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Acta Interna : The Journal of Internal Medicine
Published by Universitas Gadjah Mada
ISSN : 2303131X     EISSN : 25415441     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology
The Journal considers any original research that advocates change in, or illuminates, clinical practice. The journal also publishes interesting and informative reviews and opinions pieces on any topics connected with clinical practice. Manuscripts must be solely the work of the author(s) stated, not have been published previously elsewhere, and not be under consideration by another journal. all papers should be written to be clearly understandable to the journal`s readers in a wide range of specialities and countries. Diagrams, figures, and photographs should be used to supplement and enhance the text.
Arjuna Subject : -
Articles 152 Documents
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The Impact of Starting Urate-Lowering Therapy (ULT) During A Gout Flare on The Ongoing Episode: A Systematic Review of Randomized Controlled Trials Yogiswara, Komang Satvika; Widhiarta, Putu Raka; Wiwekananda, Ketut Shri Satya; Paramaiswari, Ayu; Achadiono, Dedy Nurwachid; Kambayana, Gede; Kertia, Nyoman
Acta Interna The Journal of Internal Medicine Vol 13, No 1 (2024): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.101289

Abstract

Background. Gout is a prevalent form of arthritis caused by the accumulation of monosodium urate (MSU) crystals. Urate-lowering therapy (ULT) may be started once an acute flare has subsided to prevent the present episode from lasting longer. Nevertheless, ULT may be commenced during an acute flare-up in order to decrease the frequency of outpatient appointments and enhance patient adherence. The objective of this study was to conduct whether the commencement of urate-lowering therapy (ULT) during an acute gout flare is effective. Method. We performed a systematic review of articles published in MEDLINE, PubMed, Cochrane library, and EMBASE databases from 2018 to 2023. The search was limited to articles published in English, and RCTs in patients older than 18 years.Results and Discussions. Among 242 recorded studies, only four with 323 patients were eligible for this research. The treatment with Allopurinol began with a daily dose    of 100 mg for the initial 14 days, followed by an increase to a daily dose of 200 mg for     the subsequent 14 days. The reported time to resolution was 15.4 days for the group receiving allopurinol and 13.4 days for the group receiving the placebo. According to this review, the start of ULT (uric acid-lowering therapy) should be determined by sufficient anti-inflammatory measures. Commencing ULT during a gout flare has no impact on the intensity, duration, or likelihood of recurrence of the flare within the following 28 to 30 days.Conclusions. This study demonstrated that the commencement of urate-lowering therapy (ULT) during an acute gout flare did not result in a longer duration of the flare. Nevertheless, it is necessary to conduct a clinical  studies with a bigger sample size in order to validate this review.
Positive Anti-Histone Antibodies in Patients with Polymyositis Falah, Khoirul; Mulya, Deshinta Putri
Acta Interna The Journal of Internal Medicine Vol 13, No 1 (2024): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.101290

Abstract

Background. Polymyositis is an idiopathic inflammatory myopathy characterized by proximal symmetric muscle weakness, increased skeletal muscle enzyme levels, electromyographic abnormalities, and nonspecific muscle biopsy findings. Autoimmune mechanisms are thought to be the pathogenesis of the disease. Some autoantibodies have specificity and a high relationship with myositis.Case. A 23-year-old male presented with progressive quadriparesis, with predominant lower limb weakness, and severe myalgia of one-month duration, significantly impairing ambulation. He has a history of occupational exposure to propylene gas and atmer liquid while working in a plastic factory. Muscle strength in upper extremities were 4 and lower extremities were 3. Laboratory examination showed CK level 11856 U/L, SGOT 773 U/L, SGPT 486 U/L, LDH 1601 U/L, ANA IF 1:1000 with speckled pattern, normal electroneuromyography, anti-Histone antibodies (++). The patient refused a muscle biopsy. The patient met 2 of the 4 criteria so he was diagnosed with possible polymyositis and was treated with methylprednisolone injection 125 mg/ 6 hours for 3 days then tappering down , mycophenolate acid 2x180 mg , mecobalamin 2x500 mcg, and vitamin D 1x400 mg. After 1 month of therapy, muscle weakness improved and he was able to walk again.Discussion. Specific antibodies for myositis include antisynthetase, anti-Jo-1, anti-PL-7, anti-EJ, anti-PL-12, and anti-Mi-2, antibodies associated with myositis include anti-PM-Sci, anti-Ku , anti-KJ, anti-Ro/SSA.Anti-histone antibodies are commonly present in drug-induced lupus, but some studies have shown an association with other autoimmune and rheumatic diseases. Specificity pattern of serum anti-histone antibodies (AHA) on part of polymyositis patient similar with serum pattern of systemic sclerosis. Another study showed positive results in 17% of 46 polymyositis and dermatomyositis patients.Summary. A young man with clinical and laboratory criteria fulfilling the diagnosis of possible polymyositis, positive anti-histone antibodies were obtained, which is an antibody that is rarely found in cases of polymyositis.

Page 16 of 16 | Total Record : 152

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