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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. 32 no. 2 (2026)" : 23 Documents clear
Quartan Malaria with Anemia and Thrombocytopenia Nita Wiyono; Marisa Setiawan; Puspa Wardhani
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 2 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i2.2382

Abstract

Malaria is a life-threatening result of infection by Plasmodium species. Indonesia reports the second largest number of malaria of the Asian continent. Plasmodium malariae infection is a rare form of malaria, and is characterized by a relatively low parasitic load. However, the disease can progress rapidly and, in the absence of treatment, may lead to death within hours or days. A male 42 y.o was admitted with sustained fever for 2 weeks and vomiting. The patient had a history of traveling of travel to an endemic area, Papua, 2 weeks prior to admission. A complete blood examination found anemia and thrombocytopenia, while a microscopic examination showed Plasmodium malariae species with  3,200/μL parasites. Malaria rapid diagnostic tests (RDTs) showed a positive result for Pan. Compared to other Plasmodium species P. malariae remains neglected due to its low prevalence with relatively lower disease severity. Early diagnosis is crucial in preventing complications.
Sudden Death Due to Intracranial Hemorrhage Caused by Acute Promyelocytic Leukemia Nur Chumairoh; Khoiruman Khoirulwaro; Arifoel Hajat; Paulus Budiono Notopuro
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 2 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i2.2392

Abstract

Intracranial hemorrhage (ICH) is one of the complications that causes early death in the diagnosis of acute promyelocytic leukemia (APL). Bone marrow failure in APL due to platelet dysfunction significantly increases the risk of bleeding complications. This case report discusses the case of a male patient who presented with the main complaint of seizures, accompanied by ICH radiological images and peripheral blood smears, leading to APL, and who died in a short time. A 58-year-old male presented to the emergency room with complaints of seizures. The patient denied the presence of trauma, fever, chills, headache, or abdominal pain. On physical examination, the temperature was 36.5°C, pulse rate 85 times/minute, respiratory rate 20 times/minute, and 115/78 mmHg blood pressure, no patches on the skin, and no inflammation in the joints. An initial laboratory examination was performed, and the results revealed hemoglobin level 11.6 g/dL, platelet count 51,000/μL, and leukocyte count 95,890/μL. Radiological examination was performed, and there was bleeding in the cortical-subcortical left parietal lobe and brain edema, leading to intracranial hemorrhage (ICH). The peripheral blood smears showed 78% bilobed, cup-like blast and promyelocytic images, and immunophenotyping CD33, CD13, MPO, and CD117 results were positive. Patients with clinical symptoms showing signs of cerebral hemorrhage, with hematology laboratory results (hyperleukocytosis), should be taken heed as one of the complications due to acute promyelocytic leukemia.
ACCELERATED-PHASE OF CHRONIC MYELOID LEUKEMIA IN A THIRTEEN-YEAR-OLD BOY: A CASE REPORT I Dewa Agung Gede Agastya Janardhana; Sianny Herawati; Ni Kadek Mulyantari; Anak Agung Wiradewi Lestari
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 2 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i2.2408

Abstract

A myeloproliferative disease known as Chronic Myeloid Leukemia (CML) affects one to 1.5 persons per 100,000 people worldwide. The first cancer that is reliably linked to a particular chromosomal anomaly called the Philadelphia chromosome is chronic myeloid leukemia (CML). A 13-year-old kid was diagnosed with chronic myeloid leukemia seven months ago, which is marked by paleness and lethargy. The test results indicated hyperleukocytosis, anemia, and mild thrombocytopenia. Bone marrow aspiration indicated an accelerated phase CML, with 14.5% of blasts found. The cytogenetic test revealed the existence of the Philadelphia chromosome and a complicated karyotype. The patient has a 10-day therapy and gradually improves their general condition until cleared for discharge. The diagnosis of CML has three distinct phases: chronic, accelerated, and blastic crisis. Blood smears and bone marrow exams show blast numbers of 10% to 19% in the accelerated phase of CML. Cytogenetic tests show Philadelphia chromosomes. The detection of a Philadelphia chromosome on cytogenetic analysis, as well as all forms of myeloid stage with 14.5% myeloblasts, confirms the patient's accelerated-phase CML diagnosis. A thirteen-year old boy with accelerated-phase of CML with positive Philadelphia that showed improvement after hospital treatment and was allowed to go home.
CONCORDANCE OF MYCOBACTERIUM TUBERCULOSIS DETECTION GENEXPERT MTB/RIF AND GENEXPERT MTB/RIF ULTRA Sadriani Nadia; Tutik Kusmiati; Puspa Wardhani
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 2 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i2.2420

Abstract

Indonesia experienced a high tuberculosis (TB) burden in 2020, with 845,000 new cases and 116,400 deaths due to the disease. Laboratory diagnostic modalities, including culture and acid-fast bacilli (AFB) testing, have several limitations. The GeneXpert MTB/RIF with Real-Time Polymerase Chain Reaction (RT-PCR) method is recommended by the World Health Organization (WHO) to address the limitations of AFB microscopy and culture. The detection limit (LoD) of 116       Colony Form Unit (CFU)/mL has a sensitivity that is not better than culture (10-100 CFU/mL). GeneXpert MTB/RIF Ultra comes with a LoD of 16 CFU/mL, with additional gene targets in addition to rpoB and multicopy sequences on IS6110 and IS1810 to overcome this limitation. This study aims to analyze the concordance of MTB detection Gene Xpert MTB/RIF and Ultra in diagnosing pulmonary TB and rifampicin resistance. Patients diagnosed with TB at Dr. Soetomo General Hospital and Community Health Centr in September 2022-January 2023 with clinical symptoms and positive AFB and or RT-PCR TB examination. Sensitivity and positive predictive value (PPV) tests were conducted using Medcalc software, and the concordance test employed the Kappa value. 72 subjects, 62.5% male. The Kappa coefficient of GeneXpert MTB/RIF and Ultra for MTB detection was one, and rifampicin resistance was 0.9. The sensitivity and PPV of Ultra were 97.6% and 70.7%. There was strong agreement between GeneXpert MTB/RIF and Ultra for the detection of MTB and rifampicin resistance. The sensitivity value of Ultra was 97.6% and the PPV was 70.7%.
CORRELATION BETWEEN IFN-γ AND S-RBD SARS-COV-2 ANTIBODY LEVELS IN COVID-19 PATIENTS WITH ACUTE RESPIRATORY SYNDROME Henny Fauziah; Tenri Esa; Uleng Bahrun; Mutmainnah; Alfian Zainuddin; Arif Santoso; Andi Irhamnia Sakinah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 2 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i2.2431

Abstract

This study aimed to determine the correlation between interferon-gamma (IFN-γ) and S-RBD SARS-CoV-2 antibody levels in COVID-19 patients with acute respiratory syndrome. A cross-sectional study was conducted on 41 patients with non-severe syndrome of acute respiratory and 29 severe COVID-19 patients with severe syndrome of acute respiratory. IFN-γ levels were assessed using the enzyme-linked immunosorbent assay method. Antibody levels targeting the S-RBD were assessed using the Elecsys Anti SARS-CoV-2 S Cobas e411 ECLIA method. Significant difference (p <0,001) found between IFN-γ levels and the antibody levels in COVID-19 patients with non-severe and severe acute respiratory (p =0.238). However, no correlation was found between IFN-γ levels and antibody levels in patients classified as severe (p =0.208) or non-severe (p =0.081). No correlation between IFN-γ and the antibody levels in COVID-19 patients with severe acute respiratory syndrome and COVID-19 patients with non-severe, even though in non-severe patients, the IFN-γ levels are higher than in severe ones.
OPTIMAL TG/HDL RATIO CUT-OFF POINT TO INSULIN RESISTANCE IN NON-DIABETIC ADULTS Raisa Putri Secioria; Efrida; Deswita Sari
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 2 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i2.2442

Abstract

Insulin resistance is challenging to identify due to the absence of clinical symptoms, and screening is not conducted consistently. HOMA-IR has been used as an alternative assessment, but insulin measurement is quite expensive and not available in many laboratories. Numerous studies have reported the potential use of the TG/HDL ratio. This study aims to compare difference of TG/HDL ratio based on insulin resistance incidence and determine the cut-off point of TG/HDL ratio on insulin resistance in non-diabetic adults. This analytic study with a cross-sectional design was conducted on 96 non-diabetic adults at Dr. M. Djamil General Hospital Padang, from October 2022 to May 2023. Triglyceride and HDL were measured on Abbott Architect c8000 using glycerol phosphate oxidase and enzymatic colorimetric respectively. The TG/HDL ratio is determined by comparing triglycerides and high-density lipoprotein levels. HOMA-IR was computed using fasting blood glucose (mg/dL) x insulin (µU/mL)/405. The definition of insulin resistance was HOMA-IR ≥1.4. Data was analyzed using an independent t-test. Cut-off point analysis was performed using receiver operating characteristic curves based on the Youden index. Median age of subjects was 28 years. As many as 60.4% of subjects were women. Mean waist circumference and body mass index were higher in insulin resistance. Mean TG/HDL ratio was 2.6±1.1 in insulin resistance and 1.4±0.8 in non-insulin resistance (p <0.001). The AUROC was 0.862. TG/HDL ratio cutoff point for insulin resistance was 1.73, with sensitivity 76.2% and specificity 81.5%. The insulin resistance group’s TG/HDL ratio was higher than the non-insulin resistance group. The cutoff point of 1.73 can assess insulin resistance incidence in non-diabetic adults.
THE CORRELATION BETWEEN NEUTROPHIL-LYMPHOCYTE RATIO (NLR) AND PROCALCITONIN WITH THE SEVERITY OF DIABETIC FOOT ULCER Elsha Sinulingga; Ricke Loesnihari; Sylvia Youvella; Nindia Sugiharto; Malayana Rahmita Nasution
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 2 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i2.2451

Abstract

Diabetic foot ulcer (DFU) is a common complication in patients with diabetes mellitus (DM). A diabetic foot ulcer is a chronic wound below the ankle that lowers patient quality of life and raises morbidity and mortality rates. The severity of DFU can be evaluated using the Meggitt-Wagner classification. Wagner offers six grades, “0”is the least severe and“V”is the most severe. The neutrophil-to-lymphocyte ratio (NLR) is a basic inflammatory marker. Procalcitonin is an amino acid protein precursor of the hormone calcitonin secreted by thyroid C cells and other body cells. To diagnose diabetic foot infections, procalcitonin is crucial. From February 2024 to May 2024, type 2 DM patients with DFU at H. Adam Malik General Hospital in Medan who met the inclusion and exclusion criteria were enrolled in analytical cross-sectional study. Simultaneous blood samples were collected for procalcitonin measurement and analysis of neutrophil and lymphocyte counts. The correlation between NLR and DFU severity is weak and not significant (p = 0.278; r = 0.156). The median NLR value is 7.7 (1.6 - 32.03). A strong, statistically significant positive correlation was observed between procalcitonin levels and the severity of diabetic foot ulcer (DFU) (r = 0.651; p <0.05). The median procalcitonin value is 0.5 (0.03-4.7). There was a positive correlation between procalcitonin and DFU severity. There was no correlation between NLR and DFU severity.
Alterations in Liver Biomarkers Associated with The Consumption of Ursodeoxycholic Acid at A Tertiary Hospital in Indonesia: A Retrospective Cohort Study Nur Hanifah; Bagus Setyoboedi; Citrawati Dyah Kencono Wungu; Rendi Aji Prihaningtyas
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 2 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i2.2453

Abstract

Bile excretion disorders, such as cholestasis could affect people of all ages, including newborns. Although it has been regularly used to treat cholestasis, the use of ursodeoxycholic acid in pediatric patients remains a topic of debate. This study aims to assess the impact of ursodeoxycholic acid treatment on liver biomarkers in pediatric cholestasis across distinct age groups (under 3 months and 3-36 months). This was an observational analytic study using the retrospective cohort method in children with cholestasis who had received ursodeoxycholic acid therapy for 2 weeks. Secondary data including routine liver function tests; aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, and direct bilirubin were taken from medical records of the outpatient clinic in the Department of Child Health, Dr. Soetomo General Hospital, Surabaya, Indonesia, from January 2020 to December 2023. Subjects who met the inclusion criteria were divided into 2 groups based on age. The first group contains subjects with an age range of 1-3 months, while the other group contains subjects older than 3 months to 36 months. A total of 104 subjects were dominated by the male gender (56.07%). The results of the comparative test showed that the levels of AST, ALT, total bilirubin and direct bilirubin were decreased in both groups, except for ALT levels in children aged <3 months. Younger children had a significant increase in ALT levels after administration of ursodeoxycholic acid (281.8±165.2 vs 224.1±167.2, p =0.019). This was attributed to drug interactions due to the use of multiple medications that could not be controlled. Significant decreases occurred in the values of AST, total bilirubin, direct bilirubin (group 1) and AST (group 2) with sequential values were 179.2±139.2 vs 294.5±229.7, p =0.033; 10.8±4.5 vs 6.6±5.3 p =0.019; 7.3±3.6 vs 4.7±3.9 p <0.001 and 229.8±175.7 vs 229.6±210.9 p <0.001. While the difference in the values of the four parameters between the two groups was found in AST and total bilirubin marker. Ursodeoxycholic acid is effective in improving liver function biomarkers in pediatric cholestasis. Therapeutic response to ursodeoxycholic acid administration is more commonly found in younger age.
THE LEVELS OF SERUM MIDKINE AND ALPHA-FETOPROTEIN IN HEPATOCELLULAR CARCINOMA PATIENTS AT DR. WAHIDIN SUDIROHUSODO HOSPITAL MAKASSAR Dahvia Nursriyanti; Uleng Bahrun; Mutmainnah; Luthfi Parewangi; Agus Alim Abdullah; Burhanuddin Bahar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 2 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i2.2461

Abstract

Hepatocellular carcinoma (HCC) is one of the major health problems in primary liver malignancies derived from liver cells (hepatocytes) and is the leading cause of worldwide cancer-related death. Midkine (MDK) is significantly upregulated in various malignant tumors and plays an important role in carcinogenesis. This protein is known as Neurit growth-promoting factor 2 (NEGF2), which is a growth factor or heparin-binding growth factor. Several studies have shown that Midkine (MDK) has an advantage over Alpha-Fetoprotein (AFP) in diagnosing HCC at an early stage of cancer development. This cross sectional design study performed in 85 samples of HCC patients who had been divided based on the Barcelona Clinic Liver Cancer (BCLC) stages consisting of stages A, B, C and D. The MDK and AFP levels were examined using device with the ELISA method and all data obtained were processed using appropriate statistical methods. The results of the study obtained an average age of 58 years old and most were men. BCLC stages A to D were 18, 32, 13 and 22 samples respectively. The mean levels of MDK and AFP were found to be significantly in KHS. There were significantly differences in MDK and AFP levels between BCLC stages. There was a moderate to strong positive correlation between MDK and AFP between BCLC stages (p >0.05). The sensitivity and specificity of MDK are 85% and 90% to differentiate BCLC A and B with a cutoff value 1.65 ng/mL. The conclusion is that there are significant differences in MDK and AFP between BCLC stages and have a correlation with moderate to strong strength. Then the cutoff value of MDK is <1.65 ng/mL with sensitivity and specificity; 85%, 90% in differentiating HCC from BCLC A to B.
AGGREGATE INDEX OF SYSTEMIC INFLAMMATION (AISI) IN SURVIVOR AND NON-SURVIVOR SEPSIS PATIENTS Siti Fajrini Amir; Asvin Nurulita; Uleng Bahrun
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 2 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i2.2468

Abstract

Sepsis is a serious condition characterized by organ dysfunction resulting from an inappropriate immune response to infection. It is one of the primary causes of death and illness among critically ill patients, and its occurrence has risen over the past century. Aggregate Index of Systemic Inflammation (AISI) is a new method considered in the progression and diagnosis of various infections and inflammatory diseases based on routine blood test results. To compare the AISI values in sepsis survivors and non-survivors on the first and seventh day. Retrospective study of 355 sepsis patients consisting of 205 sepsis non-survivors and 150 sepsis survivors who were admitted to Wahidin Sudirohusodo Hospital from January 2021 to December 2023. The first-and-seventh-day routine blood results obtained from the patient's medical record were used to calculate the AISI value. The median first day AISI score was significantly lower in sepsis non-survivors than in sepsis survivors (2,190.58 vs. 2,973.67) with p <0.05. The median value of seventh day AISI was significantly lower in non-survivor sepsis patients than in survivor sepsis patients (1,150.93 vs. 1,591.84), with p <0.05. Non-survivor and survivor sepsis patients had a significant decrease in AISI values on day 7 compared to day 1 (p <0.001). There was a significant difference in AISI values in sepsis survivor and non-survivor patients. AISI values were found to be higher in sepsis survivors on days 1 and 7 compared to sepsis non-survivors. AISI values were found to decrease more on day seven than on day one in both groups.

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