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Abstrak :
The book is an up-to-date introduction to the disease and includes high quality colour photographs and evidence-based guidelines for diagnosing, treating and managing Lupus in primary care.

Abstrak :
Salah satu penyakit tidak menular yang mengancam masyarakat perkotaan adalah systemic lupus erythematosus. Systemic lupus erythematosus adalah penyakit autoimun dimana sistem imun memproduksi autoantibodi yang menyerang jaringan tubuh sendiri dan menyebabkan kerusakan pada organ yang diserang. Penyakit ini dapat menimbulkan masalah psikososial ketidakberdayaan karena systemic lupus erythematosus tidak dapat disembuhkan dan bersifat periodik. Karya Ilmiah Akhir Ners ini bertujuan untuk memberikan gambaran asuhan keperawatan ketidakberdayaan pada klien yang mengalami systemic lupus erythematosus. Evaluasi hasil implementasi menunjukkan berkurangnya tanda dan gejala ketidakberdayaan yang dialami klien.

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Systemic lupus erythematosus is one of non-communicable disease that threaten urban communities. Systemic lupus erythematosus is autoimune disease where immune system produces autoantibodies that attack it own body tissues and cause damage to the organ. This disease can evoke psychosocial problem that is powerlessness because systemic lupus erythematosus can not be cured and periodic. The purpose of this Paper is to describe nursing care of powerlessness in patient with systemic lupus erythematosus. Evaluation of the results of implementation shows that there is a slight decrease in the signs and symptoms of powerlessness that occured on the client.

Abstrak :
Systemic lupus erythematosus (SLE) as a chronic autoimmune disease with multi-organ involvement often occurs in women of childbearing age. We report a case of active SLE in a-23 year old woman who presented with multi-organ involvement, including pericardia! effusion, severe anemia that caused congestive heart failure, and kidney involvement. ANA and ami ds DNA were positive. The patient was treated with intravenous digoxin followed by a daily dose of oral digoxin, ROmg/day of furosemide, 600 ml packed red cell transfusion, and !.5 mg/kg bodyweight/day of prednisan. The patient was discharged in good condition on the I5'h day of hospitalization.

Abstrak :
Latar belakang: Lupus eritrematosus sistemik (LES) adalah penyakit yang kompleks dengan manifestasi yang bervariasi. Interleukin-6 (IL-6) merupakan sitokin pleitropik yang mempunyai aktivitas biologis dengan rentang luas yang berperan penting pada regulasi imun dan inflamasi. Saat ini belum ada biomarker yang dapat membedakan kondisi remisi total dengan aktivitas penyakit ringan. Interleukin-6 diharapkan dapat digunakan sebagai parameter aktivitas penyakit terutama pada kasus-kasus dimana antara manifestasi klinis dan skor SLEDAI tidak sesuai yaitu pada pasien LES dengan aktivits ringan dan remisi total. Tujuan: Mengetahui karakteristik IL-6 pada LES anak dengan berbagai aktivitas ringan dan remisi total. Metode: Penelitian kasus kontrol dilakukan di poli rawat jalan Alergi-Imunologi Departemen Ilmu Kesehatan Anak RSUPN dr. Cipto Mangunkusumo, Jakarta dan RSUP Dr. Sardjito, Yogyakarta mulai Mei hingga Juni 2019. Pasien anak usia 1-18 tahun dengan diagnosis LES dinilai kadar IL-6 dan aktivitas penyakit yang dinilai dengan skor SLEDAI. Uji korelasi chi square dilakukan untuk mengetahui hubungan variabel bebas dan luaran. Analisis data dilakukan dengan program SPSS for Window ver 20,0 Hasil: Dari 60 subjek penelitian yang terdiri dari 30 pasien LES aktivitas ringan dan 30 remisi total. tidak ada perbedaan kadar IL-6 tinggi pada kelompok kasus dibanding kelompok kontrol dengan p=0,500, OR= 0,483 (95% IK: 0,041-5,628). Terdapat 2 subyek dengan kadar IL-6 tinggi menderita infeksi saluran kencing. Simpulan: Tidak ada perbedaan aktivitas penyakit pada pasien LES anak dengan aktivitas ringan dibanding remisi total. ......Background: Systemic Lupus Erythematosus (SLE) is a complex disease with various manifestations. Interleukin-6 (IL-6) is a pleiotropic cytokine with a wide range of biological activities that plays an important role in immune regulation and inflammation. Recently, there is no other biomarker that could differentiate total remission condition and mild disease activity in juvenile SLE. Interleukin-6 may be used as a parameter of disease activity, especially in the cases with different clinical manifestations and SLEDAI scores among SLE patients with mild activities and total remissions. Aim: To indentify the characterictics of serum IL-6 concentration in juvenile systemic lupus erythematosus with mild activities and total remissions. Methods: Case control study was performed at outpatient clinic of allergy-immunology, department of child health dr. Cipto Mangunkusumo hospital, Jakarta and dr. Sardjito hospital, Yogyakarta during May-June 2019. Serum IL-6 consentration and disease activity were assessed in all juvenile SLE patients aged 1-18 year. SLE disease activity was assessed with SLEDAI scores and serum level of IL-6 was measured by enzyme linked immunosorbent assay. Chi square correlation analysis was used to determine the correlation of serum IL-6 concentration with disease activity in juvenile SLE patients. Analyses of data were performed using the SPSS statistical software for windows version 20,0. Results: Among 60 subjects included in this study, 30 subjects with mild activities in the case group and 30 subjects with total remissions in the control group. There was no differences of serum IL-6 concentration between case and control group (p=0,500, OR= 0,483 (95% IK: 0,041-5,628)). In this study, we found 2 subjects with urinary tract infection have high serum IL-6 concentration. Conclusion: There was no differences of serum IL-6 concentration between juvenile SLE patients with mild activities compared with total remissions.

Abstrak :
Kasus penyakit LES mempunyai prevalensi yang cukup tinggi di Indonesia dan dunia. Prevalensi di berbagai negara sangat bervariasi antara 2.9/100.000 – 400/100.000. Namun, belum terdapat data epidemiologi LES yang mencakup semua wilayah Indonesia. Diagnosis Lupus Eritematosus Sistemik tidak mudah dan sering terlambat akibat dari gejala yang timbul menyerupai gejala berbagai penyakit sehingga Lupus dikenal dengan sebutan penyakit 1000 wajah. Gejala penyakit Lupus sangat beragam, mulai dari gejala ringan hingga yang dapat mengakibatkan kematian. Penelitian berupa kajian kepustakaan (literature review) terhadap 3 jurnal penelitian internasional pada tahun 2000-2020. Penelitian ini bertujuan untuk mengetahui peran faktor risiko paparan silika pada kejadian Lupus Eritematosus Sistemik. Hasil penelitian menunjukan bahwa terdapat hubungan yang signifikan antara paparan silika dengan kejadian Lupus Eritematosus Sistemik dengan rata-rata OR 3,6. Paparan silika yang terhirup tidak mungkin menjadi penyebab utama LES pada populasi umum, namun paparan silika menjadi salah satu faktor risiko yang berperan dalam pengembangan penyakit LES. Memahami mekanisme yang digunakan oleh silika dalam LES dapat membantu kita lebih memahami peran paparan lingkungan terutama paparan silika pada LES. ......Literature Review: The Role of Risk Factors for Silica Exposure in Systemic Lupus Erythematosus. Systematic Lupus Erythematosus have a high prevalence in Indonesia and the world. Prevalence in various countries varies greatly between 2.9 / 100.000 - 400/100,000. However, there are no epidemiological data covering all regions of Indonesia for SLE. Diagnoses of Systemic Lupus Erythematosus is not easy and often late due to symptoms that resemble the symptoms of various diseases, so that Lupus is known as 1000 facial diseases. Symptoms of lupus are very diverse, ranging from mild symptoms to those that can result in death. The research was in the form of a literature review of 8 international research journals in 2000-2020. This study aims to determine the role of risk factors for silica exposure in the incidence of Systemic Lupus Erythematosus. The results showed that there was a significant relationship between exposure to silica with the incidence of Systemic Lupus Erythematosus with an average OR of 3.6. Exposure to inhaled silica may not be a major cause of SLE in the general population, but silica exposure is one of the risk factors that play a role in the development of LES disease. Understanding the mechanism used by silica in SLE can help us better understand the role of environmental exposure especially silica exposure in SLE.

Abstrak :
Kerusakan lingkungan yang terjadi di area perkotaan dapat memicu munculnya berbagai masalah kesehatan. Salah satu masalah kesehatan yang berisiko lebih tinggi terjadi di perkotaan adalah Systemic Lupus Erythematosus SLE . SLE dapat menimbulkan masalah psikososial, salah satunya ketidakberdayaan. SLE juga dapat memengaruhi hubungan pasien dengan keluarga atau pun orang terdekatnya. Karya Ilmiah Akhir Ners ini berutjuan untuk menggambarkan asuhan keperawatan dengan masalah ketidakberdayaan pada pasien dan keluarga pasien dengan SLE. Penulis melakukan asuhan keperawatan yang berfokus pada ketidakberdayaan dan penurunan koping keluarga selama delapan hari. Hasil evaluasi menunjukkan bahwa tanda dan gejala ketidakberdayaan pada pasien sudah berkurang. Namun, kondisi penyakit Bapak S yang memburuk menyebabkan masalah tersebut muncul kembali. Di sisi lain, keluarga pasien sudah lebih mampu dalam merawat pasien.

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Environmental damage in urban areas may cause many health problems. One of health problems which have higher risk to develop in urban areas is Systemic Lupus Erythematosus SLE . SLE may induce psychosocial problems, such as powerlessness. The aim of this paper was to describe nursing care of powerlessness in family and patient with SLE. Author conducted a nursing care which focused on powerlessness and compromised family coping problems for eight days. The evaluation result showed that sign and symptom of powerlessness in patient has decreased. However, the deterioration of patient rsquo;s health conditions causes the powerlessness signs to reappear. On the other hand, patient rsquo;s family already capable of taking cares of the patient.

Abstrak :
Latar belakang: Lupus eritematosus sistemik LES) merupakan kelainan autoimun sistemik kronik yang dapat melibatkan susunan saraf pusat sehingga terjadi gangguan neurokognitif yang memengaruhi tingkat kecerdasan intelektual. Berbagai marker biologis terkait penyakit LES dapat memegaruhi fungsi neurokognitif. Tujuan: Penelitian ini dilakukan untuk mengetahui tingkat kecerdasan intelektual anak dengan LES dan faktor-faktor yang memengaruhinya. Metode: Studi potong lintang terhadap 62 anak usia 7-18 tahun dengan LES. Pemilihan subyek secara consecutive sampling mulai September-Desember 2019. Tingkat kecerdasan intelektual ditetapkan dengan Weschler Intelligence Scale for Children (WISC)-IV melalui penilaian Intelligence Quotient (IQ). Analisa korelasi lama sakit, derajat aktivitas penyakit, dosis kumulatif kortikosteroid, Indeks Massa Tubuh (IMT) dan kadar hemoglobin terhadap IQ dilakukan uji korelasi Spearman. Analisa bivariat marker autoantibodi antiphospholipid syndrome (APS) terhadap IQ dilakukan dengan uji Chi Square. Hasil: Prevalens subjek dengan IQ di bawah rata-rata (IQ<90) sebesar 73%. Nilai rerata IQ verbal, IQ performa dan IQ total pada anak dengan LES secara berurutan adalah 85,02 ; 84,37 dan 83,11. Hasil korelasi lama sakit, derajat aktivitas penyakit, dosis kumulatif kortikosteroid, IMT dan kadar hemoglobin terhadap IQ total secara berurutan r=-0,029; r=-0,063; r=0,03; r=0,014; r=0,108 dengan P>0,05). Proporsi marker autoantibodi APS terhadap IQ verbal, IQ performa dan IQ total dibawah rata-rata dibandingkan rata-rata tidak berbeda bermakna secara berurutan p=0.18; p=0,57; dan p=0.854. Kesimpulan: Rerata IQ verbal, IQ performa dan IQ total pada anak dengan LES di bawah nilai normal. Lama sakit, derajat aktivitas penyakit, dosis kumulatif kortikosteroid, marker autoantibodi APS, IMT dan kadar hemoglobin pada LES tidak memengaruhi tingkat kecerdasan intelektual.

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Background: Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disorder that can involve central nervous system resulting in neurocognitive disorder that affect the level of intellectual intelligence. Various biological markers associated with LES can influence neurocognitive function. Objective: This study was conducted to determine the level of intellectual intelligence of children with LES and the factors that influence it. Method: A cross-sectional study was conducted on 62 children aged 7-18 years with SLE by consecutive sampling from September to December 2019. The level of intellectual intelligence was determined by the Weschler Intelligence Scale for Children (WISC)-IV with an Intelligence Quotient (IQ) level. Correlation of duration, disease activity, cumulative dose of steroid, body mass index (BMI) and hemoglobin level to IQ was analyzed by Spearman test. Bivariate analysis autoantibody markers of antiphospholipid syndrome (APS) on IQ was performed with Chi Square test. Result: The prevalence of IQ below average (IQ < 90) was 73%. Mean value of verbal, performance and full IQ were 85.02 ; 84.37 and 83.11,respectively. The correlation results of duration, disease activity, cumulative dose of steroid, BMI and hemoglobin level werent statistically significant to full IQ respectively (r =-0,029; r=-0,063; r=0.03; r=0.014; r=0.108 with p>0.05). The proportion of autoantibody markers of APS to verbal, performance and full IQ below average compared to average didt significantly difference (p=0.18; p=0.57; p=0.854, respectively). Conslusion: Average of verbal, performance and full IQ in children with SLE is below normal level. Neither duration and activity of disease, cumulative dose of steroid, autoantibody markers of APS, BMI nor hemoglobin level are correlated to intellectual intelligence in children with SLE

Abstrak :
ABSTRACT
This case study aim to evaluate the response of steroid treatment for autoimmune endocarditis. Valvular heart disease is relatively rising in both congenital and acquired cases, but the autoimmune endocarditis remains rare. In this case, a 34 year old woman with clinical manifestation resembling systemic lupus erythematosus (SLE) is diagnosed with Libman-sacks Endocarditis. After six months of steroid treatment, her clinical manifestations and heart structure improved.

Abstrak :
Background: systemic lupus erythematosus (SLE) is still a challenging autoimmune disease, especially in pregnancy setting. An early risk factors awareness of poor pregnancy outcome is important to optimize the outcome of pregnancy in SLE patients. This study was conducted to describe pregnancy outcome and determine the risk factors associated with poor pregnancy outcome in SLE patients. Methods: a retrospective case-control study of SLE patients with poor and normal pregnancy outcome was performed. Pregnancy histories were reviewed from Dr. Hasan Sadikin General Hospital lupus registry study. The case group was pregnancy with poor outcome, defined as abortion, premature birth, stillbirth, intrauterine growth restriction (IUGR) and neonatal death. The control group was pregnancy with good outcome, defined as live birth and full term. Results: a total of 84 SLE patients were enrolled in this study with 109 pregnancies after SLE diagnosis. The median age of subjects at the time of pregnancy was 28 (25-32) years old. Poor pregnancy outcome comprising 22.9% abortion, 14.7% premature birth, 5.5% stillbirth, 1.8% IUGR and 4.6% neonatal death. There was a significant difference in the number of planned pregnancy (P=0.011) between groups with poor and good outcome. Clinical variables significantly associated with poor pregnancy outcome were lupus nephritis (OR = 4.813, 95% CI 1.709 - 13.557, P = 0.003) and neuropsychiatric SLE (OR = 5.045, 95% CI 1.278 - 19.920, P = 0.021). Conclusion: the pregnancy in SLE patient should be planned to have better outcome. Lupus nephritis and neuropsychiatric (NP) SLE were risk factors for poor pregnancy outcome in SLE patient.