VALIDITY AND RELIABILITY OF RADAR QUESTIONNAIRE FOR PATIENTS WITH RHEUMATOID ARTHRITIS

ABSTRACT Rheumatoid arthritis (RA) is a chronic debilitating autoimmune disease modifying anti-rheumatic drugs (DMARD

Minireview: Prospect of Doxycycline in Systemic Lupus Erythematosus Treatment

Doxycycline has non-antibiotic effects which are necessary for lupus treatment, such as immunosuppressive, anti-inflammatory, and anti-depressive effects. This widely used drug is a promising one to be developed as lupus drug since doxycycline has no data of its microbial resistance and it is safe for maternity. The other benefit is that doxycycline has lower side effects than the current drugs for lupus treatment. It gives excellent chances for women with lupus to be pregnant and have healthy babies. This article contains the compilation data of doxycycline target sites beyond its beneficial activities for lupus and also its limitations. Finally, this data will be a background for doxycycline in lupus drug development

The Coexistence of Systemic Lupus Erythematosus and Psoriasis: Is It Possible?

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with various clinical disorders and frequent exacerbations. Psoriasis vulgaris is a common skin disorder which affect 1-3% of general populations. The pathophysiology regarding the coexistence of these diseases is not fully understood. Therapeutic challenges arise since the treatment one of these diseases may aggravate the other. We reported two cases of SLE with psoriasis vulgaris with clinical manifestations as recurrent erythroderma with photosensitivity. Improvement in clinical condition was observed after treating the patients with methylprednisolone combined with methotrexate. The coexistence SLE and psoriasis are considered very rare. The presence of this overlap syndrome may precede one another or occur simultaneously and is closely related with the presence of anti-Ro/SSA. Thus, it raises new challenge regarding its relationships, diagnosis, therapeutic, and management

Acute Appendicitis in a Patient with Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is a chronic excacerbative autoimmune disease with wide clinical spectrum. Gastrointestinal manifestasion is a frequent clinical manifestasion seen in SLE. Management with glucocorticoid and non-steroid anti-inflammatory drugs (NSAID) can mask the gastrointestinal symptoms in patient with SLE. One of the etiologies of gastrointestinal manifestations in SLE is acute appendicitis. Patients with acute appendicitis usually have abdominal pain as its chief complaint. The pathophysiology of acute appendicitis can occur primarily from SLE and secondary from other causes eg: infection, inflammation, etc. When a SLE patient has acute appendicitis as its initial assessment, determining its etiology is pivotal to give comprehensive management and preventing life-threatening complications

Scleroderma Patients with Pulmonary Artery Hypertension: A Case Report

Scleroderma or systemic sclerosis (SSc) is a multiorgan connective tissue disorder involving the skin, lungs, heart, digestive tract, musculoskeletal system, and peripheral circulation. Pulmonary arterial hypertension (PAH) is an increase in mean pulmonary artery pressure > 25 mmHg as measured by echocardiography or catheterization. The incidence of PAHs with SSc is so rare that reports, in this case, are necessary. Objective: to describe the management of PAH patients with SSc. Case: a 32-year-old patient experiencing PAHs with SSc has stiffness of the mouth and is difficult to open. The ECG shows a sinus tachycardia with a Right axis destination and a cardiomegaly thorax photo with a 64% cardio-thorax ratio. Some clinical data show autoimmunity. Treatment is oxygen, diuretic, thrombolytic, and immunosuppressive drugs. Conclusions: Reports of PAH treatment with SSC are essential for the improvement of therap

Systemic Sclerosis and Hyperthyroidism in Pregnancy

Systemic sclerosis (SSc) is a connective tissue disease affecting women of childbearing age at least five times more than men. For a long time, pregnant women with SSc have high morbidity and mortality based on case reports and case series. Therefore, the disease was a contraindication for pregnancy. However, current retrospective studiesshow that despite of an increased frequency of prematurity and small for gestational age infants, overall maternal and neonatal survival is good. With close monitoring and appropriate therapy, most scleroderma patients can sustain a successful pregnancy

The roles of Single Nucleotide Polymorphism (SNP) Endoplasmic Reticulum Aminopeptidase 1 (ERAP 1) gene in axial spondyloarthritis Indonesian adults

This study comprised of two phases including a cross sectional study and an in-vitro experiment in post-test with a control-group design. Participants underwent a PCR investigation searching for HLA-B27. Disease activities were measured by Ankylosing Spondylitis Disease Activity Score-Erythrocyte Sedimentation Rate (ASDAS-ESR) and modified Stokes Ankylosing Spondylitis Spinal Score (mSASSS). Subjects with HLA-B27 positive underwent PCR ERAP1 gene rs27434, genome-sequencing, and analysis. ELISA sandwich method was used to measure ERAP-1, IL-17, and IL-23 levels with lipopolysaccharide and IFN-γ induction. Analysis using independent t-test, Mann Whitney, and Pearson correlation test with p < 0.0

Systemic sclerosis and hyperthyroidism in pregnancy

Systemic sclerosis (SSc) is a connective tissue disease affecting women of childbearing age at least five times more than men. For a long time, pregnant women with SSc have high morbidity and mortality based on case reports and case series. Therefore, the disease was a contraindication for pregnancy. However, current retrospective studiesshow that despite of an increased frequency of prematurity and small for gestational age infants, overall maternal and neonatal survival is good. With close monitoring and appropriate therapy, most scleroderma patients can sustain a successful pregnancy

EVIDENCE BASED MEDICINE (EBM)SEBAGAI INSPIRASI RISET TRANSLASIONAL PADA PENYAKIT REUMATIK OTOIMUN

Penyakit reumatik merupakan penyakit keradangan yang mengenai sistim muskuloskeletal. Jenisnya lebih dari 100, dengan prevalensi keseluruhan di masyarakat sekitar 5-8 %. Penyakit reumatik dapat digolongkan menjadi: 1. Penyakit reumatik otoimun: Terjadi karena gangguan pada sistim imun humoral atau seluler atau keduanya. Otoantibodi dan sel otoreaktif bereaksi terhadap molekul tubuh sendiri dan menimbulkan keradangan. Penyakit otoimun yang dikenali masyarakat adalah: a. Systemic lupus erythematosus (SLE) yang mengenai berbagai organ tubuh merupakan prototipe dari Penyakit reumatik otoimun sistemik (PROS) b. Rheumatoid arthritis (RA) c. Spondyloarthritis (SA), dan sebagainya PROS cukup banyak di masyarakat dan tidak mudah dalam diagnosis dan tatalaksana. Puluhan, mungkin ratusan gena yang berbeda berperan pada patogenesis PROS, dengan wujud klinis yang sangat bervariasi dan sering menyerupai penyakitpenyakit lain. Pada fase awal, PROS terutama SLE menunjukkan gambaran klinis yang tidak khas, bisa mengenai satu organ vital saja, misalnya; ginjal dengan nefritis, usus dengan diare kronik atau ileus, atau pada sistim syaraf berupa kelemahan anggota badan. Pada fase ini diagnosis dan tatalaksananya cukup sulit, karena sering dikira penyakit pada organ tunggal. Setelah diterapi, pasien PROS yang demikian sering tidak menunjukkan hasil, sehingga pasien berobat berpindah-pindah (doctor�s shopping). Pada tahap tersebut sebenarnya PROS sudah mengenai berbagai organ, tetapi belum menampakkan gejala dan tanda khas organ yang terkena. Biasanya pasien datang ke konsultan reumatologi sudah dalam keadaan yang berat. Modalitas terapi pada PROS terutama SLE juga masih belum memuaskan, sebagian obat sintetik, dan bahan hayati yang dipasarkan seperti antibodi antisitokin, belum menunjukkan hasil yang memuaskan, walaupun harganya mahal. Beban sosioekonomik pasien PROS juga cukup berat, mereka masih menjadi stigma di masyarakat. PROS juga masih ditelantarkan baik di bidang pelayanan maupun riset.1-3 2. Penyakit reumatik non otoimun: a. Osteoartritis (OA), yang terjadi karena pengaruh beban tubuh atau beban biomekanik dan ketuaan pada persendian. b. Artritis pirai (gout), merupakan gangguan metabolisme asam urat. c. Penyakit reumatik jaringan lunak, seperti; jari pelatuk (trigger fingger), tendinitis de Quervain, bahu kaku (frozen shoulder) dan sebagainy

CORRELATION OF RADIOGRAPHIC DAMAGE AND METABOLIC SYNDROME IN SPONDYLOARTHRITIS: A CROSS-SECTIONAL STUDY

Background: Cardiovascular complication remains the long-term complications in spondyloarthritis (SpA). Previous studies revealed that metabolicsyndrome is the risk factor of cardiovascular in SpA patients. Previous studies also revealed that the prevalence of the metabolic syndrome is 34.9–45.7% in SpA patients. However, previous studies also revealed the controversy of the correlation of SpA’ disease activity with metabolic syndrome.Aim: The aim of the study was to investigate the correlation of SpA’ radiographical damage measured with a modified Stoke Ankylosing SpondylitisSpinal Score (mSASSS) score with metabolic syndrome in SpA patients, which routinely visited Rheumatology Outpatient Department in Dr. SoetomoGeneral Hospital.Methods: An observational study with cross-sectional design with consecutive sampling technique was conducted in July–October 2018. All SpApatients who fulfilled the inclusion criteria were included in this study. Data analysis was performed with SPSS v21.0.Results: There were 33 SpA patients (10 males and 23 females) included in this study. The average age was 48.18±12.27 years-old. The averagemSASSS score was 24,36 (K:0.93, p:0.00). Metabolic syndrome was diagnosed in 54.5% patients with 100% patients had central obesity, 66.7% hadincreased blood pressure, 61.5% had impaired fasting glucose, 55.6% had increased triglycerides, and 77.8% had decreased high-density lipoproteincholesterol. Positive correlation between mSASSS score and metabolic syndrome was observed (r:0.510, p:0.002).Conclusion: A correlation between SpA disease activity measured with mSASSS score and metabolic syndrome was observed. Therefore, routinemetabolic syndrome screening is strongly suggested for SpA patients