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"Background: Cognitive dysfunction was found in 55-80% Neuropsychiatry Systemic Lupus Erythematosus (NPSLE) patients. Serious concern from clinicans was needed as its impact to patient’s quality of life. Disease activity is expected to be affecting patient’s cognitive function. Previous studies regarding correlation between disease activity and cognitive dysfunction showed various results. This study aimed to evaluate the correlation between disease activity and cognitive function in SLE patients. Methods: This study is an analytical cross-sectional study. Subjects were SLE patients at the rheumatology clinic of Dr. Hasan Sadikin Hospital Bandung during June-August 2017. Subject’s evaluations included disease activity assessment using SLE disease activity index-2K (SLEDAI-2K) and cognitive function assessment using MoCA-Ina test. Data were analyzed by using Spearman Rank correlation test. Results: Mean age of the subjects was 31 ± 8 years old, most of them were senior high school graduates (65.8 %) and median length of study was 12 years. Subject’s median duration of illness was 44 months. Their MoCA-Ina median score was 25, while SLEDAI-2K median score was 6. Cognitive dysfunctions were found in more than half of subjects (52.63%), which memory domain (78.95%) was most frequently impaired. Most of subjects were patients with active SLE (63.2%). Correlation test showed there was no correlation between SLEDAI-2K score and MoCA-Ina score (rs=0.023, p=0.445). Conclusion: There was no correlation between disease activity (SLEDAI-2K score) and cognitive function (MoCA-Ina score)."

"Background. Systemic Lupus Erythematosus (SLE) is an Autoimmune inflammatory disease that is systemic and chronic inflammation with heterogeneous of history, clinical manifestations, and prognosis. The disease activity of SLE has been proven as a predictor of organ damage and death by evidenced of inflammatory markers involved in this disease. Neutrophil to Lymphocyte Ratio (NLR) is useful for estimating the activity of autoimmune disease and inflammation that easily obtained from blood test and low cost and measurable as new biomarker to assess inflammatory response or activity of SLE. This study aimed to determine the relationship between NRL and Disease Activity based on Mex-SLEDAI in patients SLE. Methods. This study is an analytic study with cross sectional design. It started from November 2016 until March 2017. Mex-SLEDAI and blood sampling used in this study. Result. Total sample in this study is 54 patients with median age was 28.5 years, with mostly female (85,2%). Result analysis with positive correlation between NLR with disease activity on SLE (r=0.399 p=0.003 n=54), thus the Scatter plot shows there is a correlation between NRL with Mex-SLEDAI. Conclusion. Positive correlation between NLR and disease activity of the SLE, the higher of the disease activity/Mex-SLEDAI will be followed by the increase of NLR."

"Background. Antibody to complement C1q (Anti-C1q Antibody) can be found in Systemic Lupus Erythematosus (SLE) patients. Complement C1q plays a role in the clearance of apoptotic cells and immune complexes. Anti-C1q causes complement C1q become inactive so that the clearance decreases, which induces self antigen and inflammatory response. Many tissue inflammation are associated with disease activity and lupus manifestations. The aim of this study is to find out the correlation of anti-C1q level with disease activity, so that anti-C1q can be used as an objective indicator of inflammation along with SELENA-SLEDAI. Method. This is an analytic descriptive study with cross sectional design. Anti-C1q antibody levels were measured in 52 SLE patients who are hospitalized or treated routinely in outpatient clinic of Rheumatology Dr.Hasan Sadikin Hospital Bandung Indonesia from October to December 2015. Result. Most of the study subjects were women (94%), with a median age of 33 years. There were 13 new patients (25%), and the rest 42 patients were treated routinely. The median SELENA-SLEDAI was 6 (0-32). Subject were divided into no activity (11.5%), low disease activity (34.6%), medium disease activity (25%) high disease activity (15.4%) and very high disease activity (13.5%). Median anti-C1q level was 3.92 U/mL (range 0.6-100.2 U/mL). Anti-C1q antibody levels were positively correlated with SLE disease activity based on SELENA-SLEDAI scores (r=+0.304; p=0.014) Conclusion. Anti-C1q antibody levels has mild correlated with lupus disease activity based on SELENA-SLEDAI score"

"Latar Belakang: Lupus Eritematosus Sistemik (LES) merupakan penyakit autoimundengan penyebab multifaktorial. Ketidakseimbangan sitokin Th17 (Interleukin-17; IL-17) dan T-regulator (Transforming Growth Factor-; TGF- and Interleukin-10; IL-10)diduga terlibat dalam patogenesis LES yang mempengaruhi aktivitas penyakit.Tujuan: Penelitian dilakukan untuk menguji perbedaan rerata IL-17, TGF- dan IL-10dengan aktivitas penyakit LES dan menguji korelasi sitokin Th17/T-regulator.Metode: Penelitian ini merupakan studi potong lintang melibatkan 68 pasien LESberdasarkan kriteria inklusi MEX-SLEDAI <2 untuk LES inaktif dan >=2 untuk LESaktif. Kriteria eksklusi adalah pasien LES dengan riwayat autoimun lain, inflamasikronik; infeksi akut secara klinis; serta asma bronkial, dermatitis atopi dan urtikariadidasarkan pada catatan rekam medis. Serum IL-17, TGF-, IL-10 diperiksa denganmetode ELISA. Data dianalisis dengan perangkat lunak SPSS 20 menggunakan uji-Tindependen untuk data berdistribusi normal dan uji Mann-Whitney untuk data tidaknormal.Hasil: Rerata IL-17 serum adalah 19,67 (1,299) pg/ml. Median TGF- dan IL-10 adalah175,02 (132-396) pg/ml dan 2,96 (0-11) pg/ml. Tidak terdapat perbedaan rerata yangsignifikan dari kadar IL-17, TGF- dan IL-10 serum pasien LES aktif dan tidak aktif.Didapatkan korelasi positif sedang yang signifikan antara IL-17 dan IL-10 (p<0,005;r=0,529) dan korelasi yang tidak signifikan antara IL-17 dan TGF- (p>0,005; r=-0,142).Simpulan: Tidak didapatkan perbedaan rerata yang signifikan sitokin Th17/Treg pasienLES aktif dan inaktif. Terdapat korelasi positif signifikan sedang antara IL-17 dan IL-10, sementara tidak terdapat korelasi signifikan antara IL-17 dan TGF-. Penelitianlanjutan dengan disain kohort prospektif diperlukan untuk mengkonfirmasi peransitokin jalur Th17/Treg ini pada pasien LES aktif dan inaktif.

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"Latar Belakang: Lupus Eritematosus Sistemik LES adalah suatu penyakit autoimun kronik yang melibatkan multiorgan dan multietiologi. Komplikasi kardiovaskular pada pasien LES merupakan salah satu penyebab morbiditas dan mortalitas terbesar. Proses aterosklerosis diketahui terjadi pada pasien LES usia muda dan menjadi salah satu faktor penyebab disfungsi diastolik. Penegakkan diagnosis disfungsi diastolik memerlukan pemeriksaan yang cukup mahal dan tidak merata di setiap fasilitas kesehatan. Oleh karena itu, diperlukan suatu metode diagnostik yang lebih mudah dan murah tetapi tetap dapat diandalkan untuk penegakkan diagnostik tersebut, seperti metode sistem skoring. Umur, lama sakit, komorbiditas hipertensi dan atau diabetes mellitus dan atau dislipidemia , anemia, Index Massa Tubuh IMT , kadar serum kreatinin, dan APS diketahui berhubungan dengan disfungsi diastolik dan dapat menjadi determinan diagnosis disfungsi diastolik pada pasien LES. Tujuan: Menetapkan sistem skoring diagnosis disfungsi diastolik pasien LES berdasarkan determinan umur, lama sakit, komorbiditas, anemia, IMT, kadar serum kreatinin, dan APS. Metode: Penelitian uji diagnostik potong-lintang cross sectional terhadap 127 pasien LES di RSCM sejak bulan April 2017 sampai Mei 2017. Data yang digunakan adalah data primer berupa wawancara, pemeriksaan fisik, dan pemeriksaan ekokardiografi transtorakal, serta data sekunder yang diperoleh dari rekam medis. Hasil: Terdapat 9 7.08 subjek penelitian yang mengalami disfungsi diastolik. Lima dari tujuh determinan masuk dalam analisis multivariat. Setelah pemodelan, didapatkan APS dengan bobot skor 2 dan komorbiditas dengan bobot skor 1 yang selanjutnya menjadi bagian dari sistem skoring diagnosis disfungsi diastolik pasien LES. Sistem skoring ini kemudian di uji dengan kurva ROC dan didapatkan AUC sebesar 80.3 95 IK 62.7-97.8 dengan titik potong terbaik adalah lebih sama dengan 2. Skor ge;2 memiliki sensitifitas 44 , spesifisitas 94.9 , nilai prediksi positif 60 , dan nilai prediksi negatif 95.7 . Uji validasi interna dan eksterna menghasilkan nilai yang baik. Simpulan: Proporsi disfungsi diastolik pasien LES di RSCM adalah 7.08 . Determinan diagnosis disfungsi diastolik pasien LES adalah APS dan komorbiditas. Skor ge;2 merupakan titik potong terbaik untuk menentukan bahwa pasien LES mengalami disfungsi diastolik.

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Background : Systemic Lupus Erythematosus SLE is a chronic autoimmune disease involving multiorgan and multietiology. Cardiovascular complication in SLE patients is one of the highest causes of morbidity and mortality. It is known that premature atherosclerosis occurs in young SLE patients and related to diastolic dysfunction. The diagnostic of diastolic dysfunction requires a quite expensive and uneven examination at every health facilities. Therefore, it's necessary to have an accessible and inexpensive but reliable diagnostic method, such as a scoring system. Age, duration of pain, comorbidities hypertension and or diabetes mellitus and or dyslipidemia , anemia, Body Mass Index BMI , serum creatinine level, and APS are known to be associated with diastolic dysfunction and can be a determinant diagnostic of diastolic dysfunction in SLE patients.

Objective : Establish a diagnostic scoring system of diastolic dysfunction in SLE patients with determinants of age, duration of pain, comorbidities, BMI, serum creatinine level, and APS.

Methods : A cross sectional diagnostic study with 127 SLE patients in RSCM from April 2017 to May 2017. The data used are primary data such as interviews, physical examination, and transthoracic echocardiography, as well as secondary data was obtained from medical records.

Results : There were 9 7.08 subjects with diastolic dysfunction. Five from seven determinants can be used in multivariate analysis. After modeling, APS was obtained with score of 2 and comorbidities with score of 1, further it becomes a part of diagnostic scoring system of diastolic dysfunction in SLE patients. The scoring system was tested with ROC curve and obtained AUC of 80.3 95 IK 62.7 97.8 with the best cut off point was ge 2. A score of ge 2 had a sensitivity of 44 , specificity of 94.9 , positive predictive value of 60 , and negative predictive value of 95.7 . Internal and external validation test produce a good value.

Conclusions : The proportion of diastolic dysfunction in SLE patients in RSCM is 7.08 . Diagnostic determinants of diastolic dysfunction in SLE patients are APS and comorbidities. A score of ge 2 is the best cut off point for determining that SLE patients has a diastolic dysfunction."

"Seorang wanita usia 22 tahun datang dengan keluhan utama timbul bercak kemerahan dan rasa gatal pada wajah sejak 5 hari sebelum masuk rumah sakit. Keluhan lainnya adalah timbul bengkak pada kedua tungkai, nyeri tenggorokan, dan batuk. Pasien sedang dalam pengobatan untuk lupus eritematosus sistemik dan tuberkulosis paru (sejak 12 hari yang lalu). Pada pemeriksaan fisik, pasien kompos mentis, hemodinamik stabil, dengan edema anasarka, lesi multipel makulo purpura yang tersebar pada tubuhnya, konjungtivis pada kedua mata, lesi multipel ulserasi di rongga mulut, dan tampak eritema pada mukosa genitalia. Hasil laboratorium menunjukkan anemia, lekopenia, hipoalbuminemia, proteinuria. Kami mencurigai pasien ini menderita sindrom Stevens Johnson akibat obat antituberkulosis. Selama perawatan, kami menghentikan pemberian obat antituberkulosis, dan memberikan metilprednisolon parenteral, serta terapi suportif lainnya. Pasien diizinkan untuk rawat jalan setelah terjadi perbaikan klinis dan dapat mobilisasi sendiri.

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AbstractA 22-year-old woman was admitted to the hospital because of 5-days history of redness and itch on her face. Additional complains were swelling on her feet, sore throat, and cough. Patient was on treatment for systemic lupus erythematosus and pulmonary tuberculosis (since 12 days). On physical examination, patient was alert, stable hemodynamic, anasarca edema, multiple purpuric macules lesion spread on her body, conjunctivitis of both eyes, multiple oral ulcers, erythema on genital mucosa. Laboratory results were anemia, leucopenia, hypoalbuminemia, proteinuria. We suspected this patient as Stevens Johnson syndrome due to tuberculostatic drugs. During treatment, we stopped the tuberculostatic drugs, and gave her parenteral methylprednisolone, with other supportive treatments. The patient was discharge after improvement of clinical condition and capable of self mobilization."

"ABSTRAKLatar belakang: Lupus Eritematosus Sistemik LES merupakan penyakit autoimun pada anak yang mengakibatkan morbiditas dan mortalitas. Salah satu faktor risiko yang diduga berdampak terhadap morbiditas pasien LES yakni penggunaan kortikosteroid dalam waktu lama. Anak dan remaja dengan LES merupakan populasi dengan risiko lebih besar terhadap morbiditas muskuloskeletal, dalam hal ini rendahnya densitas mineral tulang dan osteoporosis.Tujuan: 1 Mengetahui gambaran densitas mineral tulang pada pasien LES anak dan remaja usia 5-18 tahun yang mendapatkan terapi glukokortikoid dan 2 Mengetahui gambaran karakteristik dosis kumulatif dan harian kortikosteroid, IMT, SLEDAI dan asupan kalsium dan vitamin D pada pasien LES anak, serta 3 Mengetahui gambaran parameter laboratorium yang menggambarkan metabolisme tulang seperti kadar kalsium, vitamin D, alkali fosfatase, fosfor dan kortisol pada pasien LES anak dengan terapi kortikosteroid.Metode: Penelitian ini merupakan penelitian potong lintang deskriptif dengan mengikutsertakan 16 pasien LES yang berobat di poliklinik anak RSCM selama November-Desember 2016 dengan diagnosis LES. Pengambilan data dilakukan dengan melihat data rekam medis, penilaian skor SLEDAI Systemic lupus erythematosus Disease Activity Index , asupan kalsium dan vitamin D, serta parameter laboratorium. Densitas mineral tulang diperiksa dengan Dual X-ray Absorbtiometry DEXA dengan melihat skor Z.Hasil: Densitas mineral tulang yang rendah skor-Z

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ABSTRACTBackground Systemic lupus erythematosus SLE is an autoimune disease affecting children with significant numbers of morbidity and mortality. One of risk factors for morbidity is chronic corticosteroid use. Child and adolescent with SLE are susceptible population for musculosceletal morbidity especially low bone mineral density and osteoporosis. Aim 1 To determine the occurence of low bone mineral density among children with SLE, 2 to describe the characteristics, incuding cumulative and daily doses of corticosteroid, body mass index, SLEDAI, and calcium and vitamin D intake among children with SLE, and 3 to describe bone metabolism laboratory paramaters including serum calcium, vitamin D, ALP, phosphorus, and cortisol among children with SLE receiving corticosteroid. Method A descriptive cross sectional study involving 16 children with SLE attending child and adolescent outpatient clinic Cipto Mangunkusumo Hospital during November December 2016. Data were recorded from patients rsquo medical records, scoring SLEDAI, performing laboratory examinations, and measuring calcium and vitamin D intakes. Bone mineral density was measured using DEXA and reported using Z score. Result Low bone mineral density accured among 7 16 patients. The mean total bone mineral density was 0,885 0,09 g cm2. Children with SLE receiving corticosteroid had low calcium 8,69 0,50 mg dL , vitamin D 19,3 5,4 mg dL , ALP 79,50 43,00 164,00 U L , morning cortisol level 1,20 0,0 10,21 ug dL , and calcium 587,58 213,29 mg d and vitamin D 2,9 0 31,8 mcg d intake. Patients with low bone mineral density tend to had higher cumulative doses of corticosteroid with longer treatment duration. Conclusion The occurence of low bone mineral density was observed among children with SLE receiving corticosteroid treatment. Low bone mineral density tend to occur among patients with higher cumulative doses and longer duration of corticosteroid treatment."

"Background: Systemic Lupus Erythematosus (SLE), an autoimmune disease, can cause damage and impairment in the nervous system. Patients who had any manifestation of neurology can be classified as patients with Neuropsychiatric Systemic Lupus Erythematosus (NPSLE). One of the most frequent NPSLE manifestation is anxiety disorder. The presence of anxiety disorder is believed to be correlated with their ability to carry out daily activities. This study aims to see the correlation between anxiety disorder and quality of life (QOL) in patients with SLE. Method: an analitic cross-sectional study was done. The data were collected by distributing validated questionnaires to patients diagnosed with SLE in the outpatient clinic of dr. Hasan Sadikin General Hospital. Quality of life and anxiety disorder was measured using Short From-36 (SF-36) and Zung Self-Rating Anxiety Scale (Zung-SAS), respectively. Normality test was done before correlating the variables using Pearson method. Result: Forty-six SLE patients fitted with the inclusion criteria were participated in the study. The assessment using Zung-SAS showed that 9 (19.56%) correspondents had mild–moderate anxiety, and 1 (2.17%) had severe anxiety. The analysis of SF-36 showed the means of Physical Component Summary (PCS) and Mental Component Summary (MCS) which were 45.18 ± 8.23 and 47.11± 9.78, in order. The correlation test of Zung-SAS with PCS and MCS showed the result of r= -0.651 (p < 0,01) and -0.654 (p < 0,01), respectively. Conclusion: There is a significant negative correlation between anxiety disorder and QOL in patients with SLE. The result of this study showed that the high degree of ones anxiety was in a parallel line with their low level of QOL, so it is important to do an early detection and prevention of anxiety disorder in SLE patients."

"Background : The aim of the study is to provide an insight about mean platelet volume (MPV) value in systemic lupus erythematosus (SLE) with and without thrombocytopenia patient. MPV wa expected to be used to determine the cause thrombocytopenia in lupus, so the patient could be treated appropriately. Method: The study design was descriptive categoric, and the data were obtained by using cross-sectional method from patient’s medical record and lab examination result in the period from January 1st 2016 – January 31st 2018. The sampling method are done using total sampling. The inclusion criteria of this study were SLE patients which MPV and platelet count had been examined at the same time, the data used is data that was first discovered in the period of the study. The exclusion criteria were incomplete medical record data, patient with thrombocytosis, and SLE with comorbidity such as thrombotic disease (ischemic stroke and deep vein thrombosis), other high inflammatory overlap diseases (such as rheumatoid arthritis and inflammatory bowel disease), and infection. Result : From 75 patients that match with the inclusion criteria, all patients were female and based on the age of diagnosis, most patients were in age group of 25-34 years old (41,33%). Based on the lab results, group with normal platelet count have 53 data of normal MPV and 12 data of high MPV, while group with thrombocytopenia have 6 data of normal MPV and 4 data of high MPV. Conclusion : Group with normal MPV value and normal platelet count has the largest proportion, while the group with thrombocytopenia in lupus and high MPV value has the lowest proportion."

"Latar Belakang: Anti dsDNA merupakan salah satu faktor risiko aterosklerosis yang berasal dari LES dan belum ada penelitian yang melihat hubungan antara kadar anti dsDNA dengan ketebalan tunika intima-media arteri karotis. Penelitian ini bertujuan untuk melihat korelasi antara anti dsDNA dengan ketebalan tunik intima-media arteri karotis. Metode: Penelitian ini adalah penelitian potong lintang, melibatkan 84 pasien LES dengan kriteria inklusi adalah pasie LES yang memenuhi kriteria diagnosis sesuai dengan ACR 1997 atau SLICC 2012, dan kriteria eksklusi adalah bila terdapat variasi anatomi pembuluh darah yang tidak dapat dilakukan pengukuran. Anti dsDNA diperiksa dengan menggunakan ELISA dan USG Doppler dilakukan pada pasien untuk mengukur ketebalan maksimal tunika intima media arteri karotis (max-IMT). Analisa statistik dilakukan dengan uji parametrik Pearson dan bila tidak memenuhi syarat dilakukan uji non parametrik Spearman. Hasil: Delapan empat responden (82 perempuan dan 2 laki-laki) dilakukan analisa. Rerata usia pasien 35,5±8,9 tahun dengan 64,3% berusia di bawah 40 tahun, median anti dsDNA 38,9 IU/L(0,9 ? 750 IU/L) dan Median max-IMT adalah 581 μm (385-1800 μm). Terdapat 43 (51,2 %) pasien dengan ketebalan pada tunika intima-media arteri karotis, 36 (42,9%) pasien dengan ketebalan saja, 6 (7,1%) pasien dengan ketebalan pada tunika intimamedia dan plak dan 1 (1,2%) pasien dengan plak di near wall bulbus kiri tanpa disertai dengan ketebalan pada tunika intima-media. Plak terutama ditemukan pada bulbus karotis kanan dan kiri. Berdasarkan uji korelasi speraman's tidak terdapat korelasi antara ati dsDNA dengan ketebalan maksimal tunika intima media arteri karotis. (r = 0,073, p= 0,520). Kesimpulan: Tidak terdapat korelasi antara anti dsDNA dengan ketebalan tunika intima-media arteri karotis pada pasien LES.

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Background: Anti dsDNA is considered as one of SLE-related risk factors for atherosclerosis. The evaluation of Carotid intimal-media thickness has recently became one of the surrogate markers for atherosclerosis. Until now, there hasn't been any study relate the level of anti dsDNA antibody with Carotid intimal-media thickness. This study is conducted to determine the correlation between anti dsDNA and Carotid intima-Media Thickness.

Methods: This is a cross sectional study, 84 SLE patients were included. Patients diagnosed as SLE according to ACR 1997 or SLICC 2012 criteria were included in the study, while SLE patients with anatomical variation which difficult to measured were excluded from this study. Doppler ultrasound was carried out for patients and max-IMT was measured. Anti dsDNA was measured with ELISA.

Study results: Eighty four subjects (82 female, 2 male) were included. Mean age was 35,5 ±8,9 years old, 64,3 % between 18-39 years old, median anti dsDNA level 38,9 IU/L (0,9 - 750 IU), and median max-IMT value was 581 μm. There were 43 (51,2 %) patients Carotid intima-media thickness, 36 (42,9%) patients with increased IMT only, 6 (7,1%) patients with increase IMT and Plaque, and 1 (1,2%) patient with plaque in near wall left bulbus without increased IMT. Based on spearman's correlation test there are no correlation between anti dsDNA and max-IMT (r=-0,073, p= 0,520).

Conclusion: There are no correlation between anti dsDNA level and Carotid intimal-media thickness this study."