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INDONESIA
Indonesian Journal of Rheumatology
ISSN : 20861435     EISSN : 25811142     DOI : -
Indonesian Journal of Rheumatology is a peer-reviewed open access journal on rheumatic diseases and connective tissue disorders. This is an official journal of Indonesian Rheumatology Associantion (IRA) and published twice a year since 2009. Our mission is to encourage the development of scientific and medical practice in rheumatic diseases and connective tissue disorders. This journal is self-focused on rheumatic disease and connective tissue disorders in the form of original article (extended and/or concise reports), review articles, editorial letters, leaders, lesson from memorable cases, book reviews, and matter arising. Both in clinical and laboratory including animal studies.
Articles 183 Documents
Risk factors for the development of knee osteoarthritis Kasjmir, Yoga I; Nasution, A R; Daud, Rizasyah
Indonesian Journal of Rheumatology Vol 1, No 1 (2009)
Publisher : Indonesian Rheumatology Association

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Abstract

Objective. This article presents case control study conducted at the Rheumatology Outpatient Unit, Department of Internal Medicine, Cipto Mangunkusumo Hospital. The aim of this study was to determine several risk factors for the development of knee osteoarthritis (OA) at Rheumatology out-patient unit Department of InternalMedicine, Cipto Mangunkusumo Hospital.Method. This study used a case control design. Subjects were divided into two groups, case group and control group. The case group included all patients who had kneecomplaints that fulfi lled the 1990 American College of Radiology criteria while the control group included patients randomly chosen from visitors of the RheumatologyOutpatient Unit of Cipto Mangunkusumo Hospital who did not complain of knee pain and had been proven of not suffering OA by physical and radiological examinations. A similar questionnaire was designed for both groups. After filling out the questionnaire, both groups were examined physically and radiologically. The risk factors were analyzed using logistic regression.Results. We included 127 patients in the case group and 102 in the control group. In the case group, there were 95 women (74.80 %) and 32 men (25.20%) while the control group consisted of 69 women (67.65%) and 33 men (32.35%). From the analysis of several risk factors, there were signifi cant differences between the case and control groups such as weight (p < 0.0001 df 3), prior history of overweight or obesity (x2 = 21.255, df 1, p < 0.0001), knee trauma (p = 0.0002), and kneel down activity (p < 0.0001). There was also a signifi cant difference of smoking habit between the case group and the control group (p < 0.0001). Duration of smoking cessation was also signifi cantly different between the case group and controlgroup (t = 2.315, df 45, p = 0.0252). From the multivariate analysis, it was found that age, kneel down activity, prior obesity condition, interval between knee trauma and onset of OA, smoking habit, and duration of smoking cessation had a signifi cant correlation with knee OA.Conclusion. Age, prior history of overweight or obesity, kneeling, and interval between knee trauma and onset of OA were risk factors of knee OA. Smoking was a negative risk factor for knee OA. The protective effect of smoking was infl uenced by the duration of smoking habit and the duration of smoking cessation.
Pathogenesis of atherosclerosis in rheumatoid arthritis Pambudi, Joko Rilo; Isbagio, Harry
Indonesian Journal of Rheumatology Vol 5, No 1 (2014)
Publisher : Indonesian Rheumatology Association

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Abstract

Increased morbidity and mortality in patients with rheumatoid arthritis (RA) is largely associated with cardiovascular disease. In this case, the factors that play a role is chronic inflammation. A chronic inflammatory associated with condition which accelerate atherosclerosis and increased cardiovascular morbidity and mortality. Inflammatory and atherogenic mediators have a role in pathogenesis of RA and atherosclerosis. Atherogenesis in RA start when cytokines from the inflamed synovial tissue are released into the systemic circulation. Circulating cytokines affects the function of other tissues such as adipose tissue, skeletal muscle, liver and vascular endothelium that would lead to proatherogenic transformation process such as insulin resistance, prothrombotic effects, pro-oxidative stress and endothelial dysfunction. Size, weight and durationof systemic inflammatory response in RA are the most important factor causing damage. IMT (Intima Media Thickness) measurement on common carotid arteries byB-mode ultrasound is a rapid non-invasive examination of the structural anatomy, reproducible and relatively low risks that are advantageous for assessing therisk of cardiovascular disease and monitoring disease progression.
Reliability and validity of European Quality of Life 5 Dimension (EQ-5D) for measuring health-related quality of life in knee osteoarthritis patients at Cipto Mangunkusumo General Hospital Pramono, A; Sumariyono, Sumariyono; Isbagio, Harry
Indonesian Journal of Rheumatology Vol 2, No 3 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: Quality of life is very important to knee osteoarthritis (OA) patients. The term quality of life denotes one that is health-related. One of the questionnaires most frequently used to measure the quality of life is the European Quality of Life 5-Dimension (EQ-5D) questionnaire. At Cipto Mangunkusumo General Hospital, until today there has not been any instrument for measuring the health-related quality of life in knee OA patients that has been tested for its reliability and validity.Objective: To prove the reliability and validity of EQ-5D as a measurement tool in  determining the healthrelated quality of life in knee OA patients at Cipto Mangunkusumo General Hospital.Methods: This is a validity study in which all patients were asked to complete both the EQ-5D form and 36- item short form (SF-36) on their fi rst visit. They were subsequently asked again to complete only the EQ-5Dform one week after their fi rst visit.Results: Data were obtained from 86 respondents.The value of the intraclass correlation coeffi cient of each EQ-5D dimension, EQ-5D index, and visual analogue scale (VAS) was excellent (>0.75). Cronbach’s α value for internal consistency reliability in this study was0.6772 (<0.7). The external validity of EQ-5D compared to SF-36 was analyzed with the Pearson’s correlation test and revealed a signifi cant correlation (p<0.01) of all EQ-5D dimensions, EQ-5D index, and EQ-5D VAS with total score of SF-36 except for the dimensions of self-care, pain, and anxiety/depression. The construct validity of EQ-5D showed that all of the dimensions were signifi cantly correlated with the EQ-5D index (p<0.01) except for self-care dimension.Conclusion: EQ-5D is a valid and reliable measurement tool. It is thus recommended for measuring the healthrelated quality of life in knee OA patients at CiptoMangunkusumo General Hospital.
Multiple autoimmune syndrome (Graves’ disease, systemic lupus erythematosus, and systemic sclerosis) in a young woman in Jakarta Dewi, Sumartini; Setiyohadi, Bambang; Mokoagow, M I
Indonesian Journal of Rheumatology Vol 2, No 2 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Multiple autoimmune syndrome (MAS) is a condition in which patients have at least threedistinct autoimmune conditions. The definition of MAS is based on 91 reported cases of such associations in the literature. A review of the literature and cluster analysis of MAS disclosed systemic lupus erythematosus (SLE), Sjögren’s syndrome, and autoimmune thyroid disease (AITD) as the “chaperones” of autoimmune diseases. This entity was described by Humbert and Dupond in 1988 as a syndrome consisting of the presenceof three or more autoimmune diseases in a single patient. While describing the syndrome, their observations led them to a rough classification of clusters based on the co-occurrence of autoimmune disease, which they identified as types one through three.1 In MAS-1, the authors grouped myasthenia gravis, thymoma, dermatopolymyositis, and autoimmune myocarditis together. In MAS-2, they grouped Sjögren’s syndrome, rheumatoid arthritis,primary biliary cirrhosis, systemic sclerosis (SSc), and AITD. MAS-3 consists of AITD, myasthenia gravis and/or thymoma, Sjögren’s syndrome, pernicious anemia, idiopathic thrombocytopenic purpura, Addison’s disese, type 1 diabetes, vitiligo, autoimmune hemolytic anemia, and SLE.1,2,3 The importance of this concept is the probability thathaving three autoimmune diseases simultaneously in one patient goes beyond epidemiological inferences or statistical chance. Disorders of autoimmune pathogenesis occur with increased frequency in patients with a history of another autoimmune disease. The tendency to develop another disease occurs in about 25% of these patients.3,4 We report a case in which the presence of Graves’ disease/AITD, SLE, vasculitis, and SSc with pulmonary hypertension and Raynaud’s phenomenon in one patient
Correlation Between Serum Procollagen Type 1 N-Terminal Propeptide Level With Modified Rodnan Skin Score In Systemic Sclerosis Patients. Vincent, Vincent; Dewi, Sumartini; Wachjudi, Rachmat Gunadi
Indonesian Journal of Rheumatology Vol 9, No 2 (2017)
Publisher : Indonesian Rheumatology Association

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Abstract

Introduction: Systemic Sclerosis (SSc) is a chronic autoimmune disease, characterized by vasculopathy, specific autoimmune, and fibrosis. Assesment of skin fibrosis by modified Rodnan Skin Score (mRSS) can not detect the minimal changes of skin fibrosis within lessthan 3 months. A biomarker is needed to assess the minimal changes of skin fibrosis progressivity with a more objective, quantitative, and rapid way. Procollagen type-1 N-Terminal Propeptide (P1NP), a degradation product of collagen type-1, may become a potential biomarker for skin fibrosis. This study aims to evaluate the correlation between skin fibrosis by mRSS with P1NP serum in systemic sclerosis.Methods: This was a cross-sectional study performed among systemic sclerosis patients at Rheumatology outpatient clinic, Dr.Hasan Sadikin Hospital Bandung, from May 2016 to July 2016. Skin fibrosis was measured by mRSS. P1NP level was determined by ELISA. Data were analyzed using Rank-Spearman Correlation.Result: There were thirty-seven subjects, with mean age 37 (SD ±7) years old. Most of subjects were female (91.9%). Subjects consisted of 23 (62.2%) limited SSc and 14 (37.8%) diffuse SSc. Six subjects (16.2%) were DMARD naïve. We found median (range) P1NP serum was 43.85 (9.81-127.90) ng/dL, while the median of MRSS was 14 (3-36). There is a moderate correlation between MRSS and P1NP serum (r=0.443, p=0.003)Conclusion: There was a significant correlation between mRSS and P1NP serum in systemic sclerosis patient at Dr. Hasan Sadikin Hospital Bandung.Keywords: systemic sclerosis, P1NP, modified rodnan skin score
Validity and reliability fatigue severity scale in patients with Systemic Lupus Erythematosus (SLE) in Indonesia Rifa’i, A; Kalim, Handono; Handono, Kusworini; Wahono, Cesarius Singgih
Indonesian Journal of Rheumatology Vol 8, No 1 (2016)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: Fatigue is one symptom of Systemic Lupus Erythematosus (SLE), which has an important effect on the quality of life. Fatigue Severity Scale (FSS)is one parameter fatigue symptom in SLE. The purpose of this study was to determine the validity and reliabilitybetween FSS with duration of ilness and disease activity of SLE patients in Indonesia.Methods: FSS performed on 40 patients with SLE. FSS original English version has been converted-translated into Indonesian version by a team of RheumatologyImmunology Medical Faculty of Brawijaya University. Reliability determined by Cronbach’s Alpha values (>0.6). Validity was determined by the value of Corrected Item-Total Correlation which each item was a valid question if below value of Cronbach’s Alpha.Results: The reliability value was determined by Cronbach’s Alpha values (>0.6) in which the SLE patients in this study had a Cronbach’s Alpha value of 0.946. Value of Corrected Item-Total Correlation overall under Cronbach’s Alpha value (range = 0.684-0.859) which indicates that each item was a valid question. There were correlation between the FSS Indonesian version with disease duration (p = 0.000) as well as the value of r = 0.581, with SLEDAI (p = 0.000) with a value of r = 0.833. Conclusion: FSS in Indonesian version has a good reliability and validity and can be used by clinicians andother researchers to assess the condition of fatigue in SLE patients in Indonesia.Keywords: validity, reliability, fatigue, fatigue severity scale, systemic lupus erythematosus
Calcinosis and myocarditis in systemic lupus erythematosus patient Dewi, Sumartini; Wachjudi, Rachmat Gunadi
Indonesian Journal of Rheumatology Vol 2, No 1 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Systemic lupus erythematosus (SLE) patients have multi-organ involvement related to their chronic inflammatory, autoimmune disease. Calcinosis can be clinical manifestations of SLE. Tissue calcinosis is reported in approximately 17% patients and myocarditis in 20-55% patients. Thus, both manifestations are not unusual in SLE. Tachypnea, tachycardia, pericardial effusion, and wheezing are often present and can be misleading in SLE patient.1,2 Calcinosis is less common in SLE, sometimesit is found as an incidental radiological finding. Calcification in SLE maybe periarticular, within joints or muscles, or in the subcutis (calcinosis universalis).1 Calcinosis is classified into four subsets: dystrophic, metastatic, idiopathic, or calciphylaxis/iatrogenic. When calcinosis cutis is isolated to a small area in extremities and joints, it is called calcinosis circumscripta; whereas its diffuse form, refers to calcinosis universalis, affects subcutaneous and fibrous structures of muscles and tendons. The pathophysiology of this condition is unknown and no effective therapy is currently available.3,4,5 Systemic lupus erythematosus can involve the myocardium, pericardium, cardiac valves,and coronary arteries. Myocarditis in SLE is not likely to produce major regional wall motion abnormalities but may contribute to global left ventricular dysfunction.7,8We report a young woman with SLE who developed calcinosis and myocarditis.
Validity And Reliability Of Lupus Quality Of Life Questionnaire In Patients With Systemic Lupus Erythematosus In Indonesia Anindito, Bagus; Hidayat, Rudy; Koesnoe, Sukamto; Dewiasty, Esthika
Indonesian Journal of Rheumatology Vol 8, No 2 (2016)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: The development of Systemic Lupus Erythematosus (SLE) treatment has led the increased of patients survival. Quality of life has became a value based medicine component that should be evaluated in treating SLE. One standardized questionnaire to asses the quality of life in SLE patients is Lupus Quality of Life (Lupus QoL). Currently, in Indonesia, there has not been any spesific questionnaire to asses the quality of life in SLE patients. This study aims to prove that Lupus QoL is valid and reliable to asses the quality of life in SLEpatients in Indonesia.Methods: This study used cross sectional study method. Firstly, we translated the Lupus QoL into Indonesian language, then we tested to 10 respondents. Then, we continued the study with larger sample size. We analyzed the reliability of the test and the re-test result using the interclass coefficient correlation and the internal consistency of the tests using cronbach alpha. Construct validity was evaluated using multi trait scaling analysis and the extrenal validity was evaluated using correlation between domains in short form 36 (SF 36)with Lupus QoL and with disease activity.Results: Data collection was done to 65 SLE patients between October – November 2015 in RSCM. The test has good external validity SF 36 (r=0.38-0.66, p<0.05) and good construct validity (r >0.4; range: 0.44-0.93). The ICC value in one week >0.7 and Cronbach α was>0.7 in each domain. The correlation between lupus QoL and the disease activity was weak and consistentwith other studies.Conclusion: Lupus QoL questionnaire is valid and reliable to asses the quality of life in SLE patients inIndonesia.Key words: Quality of Life, Systemic Lupus Erythematosus, Lupus QoL, Validity, Reliability
Clinical Manifestation and Laboratory Finding of Sclerosis Systemic Patient in Dr. Hasan Sadikin General Hospital Bandung : A Descriptive Quantitative Study Budiman, Annisa Meivira; Dewi, Sumartini; Prananta, Marietta Shanti
Indonesian Journal of Rheumatology Vol 10, No 1 (2018)
Publisher : Indonesian Rheumatology Association

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Abstract

Background Systemic sclerosis is a chronic progressive multisystem autoimmune disease in connective tissue, characterized by its heterogeneous clinical manifestation. The purpose of this study is to give information regarding clinical manifestations and laboratory findings of systemic sclerosis patients to establish diagnosis of disease. Methods This study was conducted using descriptive quantitative design in September−October 2016. Data was collected from medical records of patients visiting Rheumatology Clinic Dr. Hasan Sadikin General Hospital from 1 July 2015−30 June 2016 using total sampling method. The collected data were expected to comprise patient’s clinical manifestation and laboratory finding. Results Most of patients had cutaneous 57 (100.0%) and musculoskeletal 40 (70.2%) involvement. Some of the disease manifestations were Raynaud’s phenomenon 38 (66.7%), fingertip lesion 33 (57.9%), stiffness in skin 34 (59.6%), and arthalgia 29 (50.9%). Gastrointestinal involvements were present in 29 (50.9%) patients. Renal involvement were determined from urinalysis result showed proteinuria 10 (17.5%) and hematuria 8 (14.0%), found in 24 (42.1%) patients, while pulmonary and cardiac involvements were found in 30 (52.6%) patients, acknowledged from clinical symptoms such as dyspnea 12 (21.1%). Identification of autoantibodies was found in 12 (21.1%) patients, with 10 (17.5%) patients had reactive ANA and 3 (3.5%) had positive anti-Scl70. Conclusion Most of systemic sclerosis patients had cutaneous involvement. Renal, pulmonary, and cardiac involvement were concluded based on laboratory findings. Keywords: Systemic sclerosis, clinical manifestation, laboratory finding
Tophi which develop years before the first attack of acute gouty arthritis Hidayat, Rudy; Kasjmir, Yoga I
Indonesian Journal of Rheumatology Vol 1, No 1 (2009)
Publisher : Indonesian Rheumatology Association

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Abstract

Gout is a clinical disease associated with hyperuricemia and caused by the deposition ofmonosodium urate crystals in and around the tissue of joints. The course of classic gout passes through three distinct stages: asymptomatic hyperuricemia, acute intermittent gout, and advanced gout/chronic tophaceous gout.1,2 Tophi; described as accumulation of articular, osseus, soft tissue, and cartilaginous crystalline deposits; is one of clinical manifestation of chronic tophaceous gout stage, and usually developedafter 10 or more years of acute intermittent gout.1,2 Although patients have been reported with tophias their initial clinical manifestation

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