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"Background Patients with systemic lupus erythematosus (SLE) and systemic sclerosis (SSc), have to cope with lifelong disease manifestation and impaired physical function. Limited physical activities along the disease will affect their quality of life (QoL). The QoL is recognized as an important factor of treatment strategy. This study aims to compare the quality of life of patient with SLE and SSc. Method This study was a cross-sectional study and conducted in rheumatology outpatient clinic of Hasan Sadikin Hospital Bandung, Indonesia from January 2015 until March 2017. The respondents were patients diagnosed as SLE and SSc who regularly visit rheumatology outpatient clinic. Respondents were asked to complete the Short Form-36 (SF-36). Baseline characteristics, including age, gender, and duration of disease, were collected during the visit. The Mann-Whitney U test was used to analyze the comparison. Result There were 242 patients who completed the SF-36 questionnaires, consisted of 193 SLE patients and 49 SSc patients. SLE patients were slightly younger and had a longer duration of disease compared to SSc. The SF-36 Physical Component Summary (PCS) score was significantly higher on SLE patients (40.6 vs 40.4, p = 0.0001), but the mean of Mental Component Summary (MCS) score was similar among both diseases. Conclusion Physical functioning aspect on quality of life is better in SLE patients compared to SSc patients. However, mental aspect for both diseases are relatively similar."

"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"

"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."

"ABSTRAKLatar Belakang:Perkembangan dalam tatalaksana Lupus eritematosus sistemik (LES) telah meningkatkankesintasan pasien dengan LES. Kualitas hidup merupakan komponen evaluasi terapi LES danvalue based medicine. Salah satu kuesioner khusus untuk menilai kualitas hidup adalahLupus QoL. Saat ini di Indonesia belum ada kuesioner khusus penilaian kualitas hidup padapasien dengan LES. Penelitian ini bertujuan membuktikan Lupus QoL sahih dan andal dalammenilai kualitas hidup pasien dengan LES di Indonesia.Metode:Penelitian ini merupakan studi potong lintang. Penelitian diawali dengan menerjemahkanLupus QoL ke dalam bahasa Indonesia kemudian diujicobakan pada 10 responden. Penelitiankemudian dilanjutkan pada jumlah sampel yang lebih besar. Keandalan dievaluasi denganIntraclass Correlation Coefficient (ICC) pada tes dan tes ulang dan cronbach α padakonsistensi internal. Kesahihan konstruksi dinilai dengan multi trait scaling analysis.Kesahihan eksternal dinilai dengan menilai korelasi antara Short form 36 (SF36) denganLupus QoL dan aktivitas penyakit.Hasil:Pengambilan data terhadap 65 pasien LES yang berobat di unit rawat jalan Ilmu PenyakitDalam RSCM selama bulan Oktober ? November 2015. Kesahihan eksternal Lupus QoL baikdengan korelasi terhadap SF36 dengan r :0.38 ? 0.66 (p<0.05). Multi trait analysis scalingmenunjukkan korelasi yang baik antara nilai tiap domain dengan nilai total (r:0.46 ? 0.85)dan antara skor tiap butir pertanyaan dan skor total domain (r:0.44 ? 0.93). Nilai ICC(interval 7 hari) baik (ICC>0.7). Nilai cronbach α> 0.7 pada setiap domain. Korelasi LupusQoL terhadap aktivitas penyakit memiliki korelasi yang lemah dan tidak bermakna yangsesuai dengan penelitian ? penelitian sebelumnya.Simpulan:Kuesioner Lupus QoL Indonesia sahih dan andal dalam menilai kualitas hidup pada pasiendengan LES di Indonesia

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ABSTRACTBackground:The development in Systemic Lupus Erythematosus treatment has led into the increasment of survival.Quality of life has become a component to evaluate therapy ini SLE and value based medicine. Onespesific questionnaire to asses quality of life is Lupus Quality of Life (Lupus QoL). Currently inIndonesia there has not been spesific questionnaire to asses quality of life in SLE patients. This studyaims to prove that Lupus QoL is valid and reliable to asses the quality of life in SLE patients inIndonesia.Methods:This study is cross sectional study. This study began with the translation the Lupus QoL intoindonesian language then tested in 10 respondents. After that,this study continued with a largersample size. The intraclass coefficient correlation was used to evaluate test and re test reliability, thecronbach alpha was used to evaluate internal consistency. Construct validity evaluated using multitrait scaling analysis and the extrenal validity evaluated using the correlation between domains inshort form 36 (SF 36) with Lupus QoL and with disease activity. Results:Data collection were doneon 65 SLE patients in Oktober ? November 2015 in RSCM. The external validity with SF 36 was goodwith r:0.38-0.66(p<0.05). The construct validity is good with r > 0.4 (0.44 ? 0.93). The ICC value inone week >0.7 and Cronbach α was >0.7 in each domain. The correlation with disease activity wasweak and consistent with another studies.Conclusion:Lupus QoL questionnaire is valid and reliable to asses quality of life in SLE patients in Indonesia."

"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."

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Latar Belakang: Perbaikan fungsi fisik, emosional dan kualitas hidup penderita LES harus menjadi bagian penting penatalaksanaan paripurna. Fungsi otot, yang merupakan kombinasi dari kekuatan otot dan performans fisik (Asian Working Group on Sarcopenia 2019), merupakan salah satu determinan penting kualitas hidup subyek LES. Belum ada penelitian evaluasi pengaruh fungsi otot terhadap kualitas hidup penderita LES menggunakan kuesioner Sarcopenia Quality of Life (SarQoL).

Tujuan: Evaluasi hubungan fungsi otot dengan kualitas hidup menggunakan kuesioner SarQoL pada perempuan penderita LES.

Metode: Penelitian potong lintang ini merekrut 61 subyek LES perempuan di klinik Alergi Imunologi, RSCM, secara konsekutif, fungsi otot dinilai dengan dinamometer genggam tangan Jamar (kekuatan otot) dan uji kecepatan berjalan 6 meter (performans fisik), HRQoL dinilai dengan kuesioner Sarcopenia Quality of Life (SarQoL). Kriteria penerimaan perempuan dengan LES berusia ≥18 tahun, tanpa kondisi autoimun lain dan gangguan fungsional/anatomis yang mengganggu pemeriksaan. Analisis statistik menggunakan uji t untuk analisis beda dua rerata dan analisis multivariat regresi linier untuk penyesuaian terhadap perancu.

Hasil: Rerata skor total SarQoL subyek kekuatan otot baik dan rendah didapatkan berbeda signifikan, 74,86 (9,48) vs. 65,49 (15,51) (p=0,009), tetap signifikan setelah disesuaikan usia, asupan protein, tingkat aktivitas olahraga  dan aktivitas penyakit [B -7,12; IK 95% -14,58 –(-1,20)]. Rerata skor total SarQoL subyek dengan kecepatan berjalan baik dan rendah tidak didapatkan berbeda signifikan 70,67 (11,08) vs. 70,72 (13,56) (p=0,993).

Simpulan: Terdapat hubungan signifikan antara kekuatan otot dan kualitas hidup terkait kesehatan menurut SarQoL pada perempuan penderita LES

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Background: Improvement of physical, emotional function and quality of life of SLE patients, should be an important part of holistic clinical management. Muscle function, a combination of muscle strength and physical performance (Asian Working Group on Sarcopenia 2019), was an important determinant of quality of life in lupus patients. There was no study aimed at evaluating the impact of mucscle function on SLE patient’s quality of life using Sarcopenia Quality of Life (SarQoL) questionnaire.

Aim: This study was conducted to evaluate the relationship of muscle function and SarQoL score in women with SLE.

Methods: This cross-sectional study recruited 61 women with SLE in Allergy-Immunology Clinic of Cipto Mangunkusumo Hospital consecutively, muscle function was measured with Jamar handheld-dynamometer and 6 meter walk test, HRQoL was measured with Sarcopenia Quality of Life (SarQoL) questionnaire. Acceptance criteria include women ≥18 years old with SLE, and not with other autoimmune disease nor functional/anatomical dysfunction that disturb measurements. Statistical analysis was conducted with t-test for mean difference and linier regression was used to adjust confounders.

Results: The difference of total SarQoL score in subjects with good and low muscle strength was found to be significant; 74.86 (9.48) vs. 65.49 (15.51) (p=0.009), statistically significant after adjusments with age, protein intake, physical acitvity level and disease activity [B -7.12; 95% CI -14.58 –(-1.20)]. The difference of total SarQoL score in subjects with good and low physical performance was found to be not significant 70.67 (11.08) vs. 70.72 (13.56) (p=0.993).

Conclusion: There was a significant association between muscle strength and HRQoL according to SarQoL in women with SLE

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"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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"Often considered the prototypic autoimmune disease, Lupus is characterized by protean manifestations and affects a wide range of organ systems. Despite widespread availability of anti nuclear antibody testing and other technological diagnostic advances, the diagnosis of lupus can be elusive, difficult, and inexact. Treatment of the disease can also be challenging. Advances in immunology and biotechnology have led to a burgeoning world of new therapies in development that offer patients the real possibility of new therapies and physicians and scientists novel insights into the pathogenesis of this complicated immunological disease. Lupus erythematosus : clinical evaluation and treatment summarizes the clinical aspects of lupus facing the general clinician in the 21st century. In this invaluable, practical book, the reader will find introductory chapters regarding general diagnostic and treatment principles, followed by chapters addressing the lupus-specific organ manifestations. Special topics regarding pregnancy and comorbidities are also presented. Written by highly experienced physicians with special expertise in lupus."