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All Journal Medicina journal of internal medicine E-Jurnal Medika Udayana Indonesian Journal of Rheumatology Jurnal Penyakit Dalam Udayana Callosum Neurology Journal : Jurnal Berkala Neurologi Bali Oceana Biomedicina Journal ISM (Intisari Sains Medis) : Jurnal Kedokteran Cermin Dunia Kedokteran Oceana Biomedicina Journal
Gede Kambayana
Departemen Ilmu Penyakit Dalam, FK Universitas Udayana/RSUP Sanglah, Denpasar, Bali, Indonesia
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Fenomena raynaud sekunder pada seorang penderita kanker kolon I Gusti Agung Indra Adi Kusuma; Gede Kambayana
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (421.144 KB) | DOI: 10.15562/ism.v11i3.801

Abstract

Introduction: Secondary Raynaud's phenomenon (RP) is a transient microvascular spasm associated with other etiologies with clinical features of triphasic manifestations. Malignancy is a rare cause of secondary RP. Case Report: A man, 46 years, came to Sanglah General Hospital with secondary RP and colorectal malignancy. Discoloration white at the distal digits of the right manus and digits 3-5 left and sometimes accompanied thick at the fingertips, involved proximal to the medial phalanges. Laboratory examination showed albumin 2.55 g / dL, globulin 2.12 g / dL, LDH 323 IU / L, CRP 6.5 mg / dL, CEA 5.83 ng / mL plain abdominal radiograph impression of thickening on the part of the wall and show colitis appearance, be suspected ileus in the upper left abdominal region. Base on histopathological examination, ascending colon presents well-differentiated adenocarcinoma, and abdominal CT shows liver metastases. Management of patients with secondary RP with lifestyle and pharmacological interventions and chemotherapy for colorectal adenocarcinoma as the underlying cause. Pharmacological therapy of RP with intraoral amlodipine Conclusion: Malignancy in this patient as a cause of RP and management is carried out to treat primary disease and Raynaud's  Pendahuluan:    Fenomena Raynaud (RP) sekunder merupakan vasokontriksi transien pada mikrovaskular dikaitkan dengan etiologi lain dengan gambaran manifestasi trifasik. Keganasan menjadi kausa yang jarang pada RP sekunder.Laporan Kasus: Seorang laki-laki, usia 46 tahun, datang ke RSUP Sanglah dengan RP sekunder dan keganasan kolorektal. Dengan pucat  pada distal digiti manus dekstra dan digiti 3-5 sinistra dan disertai kadang tebal di ujung jari, meliputi proksimal sampai  medial falang. Pemeriksaan laboratorium menunjukkan albumin 2,55 g/dL, dan globulin 2,12 g/dL, LDH 323 IU/L, CRP  6,5 mg/dL, CEA 5,83 ng/mL dengan foto polos abdomen kesan penebalan pada sebagian dinding usus menunjukkan suatu gambaran kolitis yang diduga ileus pada regio abdomen kiri atas, kolon asenden dengan gambaran well differentiated adenokarsinoma  pada hasil biopsi histopatologi dan CT abdomen menunjukkan metastasis pada hepar. Penatalaksanaan pasien RP sekunder dengan intervensi gaya hidup dan farmakologis serta kemoterapi untuk adenokarsinoma kolorektal sebagai penyebab dasar. Terapi farmakologis RP dengan pemberian amlodipin intra oral.Simpulan: Kondisi keganasan pada pasien sebagai kausa dari RP dan tatalaksana  pengobatan spesifik RP. 
NEUROMYELITIS OPTICA SPECTRUM DISORDER (NMOSD) DENGAN ANTIBODI AQP4 POSITIF Rima Febry Lesmana; Anak Agung Mas Putrawati Triningrat; Made Paramita Wijayanti; I Made Agus Kusumadjaja; Ida Ayu Sri Indrayani; Gede Kambayana
Callosum Neurology Vol 4 No 2 (2021): Callosum Neurology Journal
Publisher : The Indonesia Neurological Association Branch of Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29342/cnj.v4i2.138

Abstract

Background: Neuromyelitis optica (NMO) is an in?ammatory demyelinating autoimmune disease of the central nervous system that most commonly affects the optic nerves and spinal cord. Seropositive antiAQP4 differentiates NMO from MS and the presence of manifestation in the postrema, brainsteam or diencephalic areas extend to NMO Spectrum Disorder (NMOSD). Case Description: A 18 years old male complain sudden vision loss on his left eye since 2 weeks ago. The examination show the visual acuity on the right eye was 6/6 and LPBP on the left eye. Positive RAPD on the left eye, funduscopy and the OCT RNFL within normal limits. Head MRI focus orbita with contrast show optic neuritis. Patient was diagnosed with left eye retrobulbar optic neuritis and ONTT therapy was given. The visual acuity improved to 1/60 then therapy change to oral steroid. Four months later, the patient suddenly got vision loss on the right eye accompanied by paraparesis. The visual acuity on the right eye was NLP and the left eye was 1/300, with mid-dilated papil. The results of the OCT RNFL show on the right eye edema papil and left eye atrophy papil. An MRI of the head focus orbital and whole spain was reexamined followed by VEP examination and an AntiAQP4 which showed an NMOSD. He was given ONTT then continued with immunosuppressants. The visual acuity of the right eye improved to 3/60 and the left eye remained 1/300. Discussion: This patient first presented with complain on the left eye with clinical and supporting symptoms suggesting an optic neuritis. The presence of a new attack on the right eye with paraparesis is a clinical feature of NMO supported by MRI results and seropositive AQP4 indicates an NMOSD. Conclusion: Establishment of diagnosis and administration of therapy quickly and precisely can reduce the severity and risk of recurrence which leads to greater disability and blindness. Key Words: Neuromyelitis Optica, Neuromyelitis Optica Spectrum Disorder, AQP4
Keganasan Kolorektal dengan Fenomena Raynaud Sekunder Ni Made Dwi Adnyani; Ida Bagus Aditya Nugraha; Gede Kambayana
Cermin Dunia Kedokteran Vol 46 No 12 (2019): Kardiovakular
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i12.396

Abstract

Penyakit Raynaud adalah penyakit vaskuler primer yang ditandai dengan spasme sementara pada arteri kecil dan arteriol, biasanya di jari tangan atau, yang lebih jarang, jari kaki. Penyebab penyakit Raynaud dapat primer atau sekunder; salah satu penyebab sekunder adalah proses keganasan. Dilaporkan kasus pada pasien laki-laki, usia 46 tahun, suku Jawa dengan fenomena Raynaud sekunder diduga akibat kanker kolorektal. Raynaud’s disease is a primary vascular disease characterized by temporary spasm of small arteries and arterioles, usually in fingers or, rarely, in toes. The cause of Raynaud’s disease can be primary and secondary; one of the secondary causes is malignancy. This is a case of a 46 year-old Javanese male with secondary Raynaud’s phenomenon associated with colorectal cancer.
Co-Authors Abd. Halim Adnyani, Ni Made Dwi Ali Djamhuri Anak Agung Mas Putrawati Triningrat Andisari, Hendrata Erry Andriyasa Andriyasa Andriyasa, Andriyasa Anna Ariane Anwar Santoso Awalia Awalia Bagus Rhama Dwi Budi Darmawati Dwijo Anargha Sindhughosa Faisal Parlindungan Gede Putu Arsana Harry Isbagio Hendrata Erry Andisari I Gusti Agung Friskha Surya Putra I Gusti Agung Indra Adi Kusuma I Gusti Ngurah Wien Aryana I K Rina I Ketut Suastika I Nyoman Suarjana I.B. Aditya Nugraha IA Ratih Wulansari Manuaba Ida Ayu Sri Indrayani Ida Bagus Aditya Nugraha IGN Eka Imbawan Indrawan, IGNM Budiana Ketut Suega Laniyati Hamijoyo Made Agus Kusumadjaja Made Paramita Wijayanti Manaek, Andi Ni Ketut Donna Prisilia Ni Made Dwi Adnyani Ni Made Dwi Adnyani Ni Putu Dewi Indriyani Nugraha, I.B. Aditya Pande Ketut Kurniari Prisilia, Ni Ketut Donna Putra, T R Putu Imayati Rakhma Yanti Hellmi Rima Febry Lesmana Rudy Hidayat T R Putra T R Putra Tjokorda Raka Putra Tonny, Tonny Try Parama Arthika Wira Gotera Yenny Kandarini Yuliandari KK, Cok Istri