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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 20 Documents
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Search results for , issue "Vol. 31 No. 1 (2024)" : 20 Documents clear
A-9-Years-Old Female with Diabetes Mellitus Type 1 with Hyperthyroidism Puspa Sari, Ni Ketut; Mulyantari, Ni Kadek; Herawati, Sianny; Lestari, AA. Wiradewi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 1 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i1.2060

Abstract

Diabetes Mellitus Type 1 (DMT1) and thyroid disease can occur together, which is defined as a variant of autoimmune polyglandular syndrome type 3. It is known that the action of insulin and thyroid hormones affect cellular metabolism, thyroid hormones contribute to carbohydrate metabolism and pancreatic function. Since the thyroid gland plays a central role in the regulation of metabolism, abnormal thyroid function can have a major impact on the control of diabetes and poor glycemic control can cause alterations in thyroid hormone. A female, 9 years old, with decreased consciousness. Previous medical history, polyuria, increased appetite, and drastic weight loss. She also complained of sweating even in a cold room and was often emotional. On physical examination, there was fever, shortness of breath, tachycardia, and a soft and diffused slightly enlarged thyroid gland, with no bruit on auscultation. Laboratory tests showed blood glucose levels at 739 mg/dL, HbA1c 9.2%, C-peptide 0.2 ng/mL, TSH levels 0.01 µIU/mL, FT4 levels 2.77 ng/dL, the presence of metabolic acidosis, proteinuria, glucosuria, and ketonuria. Thyroid dysfunction will have a negative effect on DM control while poor glucose control will harm the work of thyroid hormones. Improvement in glycemic control and routine insulin injection with the right dose will reduce the risk of diabetic vascular and metabolic complications onset and progression.
Light Chain Multiple Myeloma: A Case of Distinctive Presentations Henrika, Fify; Wisdharilla, Reiva
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 1 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i1.2088

Abstract

Multiple Myeloma (MM) is a malignancy of immunoglobulin-producing plasma cells. Lambda Light Chain Multiple Myeloma (LCMM) is a less common type of MM with a more aggressive course, which presents a diagnostic challenge due to the absence of typical M-spike on screening and unspecific manifestations. This case presented an initially misdiagnosed patient, who had an uncommon light chain pattern on electrophoresis, atypical plasmocytes in bone marrow smear, particular complications and risks associated with LCMM, and a worse prognosis.
Association between Platelet-Lymphocyte Ratio and Proteinuria in T2DM Patient Riyanti, Rini; Putri, Rona Andini; Sofiana, Kristianningrum Dian
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 1 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i1.2214

Abstract

Diabetes Mellitus (DM) is a group of metabolic disorders characterized by hyperglycemia and glucose intolerance. Type 2 DM (T2DM) covers over 90% of DM cases. Diabetic nephropathy is a microvascular complication of DM. Proteinuria is as a marker of diabetic nephropathy in DM patients, which reflects disturbances of glomerular filtration and protein reabsorption. Platelet-to-Lymphocyte Ratio (PLR) is a new marker of inflammation and predictor of various medical conditions that is cheap and easy to access through a complete blood count. The pathophysiology of diabetic nephropathy has been reported to be related to chronic inflammation, hypercoagulation, and oxidative stress, which can affect the increase in the number of platelets and decrease in the number of lymphocytes. This study aimed to determine the correlation between PLR and proteinuria in T2DM patients. This cross-sectional study design used medical records data and involved patients presenting T2DM at dr. Soebandi Hospital, Jember from April 2021 to March 2023. The correlation between variables was analyzed using the Spearman correlation test (p <0.05). Based on the result with a subject of 98 T2DM patients, statistical analysis showed a significant correlation between PLR and proteinuria (p=0.000) with moderate strength of correlation (r=0.468). The average PLR value in T2DM patients with proteinuria was higher (255.41) than in T2DM patients without proteinuria (139.85).
Profile Laboratory of Thalassemia in the General Hospital Dr. Zainoel Abidin Banda Aceh Mutiawati, Vivi Keumala; Aman, Adi Koesoema
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 1 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i1.2218

Abstract

Thalassemia refers to the globin gene abnormality that affects the a and b globin genes. A comprehensive peripheral blood laboratory examination, Mentzer index, blood morphology, and Hb analysis were all performed on every patient with thalassemia who attended treatment as part of this analytical observational study. This research aims to know the profile of laboratory examinations of thalassemia patients in the Dr. Zainoel Abidin General Hospital (RSUZA) Banda Aceh. The study's target population was 547 individuals, with 278 males and 269 females making up the male and female split, respectively (50.7% and 49.3%). With a total of 197 subjects (36.4%), this study revealed that the subjects were most frequently found in the age range of 0–5 years. Only 8 subjects, or 1.5%, of the population in the over-65 age group, were detected. The typical value of the erythrocyte index further fell and was discovered in 469 participants with a value of 85.3%. A total of 504 patients, or 91.6%, had more elevated RDW features. Results for the Mentzer index with 432 subjects were determined to be 13 were 78.5%. In the 450-subject hypochromic microcytic group, subjects were most frequently observed (81.8%). Blood morphology features from 505 participants, or 91.8% of the total, showed no additional blood morphology characteristics in normoblasts, and from 361 subjects, or 65.6% of the total, showed no target cells. When a person has anemia or a family history of thalassemia, it is strongly advised that they get a full blood count (CBC). The proper laboratory testing is still necessary for the health issue of thalassemia. 
White Blood Cell and Peripheral Blast Counts in Leukemia Patients with Non-Graying WBC-Diff Scattergram Lismayanti, Leni; Arif, Mansyur
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 1 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i1.2222

Abstract

Graying scattergram of White Blood Cell differential (WBC-diff) is often accompanied by blasts in the blood and/or leukocytosis in leukemia patients. Therefore, monitoring White Blood Cell (WBC) and peripheral blast count is crucial for patient management. In contrast, patients with non-graying WBC-diff scattergrams may have varying WBC counts and peripheral blasts. This study aimed to establish the cut-off values of WBC and peripheral blast counts that could predict a non-graying scattergram in leukemia patients. A retrospective descriptive study with a cross-sectional design analyzed secondary data from 21 leukemia patients. The acute and chronic leukemia diagnosis were based on bone marrow aspirates, which simultaneously showed a graying WBC-diff scattergram on Complete Blood Count (CBC). Receiver Operating Characteristic (ROC) curve analysis was conducted when the patient’s CBC displayed a non-graying scattergram. The cut-off value for WBC count was 16,380 x 109/L with an Area Under Curve (AUC) of 0.932, a sensitivity of 85.7%, p = 0.001, and the cut-off for peripheral blast count was 35.5% with an AUC of 0.872, the sensitivity of 76.2%, p=0.001. The results suggest that a non-graying scattergram of the WDF channel in leukemia is more likely associated with WBC counts below 16,380 x 109/L and peripheral blast counts below 35.5%, which have excellent and good predictive value.
Antibiotic Susceptibility among Infective Endocarditis Population: Syndromic Antibiogram Evaluation at Indonesian National Cardiovascular Center Indrawati, Lilik; Sugianli, Adhi Kristianto; Prakoso, Baskoro Justicia; Gunawan, Adrian; Soerarso, Rarsari; Soesanto, Amiliana M.; Dewi, Andaru Dahesih
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 1 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i1.2223

Abstract

Infective Endocarditis (IE) is a life-threatening disease with a high mortality rate (25%). Laboratory approaches to support the diagnosis of IE especially blood and/or cardiac vegetation culture, are crucial for providing definitive therapy. However, negative culture is frequently observed, therefore empirical use of antibiotics seems unavoidable and may lead to increasing antimicrobial resistance. This study aims to observe the prevalence of antibiotic susceptibility among the IE population using the WISCA approach. This retrospective study observed medical record data of all inpatients diagnosed with IE according to ICD-10 at Cardiovascular Center Harapan Kita Hospital (NCCHK) between January 2018 and December 2022. Patient data were combined with bacterial identification and antibiotic susceptibility test data from the laboratory information system, and evaluated based on period (year). A total of 67,858 inpatients and 1.1% (n=772) were diagnosed with IE. Successful culture growth (blood and/or cardiac vegetation specimen) was between 36.8% and 70% annually. Streptococcus viridans group (82/237, 34.6%) and Coagulase-negative Staphylococci (57/237, 24.1%) were dominantly observed among the IE population. Low susceptibility among Penicillin (34.3%) towards Gram-positive bacteria, as first-line treatment option in IE. Meanwhile, high susceptibility range was observed in Ceftriaxone (95.7%), Gentamicin (80.4%), Rifampicin (84.4%), and Vancomycin (98.7%) as second-line treatment in IE. Despite the low prevalence, the occurrence of antimicrobial resistance in IE has become a priority concern. Continuing the syndromic antibiogram is mandatory to assist the trend of empirical antibiotic usage and refine the established local treatment guidelines.
The Utility of Micro-R/Hypo-He Ratio Cut-off for Distinguishing Iron Deficiency Anemia and Minor Thalassemia Audiyananda, Dwika; Prihatni, Delita; Surata, Nida; Sugianli, Adhi Kristianto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 1 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i1.2234

Abstract

     Thalassemia is a genetic disease with impaired synthesis of the globin chain that causes anemia. Thalassemia and Iron Deficiency Anemia (IDA) are both microcytic hypochromic anemia but have different proportions of hypochromic and microcytic erythrocytes due to differences in disease mechanisms. Research parameters of the hematology analyzer: %Micro-R, %Hypo-He, and MH ratio can be used as early screening for thalassemia and IDA. This study aimed to evaluate the cut-off of %Micro-R, %Hypo-He, and MH ratio to differentiate thalassemia from IDA. A cross-sectional study was carried out on 217 subjects. Subjects were divided into two groups, thalassemia and IDA based on hemoglobin electrophoresis, hematology examination, and Mentzer index. Differences and cut-off values of %Micro-R, %Hypo-He, and MH ratio between the two groups were analyzed. The number of collected data was 134, consisting of 89 thalassemia patients and 45 IDA patients. Thalassemia patients had a median %Micro-R value of 51.2 (4.3-79.0), %Hypo-He value of 7.2 (0.2-50.2), and MH ratio of 7.17 (1.10-64.50), higher than IDA patients (p=0.000; p=0.176; p=0.000). The optimal cut-off value for %Micro-R in discriminating thalassemia trait from IDA was >12.7, with the area under the ROC curve (AUC) of 0.945, sensitivity of 92.1%, and specificity of 82.2%. The cut-off value for MH ratio > 3.27 with AUC 0.833, sensitivity of 85.4%, and specificity 77.8% showed lower performance of cut-off value compared to %Micro-R. The algorithm using %Micro-R and MH ratio was proposed for thalassemia trait screening. High %Micro-R and MH are suggestive of thalassemia trait than of IDA.
The Concordance between GeneXpert MTB/RIF and Isothermal Amplification Assay for Detecting Mycobacterium tuberculosis Ulfah, Nuri Dzulfiani; Andriyoko, Basti; Turbawaty, Dewi Kartika
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 1 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i1.2235

Abstract

Tuberculosis (TB) is an infectious disease and one of the biggest causes of death worldwide. The main problem today is the lack of accurate and rapid tests to detect Mycobacterium tuberculosis (MTB). Several molecular methods have been developed to detect MTB. GeneXpert MTB/RIF® can detect MTB and rifampicin resistance simultaneously in <2 hours. Cross Priming Amplification (CPA) is one of the isothermal amplification assay methods that can detect MTB. Both of these methods are molecular rapid tests so they can detect MTB faster. This study aims to evaluate the concordance of GeneXpert MTB/RIF® results with CPA to detect MTB at Hasan Sadikin General Hospital, Bandung. This is an observational cross-sectional study. The subjects were patients with suspected pulmonary TB and examined with GeneXpert MTB/RIF® then CPA (Ustar EasyNAT MTC™) was also examined. This study used total sampling with 50 subjects and analyzed with Cohen's Kappa test. The results of GeneXpert MTB/RIF® and Ustar EasyNAT MTC™ in detecting MTB obtained Kappa of 0.662 (good agreement) with p-value <0.001. Of the 11 low positive samples on GeneXpert MTB/RIF® as many as 6 subjects (54.55%) had positive results, and 5 subjects (45.45%) had negative results on UStar EasyNAT MTC™. Meanwhile, of the 4 very low positive samples, there was only 1 sample with positive results on UStar EasyNAT MTC™. There is a match results between high and medium positive GeneXpert MTB/RIF® and UStar EasyNAT MTC™. However, there is a difference between low and very low positive results on GeneXpert MTB/RIF® and UStar EasyNAT MTC™.
Correlation Crossmatching Test with Effectiveness of Transfusion in Hemolytic Anemia Patients Primadita, Cherylia; Julyani, Sri; Muhiddin, Rachmawati A.
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 1 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i1.2237

Abstract

Hemolytic anemia is anemia caused by the premature destruction of red blood cells. Transfusion with hemolytic anemia is a dilemmatic indication and is still based on clinical decisions. Several studies assessed the effectiveness of transfusions in hemolytic anemia patients with incompatible crossmatching showed effectiveness. This study aimed to analyze crossmatching with transfusion effectiveness in hemolytic anemia patients.  Retrospective cohort observational study with medical record data from January 2019 to May 2022 of hemolytic anemia patients who got transfusion therapy. The variables included age, gender, hemoglobin levels before and after transfusion, crossmatching test, and transfusion effectiveness based on increased hemoglobin after transfusion 1 g/dL of 1 Pack Red Cell (PRC) unit. One hundred three (103) patients with hemolytic anemia 45 received PRC, 12 males (26.7%) and 33 females (73.3%). Ages 19 - < 45 years subjects had the most transfusions. Hemoglobin levels before and after transfusion showed significant differences (p-value =0.000) in the patients with a diagnosis of hereditary, unspecified, and autoimmune hemolytic anemias. The correlation between the effectiveness of transfusions with gender and age was not found (p=0.521, p=0.240). The correlation between crossmatching with the effectiveness of transfusion was not found (p=0.089). Hemolytic anemia patients with transfusion showed an increase in hemoglobin levels between before and after transfusion even with incompatible crossmatching. The correlation between the results of crossmatching with transfusion effectiveness in patients with hemolytic anemia was not found. Good premedication treatment can provide effective transfusion.
Diagnostic Value of Osteopontin, Lymphocyte-to-Monocyte Ratio, and CA-125 in Ovarian Carcinoma Suspect Surohadi, Natra D.; Triwardhani, Ria; Kustarini, Indranila; Hendrianingtyas, Meita; Rachmawati, Banundari
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 1 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i1.2238

Abstract

Osteopontin (OPN) is an important protein in cancer development and progressivity. Lymphocyte-to-Monocyte Ratio (LMR) as a systemic immunity and inflammatory indicator could be an ideal predictor biomarker because of its method’s simplicity and availability. Elevated CA-125 and OPN as well as decreased LMR were reported as signs of ovarian malignancy. Limited studies about OPN and LMR as diagnostic biomarkers, as well as various specificity and sensitivity of CA-125 intrigued the researcher to prove OPN, LMR, and CA-125 as diagnostic biomarkers for ovarian carcinoma. This study aimed to measure the diagnostic value of OPN, LMR, and CA-125 levels against histopathology results for ovarian carcinoma diagnosis. Eighty patients involved with suspected ovarian carcinoma who were referred to Dr. Kariadi Hospital, Semarang. Osteopontin and CA-125 levels were measured using ELISA, and LMR was calculated from absolute lymphocyte and monocyte counts using an automated hematology analyzer. The receiver operating characteristics curve was used to determine the cut-off and 2x2 table. The cut-off values for OPN, LMR, and CA-125 were 124 ng/mL, 3.7 and 45.4 U/mL, respectively. The sensitivity for OPN, LMR, and CA-125 was 67.24%, 62.07% and 60.34%. Specificity for OPN, LMR, and CA-125 were 68.18%, 54.55% and 59.09%. Osteopontin is the best parameter for determining the diagnosis of ovarian carcinoma but it is still not sufficient because OPN cut-off was still within the normal reference value.

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