineage. White Precursor Cell (WPC) channel test showed an abnormal lymphocytes population. The differential diagnosis of patients with dominant mature lymphocytes BSE with cytoplasmic projections was CLL and HCL. Immunophenotyping of CLL showed positive results on B cell markers (CD19, CD20, CD79a, and HLA-DR) with aberrant CD5. However, in such an HCL case like this, there were strongly positive results on B cell markers but the absence of aberrant CD5. This study was supported by the presence of abnormal lymphocytes population in the WPC test. The diagnosis of HCL in this patient was based on interpretation of BSE and immunophenotyping, supported by the WPC test.
Correlation between APRI, FIB-4 and GPR Indices to Fibroscan and HBeAg Status in Patients with Chronic Hepatitis B Rina Erlina; Puspa Wardhani; Yessy Puspitasari; Ulfa Kholili
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1718

Abstract

Liver fibrosis is a complication of chronic hepatitis B. Early detection of liver fibrosis is important for therapy. The aspartate aminotransferase index (AST)-to-platelet ratio index (APRI) and the fibrosis index based on 4 factors (FIB-4) in chronic hepatitis B have been widely studied despite the inconsistent results. Research on other serum markers is extensively carried out, including Gamma-Glutamyl Transpeptidase (GGT)-to-platelet ratio (GPR). Previous studies have shown that the GPR index was more accurate than APRI and FIB-4. HBeAg status is an indication for therapy. There have not been many studies on the correlation of serum markers with HBeAg status. This study aimed to determine the correlation of APRI, FIB-4, and GPR with Fibroscan and HBeAg status in chronic hepatitis B patients. A cross-sectional study was carried out from June to September 2020 and found 50 chronic hepatitis B patients. Platelet count was measured using a Sysmex XN-1000 hematology device; AST, alanine aminotransferase (ALT), and GGT levels were measured using the Dimension RXL clinical chemistry device; and the degree of fibrosis was determined using transient elastography (Fibroscan). Spearman correlation test was used in this study for the correlation analysis. The results showed a significant correlation between APRI, FIB-4 and GPR indices with Fibroscan (r=0.454, p 0.001; r=0.610, p < 0.001; r=0.540, p < 0.001, respectively). A significant correlation was found between APRI, FIB-4 and GPR indices with negative (-) HBeAg (r=0.486, p 0.004; r=0.648, p < 0.001; r=0.595, p < 0.001, respectively). In addition, a significant correlation was found between FIB-4 and positive (+) HBeAg (r=0.499, p 0.049), but no correlation was found between APRI and GPR with positive (+) HBeAg (r=0.295, p 0,267; r=0.386, p 0.140, respectively).
Hematology Profile of Tuberculosis Lymphadenitis Patients at Siti Rahmah Hospital, Padang, Indonesia Debie Anggraini; Meta Zulyati Oktora
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1719

Abstract

Tuberculosis (TB) is a progressive granulomatous infectious disease caused by Gram-positive acid-resistant bacilli classified in the genus Mycobacterium. Tuberculosis in humans is caused by Mycobacterium tuberculosis (MTB) and it mainly infects the lungs, although it can also infect intestines, meninges, bones, lymph nodes, skin that cause extra-pulmonary TB. Tuberculous lymphadenitis is an inflammatory process in lymph nodes as a result of MTB activity. The inflammatory process caused by MTB activity is often associated with anemia as the most common complication. Anemia in TB is caused by an inflammatory process associated with bone marrow suppression due to pro-inflammatory cytokines, thus inhibiting the proliferation and differentiation of erythroid progenitor cells. This chronic TB infection also affects iron hemostasis, thus further affecting the hematological profile of TB patients. This study aimed to determine the hematology profile of TB lymphadenitis patients in the Siti Rahmah Hospital, Padang, Indonesia. This was a descriptive study, with a population of patients diagnosed with TB lymphadenitis based on the results of a fine needle biopsy in the Colli region. The samples of this study consisted of 24 patients who have tested the hematology profile. Tuberculosis lymphadenitis patients in females were higher than males, the mean age was 26.75±19.53 years old dominated by an adult (54%). The mean of 3 hemoglobin levels was 11.8±1.522 g/dL, with 62.5% anemia patients. The mean leukocyte count was 10400±3018.926/mm , 3 with 54.2% of patients had normal levels of leukocyte. The mean of thrombocyte count was 334750±74440.668/mm , with 83.3% in normal levels and the mean of Erythrocyte Sedimentation Rate (ESR) was 35.25±31.489 mm/h, with 54.2% patients in high ESR. Hematology profile in TB lymphadenitis patient was anemia, normal levels of leukocytes, thrombocyte, and increased levels of ESR.
The Relationship between Platelet to Lymphocyte Ratio and Platelet Indices with Disease Severity Level of Systemic Lupus Erythematosus Purbosari Purbosari; Umi Solekhah Intansari
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1763

Abstract

Systemic Lupus Erythematosus (SLE) is an episodic, chronic autoimmune inflammatory disease characterized by remission and flare phases. Laboratory parameters required to assess the severity of disease activity in SLE include platelet count and platelet indices. Several studies regarding the Platelet to Lymphocyte Ratio (PLR) and platelet indices on the severity of SLE patients remain inconsistent. This study aimed to evaluate the relationship between PLR value and platelet index with the degree of disease severity in SLE patients. This study used a retrospective analytic observational design in SLE patients from January 2016 to December 2019 at Dr. Sardjito Central Hospital. Disease severity was assessed using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score. Platelet to Lymphocyte Ratio (PLR) values and platelet indices were measured with a hematology analyzer. The data were analyzed using correlation, bivariate, multiple regression tests, and the ROC curve to determine the PLR cut-off. There were 55 SLE patients with high activity (SLEDAI 11-19; n=30(54,54%)) and very high activity (SLEDAI 20; n=25(45.45%)). There was a significant correlation (p <0.05) between the PLR value, platelet count, plateletcrit, and Mean Platelet Volume (MPV) with SLEDAI scores (p <0.05), but only the MPV variable was significant as an independent variable (p=0.0357). In the ROC curve, a cut-off PLR value of 124 was obtained with a sensitivity of 68.0%, specificity of 66.7%, likelihood ratio=2.04 (AUC=0.659 with p-value=0.035) to detect very high disease activity. Based on the PLR value, platelet count and plateletcrit negatively correlated with SLEDAI score but were related to the very high degree of thrombocytopenia in disease activity. The MPV value reflected the high platelet turnover, which had a positive correlation with the SLEDAI score. Patients with a PLR value ≤124 were 2.04 times more likely to have a SLEDAI score of 20, indicating potential use as a predictor of disease activity. The PLR value and platelet indices were significantly related to the degree of SLE activity.
Hematology and Iron Status Evaluation Based on Donation Characteristics in Dr. Sardjito Hospital, Yogyakarta Fuad Anshori; Tri Ratnaningsih; Teguh Triyono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1876

Abstract

Blood donation will reduce iron storage in the body. A high frequency of donations and short interval inter-donations may increase the risk of iron deficiency. In Indonesia, detection of iron deficiency in blood donors is not a routine procedure. Therefore, the comparison of hematology and iron status based on donor characteristics is not widely known. For a month, this study was a cross-sectional study conducted at the Blood Transfusion Service Unit, Dr. Sardjito Hospital. Subjects were routine blood donors who met the criteria for donor selection; however, subjects were excluded if the CRP level was > 10 g/L and had a history of iron supplementation. Subjects were divided based on donation frequency and blood donation interval. The Kruskal-Wallis test was used to compare variables among groups with a statistical significance of p < 0.05. This study involved 145 subjects who met the criteria. Blood donations more than 20 times showed the lowest ferritin levels and iron saturation (16.9 ng/mL and 15.08%). Ferritin levels were also increased in line with the donation interval (35.5 ng/mL; 75.3 ng/mL; 92.7 ng/mL every three months). However, the hematological parameters and iron saturation did not differ significantly based on the donation interval. Hematological parameters are easy and fast procedures but have limitations in the early detection of iron deficiency. Serum ferritin has higher specificity, but its level is affected by inflammatory conditions. Ferritin levels were consistently at the lowest level in the subjects with the highest risk of iron deficiency compared to hematologic and iron saturation parameters.
Pancreatic Cancer: Pathogenesis, Diagnosis, and Laboratory Tests Rikarni Rikarni
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1891

Abstract

Pancreatic cancer is the eleventh cause of cancer death in Indonesia in 2020. However, pancreatic cancer is the second leading cause of cancer death in the United States after lung cancer. Although it is substantially less common than the other malignancies, pancreatic carcinoma is near the top of the list of killers because it is a highly aggressive cancer. Pancreatic cancer has multistep carcinogenesis, starting from the Pancreatic Intraductal Neoplasia (PanINs IA, IB, II, and III) and is ended with an invasive neoplastic lesion. The different incidence of pancreatic cancer between countries also shows the important role of environmental factors for the disease. A better understanding of the risk factors, genetics, molecular pathogenesis, symptoms associated with this disease, and the laboratory aspect is essential to inform both health professionals and the general population as the potential preventive and/or early detection measures.

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