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3.393
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Budi Setiabudiawan
Department of Child Health Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung, Indonesia
Articles
20
Documents
Birth Weight, Age of Onset, and Sex as Risk Factors of Steroid Resistant Nephrotic Syndrome

Journal of the Indonesian Medical Association Vol. 60 No. 11 November 2010
Publisher : Journal of the Indonesian Medical Association

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Abstract

Steroid resistant nephrotic syndrome (steroid resistant NS) might cause a big problem in children, especially in the management and progress of the disease to become a chronic or terminal kidney disease. The major risk factors for steroid resistant nephrotic syndrome are birth weight, age of onset, and sex. This is an analytical retrospective study with case control design, which was held in the Pediatric Departement of Dr. Hasan Sadikin Hospital, Bandung in May-June 2010. The subjects were steroid resistant or steroid sensitive NS patients age 1-14 years old. Data was collected from medical records followed by home visit to find out the history of birth weight and gestational age. Twenty four patients with resistant steroid and 48 with sensitive steroid NS were included in the research. There were 4 patients of steroid resistant NS and 1of sensitive steroid NS with low birth weight term infant [p= 0.022; OR(95% CI):9.4(1.0-89.45)], 14 patients of steroid resistant NS and 11 of sensitive steroid NS with age of onset >6 years [p=0.003; OR(95% CI): 4.7(1.64-3.52)]. Twelve patients of steroid resistant NS and 10 of sensitive steroid NS were females [(p=0.011; OR(95% CI): 3.8(1.315-10.978)]. Recording to the multivariate analysis, low birth weight term infants had the highest OR (8.082), followed by age of onset >6 years (5.112). The three mentioned risk factors potentiate the incidence of steroid resistant NS with coeficient b >1. From this research we can concluded that low birth weigh term infant, age of onset >6 years, and female sex are risk factors for the occurrence of resistant steroid NS.Keywords: steroid resistant nephrotic syndrome, risk factor, low birth weight term infant

Characteristic of Antinuclear Antibodies in Childhood Systemic Lupus Erythematosus and Its Association with the Complication

Journal of the Indonesian Medical Association Vol. 62 No. 7 July 2012
Publisher : Journal of the Indonesian Medical Association

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Abstract

Introduction: Systemic lupus erythematosus (SLE) is a multiorgan autoimmune disease with the evidence of antinuclear antibody (ANA). Antinuclear antibody generately has some patterns that correlate with any complication or other diseases. Therefore, this study aimed to get the description of ANA pattern in children with SLE, and find its association with proteinuria as SLE complication.Methods: This a cross-sectional study on pediatric subject from Hasan Sadikin Hospital, Bandung, from January 2006-October 2011. We collected demography data, chief complaint, clinical manifestation, and laboratory results. Chi-square analysis was performed to find an association between ANA pattern and SLE complication, in this case was proteinuria.Results: From 63 subjects (mean age 11±3,11 years) which are included, with girl:boys ratio = 5,8:1, 54,8% of them had proteinuria. The majority of subjects showed positive ANA results (77,4%) with speckled pattern as the most frequent type of ANA (40,3%). However, there was no significant association between ANA pattern and proteinuria events (p=0,680).Conclusion: Speckled pattern was the most frequent ANA pattern in children with SLE. However, it has no association with proteinuria events. J Indon Med Assoc. 2012;62:273-6.Keywords: systemic lupus erythematosus in children, speckled ANA pattern, proteinuria.

The Association Between Initial Solid Food and Atopy in Children with or without Family History of Atopic Disease

Majalah Kedokteran Bandung Vol 1, No 42 (2010)
Publisher : Majalah Kedokteran Bandung

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Abstract

Atopic diseases are the most common chronic diseases in childhood. Their incidence has a tendency to increase recently. The tendency of atopy could be triggered by many factors originated in the early life, including early introduction of solid food. To investigate the association between initial solid food and atopy, an analytic comparative study with historical cohort design was conducted from May to June 2006 in Pediatric Department of Hasan Sadikin Hospital Bandung. It was the second phase study of ´allergic prevalence and risk factors identificationin the first two years of life´. Out of 800 children in Garuda, Padasuka, and Babakansari Primary Health Care Center who were included in the first phase of the study, 749 children were eligible to continue the second phase of the study, 284 children were randomized into two groups of children with and without family history of atopic disease consisting of 142 children each. They then underwent skin prick test. History of initiation time of solid food were obtained from their parents. To analyze the data chi-square and odds ratio with 95% confidence interval were used. Among 284 children who fullfilled the inclusion criteria, 50% had family history of atopic disease. Atopy was found in 28.2% children, 32.4% with family history of atopic disease and 23.9% without family history of atopic disease. There was no significant correlation between family history of atopic disease and atopy (p=0.113). There was a high risk for atopy related to initial solid food (OR = 4.50, 95%CI = 1.96-10.74, p < 0.001). The difference of atopy was strongly significant between children who had initial solid food at the age of <6 months and at the age of >6 months whether or not the children had family history of atopic disease (p=0.016 and p=0.002). Conclusions: A significant increase in the risk of childhood atopy occured if initial solid food is given at the age of <6 months, whether or not the children have family history of atopic disease.Hubungan antara Waktu Pemberian Makanan Pendamping ASIdan Kejadian Atopi pada Anak dengan atau Tanpa Riwayat PenyakitAtopik dalam KeluargaPenyakit atopik merupakan penyakit kronik yang paling sering ditemukan pada anak. Angka kejadian penyakit atopik cenderung meningkat dari tahun ke tahun. Kecenderungan atopi atau timbulnya penyakit atopik dapat dicetuskan oleh faktor faktor yang berpengaruh di awal kehidupan, salah satunya adalah pemberian makanan pendamping ASI (MP ASI). Untuk mengetahui hubungan antara waktu pemberian MP ASI dan kejadian atopi dilakukan penelitian analitik komparatif dengan rancangan historical cohort. Penelitian dilakukan pada bulan Mei-Juni 2006 di Bagian Ilmu Kesehatan Anak Rumah Sakit Hasan Sadikin Bandung. Penelitian ini merupakan fase kedua dari penelitian “Prevalens alergi dan identifikasi faktor risiko pada dua tahun pertama kehidupan”. Penelitian dilakukan di Puskesmas Garuda, Padasuka, dan Babakansari. Dari 800 anak yang mengikuti fase I, sebanyak 749anak dapat diteliti pada penelitian fase II. Dengan teknik sampling secara acak terpilih 142 anak, masing-masing dari  kelompok dengan dan tanpa riwayat penyakit atopik dalam keluarga. Selanjutnya dilakukan pemeriksaan uji tusuk kulit dan ditanyakan mengenai riwayat pemberian MP ASI. Analisis statistik yang digunakan adalah uji kai-kuadrat dan Odds ratio dengan IK95%. Dua ratus delapan puluh empat anak memenuhi kriteria inklusi penelitian. Dari jumlah tersebut diperoleh 50% anak dengan riwayat penyakit atopik dalam keluarga. Atopi didapatkan pada 28,2% anak, 32,4% di antaranya dengan riwayat penyakit atopik dan 23,9% tanpa riwayat penyakit atopik dalam keluarga. Tidak terdapat hubungan yang bermakna antara anak dengan riwayat penyakit atopik dalam keluarga dan kejadian atopi (p=0,113). Dua ratus delapan (73,2%) anak mendapat MP ASI pada usia <6 bulan, 76 (26,8%) anak mendapat ASI pada usia >6 bulan. Kejadian atopi berbeda bermakna antara anak yang mendapat MP ASI pada usia <6 bulan dan >6 bulan (OR=4,50; IK95%=1,96-10,47; p<0,001), baik pada kelompok anak dengan riwayat penyakit atopik (OR=3,38; IK95%=1,12-10,86; p=0,016) maupun tanpa riwayat penyakit atopik (OR=6,08; IK95%=1,63-26,72, p=0,002) dalam keluarga. Kesimpulan: Pemberian MP ASI pada usia <6 bulan meningkatkan risiko terjadinya atopi, baik pada kelompok anak dengan atau tanpa riwayat penyakit atopik dalam keluarga.

Distribusi Subtipe Juvenile Idiopathic Arthritis di Bandung

Majalah Kedokteran Bandung Vol 44, No 2 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Juvenile idiopathic arthritis (JIA) merupakan penyakit reumatik kronik tersering pada anak yang terjadi sebelum usia 16 tahun. Penelitian ini bertujuan mengevaluasi profil penderita yang didiagnosis JIA. Dilakukan penelitian deskriptif retrospektif terhadap penderita JIA yang datang ke Divisi Alergi Imunologi Departemen Ilmu Kesehatan Anak Rumah Sakit Dr. Hasan Sadikin Bandung pada periode Januari 2006–Oktober 2011 berdasarkan rekam medis. Didapatkan 28 penderita JIA terdiri atas 10 anak laki-laki dan 18 anak perempuan, dengan rentang usia 2–14 tahun, usia rata-rata 8,25±3,62 tahun. Sebanyak 14 penderita JIA merupakan tipe oligoartritis persisten, 6 tipe sistemik, 5 tipe poliartritis, dan terdapat 1 orang penderita poliartritis tipe dewasa. Pada pemeriksaan laboratorium, didapatkan 2 penderita dengan faktor reumatoid positif dan 14 penderita negatif. Terapi yang diberikan obat antiinflamasi nonsteroid sebagai protokol terapi standar, steroid, dan disease modifying anti-rheumatic drugs (metotreksat). Terdapat 3 penderita meninggal yang semuanya merupakan tipe sistemik. Simpulan, sebagian besar JIA merupakan tipe oligoartritis persisten, lebih banyak ditemukan pada anak perempuan dibandingkan dengan laki-laki. Kasus kematian terjadi pada JIA tipe sistemik. Sebagian besar penderita memberikan respons yang baikterhadap protokol terapi standar. [MKB. 2012;44(2):101–5].Kata kunci: Anak, juvenile idiopathic arthritis, subtipe Distribution of Juvenile Idiophatic Arthritis Subtypes in BandungJuvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children which begin before 16 years of age. The objective of this study was to evaluate the profile of patients who diagnosed as JIA. The descriptive retrospective study was done to patients with JIA who came to Allergy Immunology Division, Department of Child Health Dr. Hasan Sadikin Hospital Bandung during January 2006–October 2011 period, based on the medical records. There were 28 patients with JIA consisted of 10 boys and 18 girls, age ranged 2–14 years, with mean age of onset of 8.25±3.62 years. There were 14 patients with persistent oligoarthritis type, 6 patients with systemic type, 5 patients with polyarthritis type and 1 patient with polyarthritis adult type. The laboratory data showed 2 patients with positive rheumatoid factor and 14 patients were negative. Non-steroidal anti-inflammatory drugs >as standard protocol therapy, steroids and disease modifying anti-rheumatic drugs (methotrexate) were used for treatment. There were 3 patients with systemic type death. In conclusions, most of JIA cases were persistent oligoathritis type, girls more than boys, and all death cases were systemic JIA. Most of cases had satisfactory therapeutic outcomes with standard protocol therapy. [MKB. 2012;44(2):101–5].Key words: Children, juvenile idiopathic arthritis, subtypes DOI: http://dx.doi.org/10.15395/mkb.v44n2.78

Kadar IgE Total pada Anak Obesitas Dengan atau Tanpa Riwayat Penyakit Atopik dalam Keluarga

Majalah Kedokteran Bandung Vol 45, No 2 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Prevalensi obesitas dan penyakit atopik anak, khususnya usia sekolah meningkat pada dekade terakhir ini. Penyakit atopik diperantarai oleh IgE serta dipengaruhi faktor genetik dan lingkungan. Resistensi leptin pada obesitas berkaitan dengan stimulasi TH2 yang berpengaruh pada produksi IgE. Tujuan penelitian ini yaitu untuk mengetahui hubungan kadar IgE total dengan obesitas pada anak dengan atau tanpa riwayat penyakit atopik dalam keluarga. Penelitian potong lintang ini dilaksanakan pada periode April–September 2010 yang melibatkan 160 anak usia 6–11 tahun pada beberapa sekolah dasar di Bandung. Terdapat 4 kelompok yaitu kelompok 1: obesitas dengan riwayat penyakit atopik dalam keluarga, 2: gizi normal dengan riwayat penyakit atopik dalam keluarga, 3: obesitas tanpa riwayat penyakit atopik dalam keluarga, 4: gizi normal tanpa riwayat penyakit atopik dalam keluarga. Pemeriksaan kadar IgE total dengan metode Electro-chemiluminescene Immunoassay (ECLIA). Kemaknaan data kategorik diuji dengan Uji chi-kuadrat, berdasarkan p<0,05. Kadar IgE total tinggi pada tiap kelompok masing-masing 30 (83%), 24 (60%), 21 (54%), dan 11 (28%) anak (p<0,001). Pada kelompok riwayat penyakit atopik dalam keluarga, kadar IgE total tinggi pada anak obesitas lebih banyak [30 anak (83%)] dibandingkan dengan gizi normal [24 anak (60%)] (p=0,025). Pada kelompok tanpa riwayat penyakit atopik dalam keluarga, kadar IgE total tinggi pada anak obesitas [21 anak (54%)] lebih banyak dibandingkan dengan gizi normal [11 anak (28%)] (p=0,017). Disimpulkan kadar IgE total tinggi lebih banyak pada anak obesitas dibandingkan dengan gizi normal dengan dan tanpa riwayat penyakit atopik dalam keluarga. [MKB. 2013;45(2):130–34]Kata kunci: Anak, IgE total, obesitas, riwayat atopik keluargaTotal IgE Levels in Childhood Obesity With or Without Family Historyof Atopic DiseaseThe prevalence of obesity and atopic disease in children, especially at school age increased in the last decade. Diseases mediated by IgE and atopy were influenced by genetic and environmental factors. Leptin resistance in obesity is associated with stimulation of TH 2 which affects the production of IgE. The purpose of this study was to determine the relationship of total IgE levels with obesity in children with or without family history of atopic disease. A cross-sectional study was conducted in the period April-September 2010, which involved 160 children aged 6–11 years at several elementary schools in Bandung. There are 4 groups: group 1: obese with family history of atopic disease, 2: normal nutrition with family history of atopic disease, 3: obese without family history of atopic disease, 4: normal nutrition without family history of atopic disease. Examination of total IgE levels were done by ECLIA method. Significance categorical data were tested by Chi-Square test, based on p <0.05. High total IgE levels in each group, respectively 30 (83%), 24 (60%), 21 (54%), and 11 (28%) children (p<0.001). In the group with family history of atopic disease, total IgE levels in obese children were higher [30 children (83%)] compared with normal nutrition [24 children (60%)] (p=0.025). In the group without family history of atopic disease, high total IgE levels in obese children [21 children (54%)] were higher than the normal nutrition [11 children (28%)] (p = 0.017). Inferred high total IgE levels more in obese children compared with normal nutrition with and without a history of atopic disease in the family. [MKB. 2013;45(2):130–34]Key words: Atopy, family history, obesity, total IgE level DOI: http://dx.doi.org/10.15395/mkb.v45n2.87

Laporan Kasus: Penyakit Kawasaki Atipikal

Majalah Kedokteran Bandung Vol 43, No 3 (2011)
Publisher : Fakultas Kedokteran, Universitas Padjadjaran

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Abstract

Penyakit Kawasaki merupakan penyebab utama kelainan jantung dapatan yang sering ditemukan pada anak. Di Indonesia, penyakit ini masih sangat jarang didiagnosis karena dianggap masih jarang dan belum diketahui secara luas. Dua laporan kasus berikut merupakan laporan kasus anak perempuan dan laki-laki, masing-masing berusia 17 bulan dan 3 tahun. Keduanya datang dengan demam yang persisten lebih dari 5 hari dan hanya memenuhi 3 kriteria klasik penyakit Kawasaki, yakni mata merah dan disertai dengan perubahan mukosa bibir serta ekstremitas. Penderita kemudian didiagnosis sebagai penyakit Kawasaki atipikal. Pada pemeriksaan laboratorium didapatkan peningkatan C-reactive protein dan laju endap darah disertai gambaran ekokardiografi yang normal. Kedua anak diberikan imunoglobulin intravena (IGIV) dengan dosis 2 gram/kgBB dosis tunggal dan aspirin dosis 80 mg/kgBB/hari. Penderita mengalami perbaikan setelah 1 hari mendapat terapi kombinasi tersebut. Disimpulkan bahwa pengobatan dengan kombinasi IGIV dan aspirin memberikan respons yang baik pada penyakit Kawasaki atipikal. [MKB. 2011;43(3):146–52].Kata kunci: Aspirin, imunoglobulin intravena, penyakit Kawasaki atipikal Case Reports: Atypical Kawasaki DiseaseKawasaki disease is the most common cause of acquired heart disease in children. In Indonesia the disease is rare to diagnosed, because of difficulty in diagnosis and not widely known. These were 2 case reports about a girl and a boy age 17 months and 3 years, who came with persistent fever more than 5 days and only fulfilled 3 criteria of Kawasaki disease, which are red eyes, changes in lips, mucose of oral and extremities. They were diagnosed as atypical Kawasaki disease. Laboratory examinations showed an increased of C-reactive protein and erythrocyte sedimentation rate with normal echocardiography. The patients were improved after treated with 2 grams per bodyweight of intravenous immunoglobulin (IVIG) and 80 mg per bodyweight of aspirin. The patients were better after one day combination therapy. In conclusion that atypical Kawasaki disease has good response to combination of IVIG and aspirin. [MKB. 2011;43(3):146–52].Key words: Aspirin, atypical Kawasaki disease, intravenous immunoglobulin

Perbedaan Kadar Platelet Activating Factor Plasma antara Penderita Demam Berdarah Dengue dan Demam Dengue

Majalah Kedokteran Bandung Vol 45, No 4 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Manifestasi klinis infeksi virus dengue dapat berupa demam dengue atau keadaan yang lebih berat yaitu demam berdarah dengue. Patogenesis yang menerangkan hal tersebut belum jelas. Teori yang sering dikemukakan yaitu pada penyakit dengue berat terjadi peningkatan kadar mediator proinflamasi. Tujuan penelitian ini untuk melihat perbedaan kadar platelet activating factor plasma penderita demam berdarah dengue dengan demam dengue. Penelitian observasional dengan rancangan potong lintang dilakukan pada Januari–Februari 2013. Subjek penelitian adalah penderita dengue usia 1–14 tahun yang dirawat di Rumah Sakit Dr. Hasan Sadikin Bandung, RSUD Kota Bandung (Ujungberung), dan RSUD Kota Cimahi (Cibabat). Diagnosis dengue dikonfirmasi dengan pemeriksaan antigen nonstruktural-1 dan atau pemeriksaan serologis imunoglobulin M dan G. Sampel darah fase demam, kritis dan pemulihan diambil untuk pemeriksaan kadar platelet activating factor plasma menggunakan metode enzymelinked immunosorbent assay. Selama kurun waktu penelitian didapat 26 penderita dengue, terdiri atas 14 kasus demam dengue dan 12 demam berdarah dengue. Kadar platelet activating factor plasma pada fase kritis penderita demam berdarah dengue [541,45 (239,30–2.449,00)] pg/mL lebih tinggi secara bermakna dibandingkan dengan penderita demam dengue [289,55 (149,50–961,50)] pg/mL; p=0,007. Simpulan, kadar platelet activating factor plasma pada fase kritis penderita demam berdarah dengue lebih tinggi daripada penderita demam dengue. [MKB. 2013;45(4):251–6]Kata kunci: Demam berdarah dengue, demam dengue, platelet activating factor The Difference of Platelet Activating Factor Plasma Level between Dengue Hemorrhagic Fever and Dengue Fever patientsDengue virus infection can manifest as dengue fever and, more severely, as dengue hemorrhagic fever. Their pathogenesis until now is not fully understood. One of the most favorable theories stated the presence of increasing titer of pro-inflammatory mediator in severe dengue. The aim of this study was to determine the difference of plasma platelet activating factor titer between dengue hemorrhagic fever and dengue fever patients. This observational study with cross sectional design was conducted during January–February 2013. Subjects were dengue patients, 1 to 14 years old, hospitalized at Dr. Hasan Sadikin General Hospital, Bandung District Hospital (Ujungberung), and Cimahi District Hospital (Cibabat). Dengue cases were confirmed based on nonstructural-1 antigen and/or immunoglobulin M and G rapid test. Blood samples from febrile, critical and recovery phase were drawn for the examination of platelet activating factor titer using the enzyme-linked immunosorbent assay method. There were 26 dengue cases (14 as dengue fever and 12 as dengue hemorrhagic fever). Plasma platelet activating factor titer at the critical phase was significantly higher in dengue hemorrhagic fever patients [541.45 (239.30–2,449.00)] pg/mL compared to dengue fever patients [289.55 (149.50–961.50)] pg/mL; p=0.007. In conclusion, plasma platelet activating factor titer at the critical phase is higher in dengue hemorrhagic fever patients than in dengue fever patients. [MKB. 2013;45(4):251–6]Key words: Dengue hemorrhagic fever, dengue fever, platelet activating factor DOI: http://dx.doi.org/10.15395/mkb.v45n4.172

IL-12 PE, CD 69 PERCP, CD3 FITC, AND CD4 APC OPTIMIZATION WITH ACTIVATION OF ISOLATED AGENT HEAT-KILLED SONICATED MYCOBACTERIUM TUBERCULOSIS BEIJING STRAIN

Proceedings of The Annual International Conference, Syiah Kuala University - Life Sciences & Engineering Chapter Vol 4, No 2 (2014): Life Sciences
Publisher : Syiah Kuala University

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Abstract

Infection caused by Mycobaterium tuberculosis exists in form of intracellular infection, which leads to lymphocyte activation. CD69 is the first lymphocyte activation marker expressed in Th1 lymphocyte, which follows by IL-12 release. Flow cytometry analysis can identify the subpopulations of lymphocytes and  intracellular cytokines such as IL-12, yet precise preparation needs to be done. This research aims to conduct optimization with four color lyse/wash flow cytometry assay system FastImmune™ FACSCalibur examination, with monoclonal antibody IL-12, CD69, CD3, and CD4 in succession uses fluorochrome PE, PerCP, FITC, and APC.To activate the lymphocytes from heparinized whole blood, we used activation agent which derives from isolated heat-killed sonicated Mycobacterium tuberculosis Beijing strain. Optimal concentration from the according activation agents is 40 mL. To determine the compensation, BDTM CompBead and blank-cell unstainning are used, but the maximum result showed by blank-cell unstainning.Each monoclonal antibody dosage of IL-12PE, CD69 PerCP, and CD3 FITC is 40 mL, while CD4 APC 5 mL. Total event lymphocyte is determined minimally by 10,000 events. With 18,510 total events and Th gated events quantity are 4,692, the result obtained is IL12-PE has 7.4% gated (347 events); CD69+ perCP/CD3+ FITC 18.2% (850 events); and CD69+ perCP/CD4+ APC 3.9%.

Pola Antibodi Antinuklear Sebagai Faktor Risiko Keterlibatan Sistem Hematologi Lupus Eritematosus Sistemik pada Anak

Majalah Kedokteran Bandung Vol 47, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Lupus eritematosus sistemik (LES) adalah penyakit autoimun kronik yang melibatkan berbagai sistem organ ditandai dengan produksi berbagai autoantibodi. Penyakit ini memiliki manifestasi klinis yang sangat bervariasi. Antibodi antinuklear diketahui memiliki pola-pola tertentu yang diduga berkorelasi dengan keterlibatan sistem organ tertentu pada LES. Penelitian ini dilakukan untuk melihat hubungan pola antibodi antinuklear (ANA) dengan  keterlibatan berbagai sistem organ pada anak yang menderita LES. Studi potong lintang dilakukan terhadap 93 anak dengan diagnosis LES yang datang ke Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Padjajaran/Rumah Sakit Dr. Hasan Sadikin Bandung, pada periode September 2006–April 2015. Analisis data dilakukan dengan uji chi kuadrat dan uji-t. Subjek terdiri atas 85 (91%) perempuan dan 8 (9%) laki-laki, dengan rasio perempuan:laki-laki adalah 10,6:1. Usia rata-rata adalah 10,5±3 tahun dan rentang usia 2–17 tahun. Pola ANA terbanyak adalah speckled (58%) dan homogen (19%). Subjek dengan pola ANA homogen lebih berisiko mengalami keterlibatan hematologi yaitu anemia (OR 4,8; IK 95%: 1,1–19) dan leukopenia (OR 3,9; IK 95%: 2,0–7,5) dibanding subjek dengan pola ANA bukan homogen. Tidak didapatkan hubungan pola ANA dengan keterlibatan sistem organ lain. Titer antidsDNA pada subjek dengan pola ANA homogen lebih tinggi dibanding subjek dengan pola ANA bukan homogen (p=0,02). Simpulan, subyek dengan pola ANA homogen memiliki risiko lebih besar mengalami keterlibatan hematologi dibanding dengan pola ANA yang lain. [MKB. 2015;47(2):124–28]Kata kunci: Keterlibatan sistem organ, lupus eritematosus sistemik, pola antibodi antinuklear (ANA)Antinuclear Antibody Pattern as a Risk Factor in Hematological System Involvement in Pediatric Systemic Lupus ErythematosusAbstractSystemic lupus erythematosus (SLE) is a chronic autoimmune disease that can involve any organ system with the evidence of autoantibody production. The disease has a wide range of clinical manifestation. Antinuclear antibody is known to have particular staining patterns and suspected have a correlation with multiorgan involvement. The objective of this study was to define  antinuclear antibody (ANA) staining pattern correlation from multiorgan involvement in 93 children with SLE. This was a cross-sectional study conducted at the Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung during the period of September 2006 to April 2015. Data were analyzed using chi-square test and t-test. This study involved 93 children with SLE, consisted of 85 (91%) females and 8 (9%) males, with a ratio of 10.6:1. Mean age was 10.5±3 years with age range of 2 to 17 years. The most frequent ANA staining patterns were speckled (58%) and homogenous (19%). Subjects with homogenous pattern have a higher hematology involvement risk, which are anemia (OR: 4.8, CI 95%, 1.1–19) and leukocytopenia (OR 3.9, 95% CI 2.0–7.5). Subjects with homogenous ANA pattern had a higher titer of anti-dsDNA than those with other patterns (p=0.02). In conclusion, subjects with homogenous pattern have a higher hematology involvement risk. [MKB. 2015;47(2):124–28]Key words: Antinuclear antibody staining pattern, multisystem organ involvement, systemic lupus erythematosus  DOI: 10.15395/mkb.v47n2.571

Infeksi Gigi Sebagai Faktor Pencetus Terbanyak Henoch-Schonlein Purpura dengan Keterlibatan Ginjal

Sari Pediatri Vol 14, No 6 (2013)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

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Abstract

Latar belakang.Henoch Schonlein purpura (HSP) dengan keterlibatan ginjal memiliki prognosis yang lebih buruk, dan infeksi gigi merupakan faktor risiko terbanyak terjadinya HSP dengan keterlibatan ginjal. Tujuan.Menganalisis hubungan antara riwayat infeksi gigi dan terjadinya HSP dengan keterlibatan ginjal pada anak.Metode.Penelitian retrospektif dengan rancangan potong lintang terhadap 146 anak yang didiagnosis HSP berdasarkan kriteria American College of Rheumatology(ACR) sertaEuropean League Against Rheumatism(EULAR), Pediatric Rheumatology International Trials Organization(PRINTO), dan Pediatric Rheumatology European Society(PRESS). Penelitian dilakukan di Divisi Alergi-imunologi Departemen Ilmu Kesehatan Anak Rumah Sakit Hasan Sadikin Bandung, periode Januari 2006− Desember 2012. Data pasien diambil dari rekam medis dan dianalisis menggunakan uji Chi square.Hasil.Didapatkan 146 anak dengan HSP, 93(63,7%) laki-laki dan 53(36,3%) perempuan dengan rasio 1,8:1. Rerata usia pasien 8,05±2,9 tahun. Sembilan puluh dua pasien (63%) diduga mengalami infeksi sebagai pencetus terjadinya HSP. Didapatkan 41 pasien HSP dengan keterlibatan ginjal (28%), yaitu proteinuria 6 (14,6%), hematuria 9 (22,0%), serta proteinuria dan hematuria 26 (63,4%) Infeksi gigi merupakan faktor pencetus terbanyak dibandingkan dengan faktor pencetus lainnya pada HSP dengan keterlibatan ginjal, yaitu 25 pasien (61%) dengan p=0,025; Odd ratio(OR) 2,7 (1,1–6,4) dengan interval kepercayaan 95%.Kesimpulan. Anak dengan riwayat infeksi gigi memiliki risiko tinggi untuk terjadi HSP dengan keterlibatan ginjal.