Arifoel Hajat
Department Of Clinical Pathology, Faculty Of Medicine, Airlangga University, Surabaya

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The Differences Levels of RANTES and PF4 Based on the Storage of Platelet Concentrate Ni Made Rindra Hermawathi; Betty Agustina Tambunan; Arifoel Hajat
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1577

Abstract

Blood component transfusion is often used as the primary therapy as it is still considered safe. Platelet Concentrate (PC) transfusion plays a critical role in preventing bleeding in patients with severe thrombocytopenia. Allergic reactions are the most frequent transfusion reactions after PC administration. Regulated on Activation Normal T-Cell Expressed and Secreted (RANTES) and Platelet Factor 4 (PF4) cytokines released by platelets during PC storage are responsible for allergic reactions after transfusion. The purpose of this study was to analyze changes in RANTES and PF4 levels during PC storage. This study was an observational analytical research with a time series design carried out at the Clinical Pathology Laboratory and Blood Bank of the Dr. Soetomo Hospital, Surabaya, from June to July 2019. RANTES and PF4 levels in 27 bags derived from Platelet Rich Plasma (PRP) on storage for day 1, day 3, and day five were measured using the ELISA sandwich method. Subject same variant test or Friedman test was used for statistical analysis. The results showed no significant differences in RANTES and PF4 levels based on the storage duration of PCs on days 1, 3, and 5, with p=0.717, and p=0.614, respectively. There was no difference in the storage of PCs from day 1 to day five, and there was no effect on allergic reactions after PC transfusion.
Pancytopenia and Progressive Splenomegaly in Patient with Disseminated Histoplasmosis Paulus Budiono Notopuro; Arifoel Hajat; Made Putra Sedana
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 2 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i2.1621

Abstract

Disseminated histoplasmosis is a severe manifestation of fungal infection caused by Histoplasma capsulatum. It usuallyoccurs in a patient with an immunodeficiency state. With the increase of HIV infection and the use of immunosuppressantdrugs lately, its prevalence also increases. A case of 43 years old female with prolonged fever, pancytopenia, and massiveprogressive splenomegaly. The diagnosis of disseminated histoplasmosis and the secondary hemophagocytic syndromewas made based on bone marrow examination that showed increased hemophagocytic processes and multipleintracytoplasmic H.capsulatum. She had been treated with Itraconazole 200 mg for three months. In the first month'sevaluation, her complete blood count improved without any transfusions, and the size of her spleen size decreased. She hadbeen fully recovered after the completion of 3-month treatment.
RELATIONSHIP BETWEEN D-DIMER LEVEL AND CLINICAL SEVERITY OF SEPSIS Yessy Puspitasari; Aryati Aryati; Arifoel Hajat; Bambang Pujo Semedi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 23, No 3 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v23i3.1196

Abstract

D-dimer merupakan tolok ukur laboratorium yang menunjukkan derajat keparahan pada sepsis. Selama tahapan sepsis terjadiaktivasi prokoagulan yang tidak diimbangi aktivitas antikoagulan (depresi protein C dan meningkatnya pelepasan Plasminogen activatorinhibitor) sehingga dapat meningkatkan hasilan fibrin polimer. Fibrin polimer yang telah mengalami cross-linked akan difibrinolisis olehplasmin membentuk formasi D-dimer. Tujuan penelitian untuk menganalisis hubungan D-dimer dengan derajat keparahan klinis darisepsis. Metode penelitian bersifat potong lintang observasional. Sampel darah sitrat dari 52 pasien sepsis yang dirawat di IRD, ICU, ROI,Ruang penyakit dalam RSUD. Dr. Soetomo Surabaya, dikumpulkan selama Februari 2016–Juni 2016. Kadar D-dimer diukur denganmetode ELFA (Enzyme Linked Fluorescent Assay). Proses dan tafsiran data menggunakan analisis deskriptif, One sample Kolmogorovsmirnovdan uji Pearson digunakan untuk menganalisis kenasaban. Didapatkan rerata kadar D-dimer 3879,46±2800,29 ng/mL.D-dimer pada non-survivors sepsis menurut skor APACHE II dan SOFA lebih tinggi daripada survivors sepsis. Terdapat kenasabanpositif yang bermakna antara kadar D-dimer dengan skor APACHE II dan skor SOFA r=0,513 dan r=0,580 (p=0,01). Berdasarkantelitian ini dapat disimpulkan D-dimer memiliki kenasaban dengan derajat keparahan klinis dari sepsis, semakin tinggi nilai D-dimermenunjukkan keparahan sepsis.
LEUKOCYTE INTERFERENCE ON HEMOGLOBIN EXAMINATION IN HEMATOLOGY MALIGNANCY Trinil Sulamit; Fery H. Soedewo; Arifoel Hajat
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 23, No 3 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v23i3.1193

Abstract

Pasien keganasan hematologi sering menunjukkan gejala anemia dengan hasil laboratorium leukositosis. Tolok ukur penentu anemiasalah satunya hemoglobin, namun pemeriksaannya terganggu oleh jumlah leukosit tinggi yang menyebabkan hemoglobin tinggi palsu.Penelitian ini bertujuan mencari berapa jumlah leukosit minimal penyebab hemoglobin tinggi palsu pada keganasan hematologi. Sampeldarah EDTA pasien keganasan hematologi yang memeriksakan darah rutin di Laboratorium Patologi Klinik RSUD Dr. Soetomo bulanApril–Mei 2016. Penelitian analisis observasional dengan membandingkan hemoglobin tanpa pemusingan dengan hemoglobin setelahpemusingan serta dibuang buffy coat-nya. Terdapat 93 sampel dengan leukemia 43%, limfoma 16,12% dan terduga leukemia 38%.Rerata selisih hemoglobin yaitu 0,06±0,089; 0,025±0,05; 0,1±0,081; 0,15±0,07; 0,81±0,63; 0,94±1,13; 1,13±0,718; 1,6±0,818 g/dL pada peningkatan kelompok jumlah leukosit secara berurutan >11.000-20.000 sel/μL, >20.000-30.000 sel/μL, >30.000-40.000sel/μL, >40.000-50.000 sel/μL, >50.000-100.000 sel/μL, >100.000-200.000 sel/μL, >200.000-300.000 sel/μL, >400.000 sel/μL.Kenasaban rerata selisih hemoglobin dengan kelompok jumlah leukosit menunjukkan makin tinggi leukosit maka makin besar rerataselisih hemoglobin dengan kenasaban positif sedang. Semakin tinggi jumlah leukosit makin tinggi persentase hemoglobin tinggi palsudan rerata selisih hemoglobin makin besar. Leukosit minimal penyebab hemoglobin tinggi palsu pada keganasan hematologi yaitu 56.745sel/μL yang memiliki kepekaan 89,4% dan kekhasan 100%, dengan koefisien  0,592.
CORRELATIONS BETWEEN MEAN PLATELET VOLUME AND IMMATURE PLATELET FRACTION TO HEMOGLOBIN A1C IN PATIENTS WITH TYPE 2 DIABETES MELLITUS Dian W Astuti; Sony Wibisono; Arifoel Hajat; Sidarti Soehita
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 1 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i1.1148

Abstract

Pasien diabetes melitus tipe 2 berkebahayaan mengalami komplikasi makro dan mikrovaskuler, yang dipengaruhi oleh kendaliglikemik. Reaktivitas trombosit berperan pada timbulnya komplikasi ini, terutama komplikasi kardiovaskuler. Tujuan penelitian iniadalah membandingkan MPV dan IPF di kendali glikemik baik dan buruk dan menentukan adanya kenasaban MPV dan IPF terhadapHbA1c. Penelitian bersifat analitik observasional dengan rancang bangun potong lintang. Sampel darah EDTA dari 43 orang pasienDM tipe 2, dikumpulkan selama Januari-Februari 2016. HbA1c diperiksa dengan Dimension RxL, sedangkan MPV dan IPF diperiksadengan Sysmex XN-1000. Rerata nilai MPV 10,36±0,84 fL, rerata nilai IPF 4,22±2,29%. Uji perbedaan nilai MPV menurut kendaliglikemik didapatkan p=0,494, uji perbedaan IPF didapatkan p=0,462. Uji kenasaban Pearson antara IPF dan MPV didapatkanr=0,877 (p<0,0001), MPV dan HbA1c didapatkan r=0,018 (p=0,907), IPF dan HbA1c didapatkan r=0,128 (p=0,414). Penelitian inimenunjukkan rerata MPV berada dalam rentang normal, sedangkan rerata IPF meningkat, namun tak terdapat perbedaan bermaknanilai MPV dan IPF di kendali glikemik baik dan buruk. MPV dan IPF pada penelitian ini tak bernasab dengan HbA1c.
Hairy Cell Leukemia (Morphologic and Immunophenotypic Profile) Anindita Novia Damayanti; Arifoel Hajat
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1712

Abstract

Hairy Cell Leukemia (HCL) is a lymphoproliferative B cell abnormality dominated by mature lymphocytes with cytoplasmic projections and often misunderstood as Chronic Lymphocytic Leukemia (CLL). Misdiagnosis can be caused by errors in the preparation of peripheral Blood Smear Evaluation (BSE). Immunophenotyping is an option to differentiate HCL from CLL. A 56-year-old female presented with complaints of weakness. Physical examination showed conjunctival anemia 3 3 and hepatosplenomegaly. Hematological test results were as follows: Hb 7.4 g/dL; WBC 131.24x10 /uL; and Plt 61x10 /uL. BSE And Bone Marrow Aspiration (BMA) showed predominantly mature lymphocytes with cytoplasmic projections and suspected CLL with HCL as the differential diagnosis. Immunophenotyping with peripheral blood samples showed CD19+, CD20+, CD79a+, HLA-DR+, CD5-, and CD7- suggesting an increasing mature lymphocytes population (74.16%) that expressed B lymphoid lineage. White Precursor Cell (WPC) channel test showed an abnormal lymphocytes population. The differential diagnosis of patients with dominant mature lymphocytes BSE with cytoplasmic projections was CLL and HCL. Immunophenotyping of CLL showed positive results on B cell markers (CD19, CD20, CD79a, and HLA-DR) with aberrant CD5. However, in such an HCL case like this, there were strongly positive results on B cell markers but the absence of aberrant CD5. This study was supported by the presence of abnormal lymphocytes population in the WPC test. The diagnosis of HCL in this patient was based on interpretation of BSE and immunophenotyping, supported by the WPC test.
Determining Acute Leukemia Lineage Using Mie Map Red Blood Cell Nelly Zuroidah; Arifoel Hajat; Paulus Budiono Notopuro
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1747

Abstract

The determination of myeloid and lymphoid lineage is essential for the diagnosis and therapy of acute leukemia. Immunophenotyping is the gold standard to determine the lineage of acute leukemia, but it is still constrained and relatively expensive. Mie Map RBC in the ADVIA 2120i is a parameter that can give additional information about myeloid and lymphoid lineage but has never been studied before. It is expected that Mie Map RBC can be used to differentiate the lineage of acute myeloid and lymphoid leukemia if immunophenotyping is not present. This study aimed to analyze the diagnostic value of Mie Map RBC with ADVIA 2120i towards immunophenotyping in determining myeloid and lymphoid lineage in acute leukemia. Child and adult patients diagnosed with acute leukemia (n=30) that had peripheral blood smear and bone marrow aspiration with blasts > 20% were examined using ADVIA 2120i. The Mie Map RBC lineage results were compared to the lineage of immunophenotyping. The sensitivity and specificity of the Mie Map RBC myeloid series are respectively 60.00%, 93.33%. The sensitivity and specificity of the Mie Map RBC lymphoid series are respectively 93.33% and 60.00%. The diagnostic accuracy value of Mie Map RBC is 76.67%. The determination of acute leukemia myeloid series lineage has high specificity. If there is no population outside the matrix of Mie Map RBC, it highly suggests myeloid series. On the other hand, the determination of acute leukemia lymphoid series lineage has a relatively low specificity meaning that the population outside the matrix of Mie Map RBC does not always suggest a lymphoid lineage
Correlation between WDF, WNR, and RET Abnormal Scattergram Detected by Sysmex XN-1000 and Parasitemia of Malaria Patients in Merauke Hospital Merylin Ranoko; Aryati Aryati; Arifoel Hajat
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 1 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i1.1521

Abstract

Malaria remains a health problem in Indonesia. Microscopic examination with Giemsa staining is the gold standard for diagnosing malaria. The density of parasites correlates with the degree of severity and response to therapy of malaria. Malaria-causing plasmodium can be detected by Sysmex XN-1000 which is marked by abnormalities in the WDF, WNR and RET scattergram. This research aimed to determine the correlation of WDF, WNR and RET abnormal scattergram detected by Sysmex XN-1000 and the parasitemia index of malaria at the Merauke General Hospital. This was a cross-sectional study with observational approach conducted between November 2017 – February 2018 at the Merauke General Hospital. Positive malaria samples were stained with Giemsa, their parasitemia index was calculated, routine complete blood count using Sysmex XN-1000 was performed, and the scattergram abnormalities were then analyzed. There were 65 positive malaria samples as follows: P.falciparum (35%), P.vivax (60%), P.ovale (3.1%), and P.malariae (1.5%), but the species did not correlate with parasitemic index (p=0.691). Abnormalities of WDF and WNR scattergram were predominantly found than RET scattergram (80% vs. 27.7%). P.vivax predominantly caused abnormalities of the WDF and WNR scattergram in 36 of 39 samples (92.3%), whereas P.falciparum predominantly caused abnomalities of the RET scattergram in 14 of 23 samples (60.9%). There was 95% positivity of an abnormality in WDF/WNR/RET scattergram with a cut-off of > 5,0165.5/µL. There was correlation between WDF, WNR, RET scattergram detected by Sysmex XN-1000 and the parasitemia index.
The Difference of Reticulocyte Hemoglobin Equivalent Pre- and Post-Ultrafiltration Hemodialysis in Patients with Chronic Kidney Disease Ni Made Rindra Hermawathi; Arifoel Hajat; Yetti Hernaningsih; Widodo Widodo
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 3 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i3.1556

Abstract

Chronic Kidney Disease (CKD) is a condition characterized by kidney damage and a decrease of Glomerular Filtration Rate of less than 60 mL/ min/1.73 m2 in more than three months. Anemia is the most common complication in patients with CKD who regularly undergo hemodialysis. Reticulocyte Hemoglobin Equivalent (Ret-He) is a new parameter that can reflect the storage of iron for erythropoiesis. This study compared the Ret-He level pre and post-hemodialysis and evaluated the effect of ultrafiltration (UF) hemodialysis to Ret-He level in CKD patients. This research was an observational analytical study. Samples were 50 patients with CKD who underwent hemodialysis regularly in Dr. Soetomo Hospital Surabaya by consecutive sampling from August–September 2017. The measurement of the Ret-He level pre ultrafiltration hemodialysis was divided into UF < 2 L and UF ≥ 2 L. Both groups showed homogenous results. The group with UF < 2 L increased significantly from pre to post ultrafiltration (p=0.010). The group with UF ≥ 2 L was not increased considerably from 30.57±3.62 to 32.69±3.45 (p=0.413). Ret-He level in the group with UF < 2 L was 0.81±1.10, significantly higher than the group with UF  ≥ 2 L  0.12±0.83 (p=0.017). The difference of Ret-He level pre and post ultrafiltration was significant in UF < 2 L. There was a significant increase of the Ret-He level in hemodialysis with  UF < 2 L compared to UF ≥ 2 L. The measurement of Ret-He should be performed before hemodialysis due to an increase in Ret-He after ultrafiltration hemodialysis.
The Differences Levels of RANTES and PF4 Based on the Storage of Platelet Concentrate Ni Made Rindra Hermawathi; Betty Agustina Tambunan; Arifoel Hajat
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1577

Abstract

Blood component transfusion is often used as the primary therapy as it is still considered safe. Platelet Concentrate (PC) transfusion plays a critical role in preventing bleeding in patients with severe thrombocytopenia. Allergic reactions are the most frequent transfusion reactions after PC administration. Regulated on Activation Normal T-Cell Expressed and Secreted (RANTES) and Platelet Factor 4 (PF4) cytokines released by platelets during PC storage are responsible for allergic reactions after transfusion. The purpose of this study was to analyze changes in RANTES and PF4 levels during PC storage. This study was an observational analytical research with a time series design carried out at the Clinical Pathology Laboratory and Blood Bank of the Dr. Soetomo Hospital, Surabaya, from June to July 2019. RANTES and PF4 levels in 27 bags derived from Platelet Rich Plasma (PRP) on storage for day 1, day 3, and day five were measured using the ELISA sandwich method. Subject same variant test or Friedman test was used for statistical analysis. The results showed no significant differences in RANTES and PF4 levels based on the storage duration of PCs on days 1, 3, and 5, with p=0.717, and p=0.614, respectively. There was no difference in the storage of PCs from day 1 to day five, and there was no effect on allergic reactions after PC transfusion.