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All Journal Acta Interna : The Journal of Internal Medicine Collaborative Medical Journal (CMJ) Jurnal Penyakit Dalam Indonesia
Deshinta Putri Mulya
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Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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CORRELATION BETWEEN CHILD PUGH SCORE AND CYSTATIN C IN LIVER CIRRHOSIS PATIENTS Mulya, Deshinta Putri; Nurdjanah, Siti; Ratnasari, Neneng
Acta Interna The Journal of Internal Medicine Vol 1, No 1 (2011): Acta Interna The Journal of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

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Abstract

ABSTRACTBackground. Renal dysfunction is a serious problem and it provides a poor prognosis for patients with advanced liver cirrhosis, where this condition can progress to kidney failure. This condition is known as hepatorenal syndrome. Cystatin C utilization as a marker of decreased kidney function in patients with liver cirrhosis has been widely proven. Data on how far the severity of liver cirrhosis can affect the decline in renal function has not been widely known. Objective. This study aimed is to verify correlation between the severity degree of the liver (Child Pugh/CP score) with levels of Cystatin C serum. Methods. This study was a cross sectional study. Population studied were patients with liver cirrhosis who visited the clinic of Gastroentero-hepatology and treated in the department of Internal Medicine ward Dr. Sardjito Hospital - Yogyakarta during October 2009 - March 2010. Data were analyzed with a computer; the analyzed of the CP score correlation with increased levels of Cystatin C using Spearman correlation for data not normally distributed. Result. We found 48 research subjects during the month of October 2009 - March 2010. The subjects were 35 male (72.9%) and 13 female (27.1%) with average age 53.1 ± 11.9 years old. Subjects with CP-A were 9 patients (18.8%), CP-B were 14 patients (29.2%) and CP-C were 25 patients (52.1%). The range value of Cystatin C between CP class shows CP-A  0.7 - 0.97 mg/L, CP-B 0.7 - 0.49 mg/L, and CP-C 0.7 – 2.49 mg/L (statistically significant difference with p <0.05). Liver cirrhosis patients who had Cystatin C levels <0.96 mg/L were 22 patients (45.83%) and 26 patients (54.1%), had higher levels of Cystatin C> 0.96 mg/L. Child score was positively correlated to increased levels of Cystatin C (p= 0.000; r= 0.566) linear regression equation with Cystatin was = 0.37 + 0.08 * Child score (r square 0.32). Conclusion. This study concluded that the Child score had a moderate positive correlation with Cystatin C serum level.  Key words: Liver Cirrhosis – Child Pugh score - Cystatin C 
CORRELATION BETWEEN CHILD PUGH SCORE AND CYSTATIN C IN LIVER CIRRHOSIS PATIENTS Deshinta Putri Mulya; Siti Nurdjanah; Neneng Ratnasari
Acta Interna The Journal of Internal Medicine Vol 1, No 1 (2011): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1746.805 KB) | DOI: 10.22146/acta interna.3860

Abstract

ABSTRACTBackground. Renal dysfunction is a serious problem and it provides a poor prognosis for patients with advanced liver cirrhosis, where this condition can progress to kidney failure. This condition is known as hepatorenal syndrome. Cystatin C utilization as a marker of decreased kidney function in patients with liver cirrhosis has been widely proven. Data on how far the severity of liver cirrhosis can affect the decline in renal function has not been widely known. Objective. This study aimed is to verify correlation between the severity degree of the liver (Child Pugh/CP score) with levels of Cystatin C serum. Methods. This study was a cross sectional study. Population studied were patients with liver cirrhosis who visited the clinic of Gastroentero-hepatology and treated in the department of Internal Medicine ward Dr. Sardjito Hospital - Yogyakarta during October 2009 - March 2010. Data were analyzed with a computer; the analyzed of the CP score correlation with increased levels of Cystatin C using Spearman correlation for data not normally distributed. Result. We found 48 research subjects during the month of October 2009 - March 2010. The subjects were 35 male (72.9%) and 13 female (27.1%) with average age 53.1 ± 11.9 years old. Subjects with CP-A were 9 patients (18.8%), CP-B were 14 patients (29.2%) and CP-C were 25 patients (52.1%). The range value of Cystatin C between CP class shows CP-A  0.7 - 0.97 mg/L, CP-B 0.7 - 0.49 mg/L, and CP-C 0.7 – 2.49 mg/L (statistically significant difference with p <0.05). Liver cirrhosis patients who had Cystatin C levels <0.96 mg/L were 22 patients (45.83%) and 26 patients (54.1%), had higher levels of Cystatin C> 0.96 mg/L. Child score was positively correlated to increased levels of Cystatin C (p= 0.000; r= 0.566) linear regression equation with Cystatin was = 0.37 + 0.08 * Child score (r square 0.32). Conclusion. This study concluded that the Child score had a moderate positive correlation with Cystatin C serum level.  Key words: Liver Cirrhosis – Child Pugh score - Cystatin C 
PSIKOSIS PADA AUTOIMUN SEBUAH LAPORAN KASUS SISTEMIK LUPUS ERITEMATOSUS KOINSIDENSI DENGAN MULTIPLE SKLEROSIS Deshinta Putri Mulya; Arief Darmawan
Collaborative Medical Journal Vol 5 No 1 (2022): Januari
Publisher : LPPM Universitas Abdurrab

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36341/cmj.v5i1.1725

Abstract

Varied symptoms of Systemic lupus erythematosus make its diagnosis challenging. A 40 year old woman was admitted to the Emergency Room for self-talking, rambling and being rowdy. Psychiatric assessment showed an indication of organic hallucination. The patient had been undergoing neurologic treatment for four months due to multiple sclerosis with onset symptoms including of paraperese which was improved after taking steroids. In addition to neurologic symptoms, other conditions including mucous ulcers, malar rash, vasculitis, hair loss, and arthritis were found. The laboratory test indicated the presence of strong positive ANA profile in the RNP/Sm, Sm, SS-A native, Ro-52, SS-B and Ribosomal Protein. Patient’s condition significantly improved after undergoing treatment for Systemic lupus erythematosus flare with a coincidence of multiple sclerosis.
Meningoensefalitis Manifestation in Wegener’s Granulomatosis with Anca Negative: Case Report Sudibyo, Triyanti Kurniasari Ananta Putri; Mulya, Deshinta Putri; Budiono, Eko; Satiti, Sekar; Rosalia, Levina Prima
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 3
Publisher : UI Scholars Hub

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Wegener’s granulomatosis is a vasculitis that affects small to medium blood vessels, generally occurring at the age of 64- 75 years with an incidence of 8-10 / 1,000,000 people. Meningoencephalitis manifestations are rarely found in Wegener’s granulomatosis with the incidence only in the range of 0-7%. Anti-neutrophil cytoplasmic antibody (ANCA) is often used in diagnosing Wegener’s granulomatosis, but negative ANCA can be found in 10-20% of cases. A 30-year-old man came with a decrease in consciousness. His anamnesis and physical examination showed signs that led to Wegener’s granulomatosis, despite negative ANCA examination results. After getting therapy according to the management of the Wegener’s granulomatosis there is a clinical improvement in the patient. This case is raised because it is a rare case and needs sharpness in establishing a diagnosis. Wegener’s granulomatosis can cause very bad progress, but if handled properly, complete remission can be achieved.
Sensitisasi Alergen Makanan pada Pasien Kolitis Eosinofilik: Laporan Kasus Zagoto, Agnes Dina Irene Dorithy; Mulya, Deshinta Putri; Ratnasari, Neneng
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 1
Publisher : UI Scholars Hub

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Eosinophilic colitis is a very rare disease that can occur in the bimodal population (neonates and young adults) with a prevalence was 2.1/100,000 in overall population and 2.3/100,000 in adults. However, only about 0.1% of cases were diagnosed from biopsy results obtained during colonoscopy. The lack of precise histological criteria for the quantity of eosinophils in the colon mucosa creates a distinct challenge in diagnosing eosinophilic colitis. Eosinophilia in the gastrointestinal tract can be mediated by IgE and non-IgE, but non-IgE tends to be dominant in adults. This report discusses about a case of a 64-year-old male with bloody diarrhea that has been occur for two years. The anamnesis revealed symptoms suggestive of eosinophilic colitis, including complaints of diarrhea with abdominal pain and weight loss. Laboratory tests revealed an increase in peripheral eosinophil count and elevated levels of IgE. A positive skin prick test supported the presence of food allergen sensitization. The endoscopy revealed signs of ulcerative colitis, but the biopsy showed evidence of eosinophilic colitis. Initially, the patient was treated for ulcerative colitis but did not show improvement. Following treatment for eosinophilic colitis, the patient’s clinical status showed improvement. Since eosinophilic colitis can be chronic and recur, an accurate diagnosis and proper management are crucial for achieving complete remission. Keywords: chronic diarrhea, eosinophilic colitis, food allergen sensitization, IgE, peripheral eosinophilia
Anti-DFS70 as Nonsystemic Autoimmune (Primary Billiar Cholangitis) Concomitant Disease Marker in Systemic Lupus Erythematosus Putra, Yasjudan Rastrama; Mulya, Deshinta Putri; Indrarti, Fahmi
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 2
Publisher : UI Scholars Hub

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Abstract

Anti-dense fine speckled 70 (DFS70) is known as a non-systemic autoimmune marker. It is only found in 1% of systemic autoimmune patients and 2–22% in healthy population. To the best of our knowledge, no anti-DFS70 positive has been reported in systemic lupus erythematosus (SLE) patients with primary billiary cholangitis (PBC) comorbidities. We reported a 40-year-old woman that was diagnosed with SLE 1-month before, came to the hospital due to seven days of fatigue, loss of appetite, icteric, arthralgia, hair loss, and unexplained fever. Total bilirubin was 9.46 mg/dl, direct bilirubin 7.73 mg/dl, gamma-glutamyl transferase (GGT) 503 U/L, alkaline phosphatase (ALP) 520 U/L, ANA-IF 1:1000, ANA-profile measurement borderline on the anti-centromere B, and three positives on the DFS70. Magnetic resonance cholangiopancreatography (MRCP) shown the PBC feature. After ursodeoxycholic acid (UDCA) therapy 250 mg twice daily, ALP and GGT backed to normal limits within two months. This case reminds the doctor that anti-DFS70 finding in SLE needs further evaluation, whether other nonsystemic autoimmune exist or not. Concomitant PBC with SLE well responded with UDCA standard therapy.
Co-Authors Arief Darmawan Eko Budiono Fahmi Indrarti Jamhari Jamhari Neneng Ratnasari Neneng Ratnasari Putra, Yasjudan Rastrama Rosalia, Levina Prima Satiti, Sekar Siti Nurdjanah Sudibyo, Triyanti Kurniasari Ananta Putri Zagoto, Agnes Dina Irene Dorithy