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COLD AGGLUTININ PADA PENDERITA COMMUNITY ACQUIRED PNEUMONIA Johanis Johanis; Juli Soemarsono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 18, No 3 (2012)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v18i3.379

Abstract

Cold agglutinins at below physiologic body temperature can cause spontaneous agglutinations of erythrocytes. Cold agglutinins result from a particular antibodies activation on erythrocytes associated with a primary disease, including infection. The generation of antibody activates complement resulting in hemolysis. A 63-year-old man suffered from shortness of breath accompanied with productive cough, fever, right chest pain, loss of appetite, nausea, and occasionally vomiting. Physical examination showed an increase of pulse rate, respiration rate, and body temperature. Lung examination showed right intercostals retraction and rales in both lungs, but no abnormality detected in other organs. Chest X-ray showed pneumonia. EDTA whole blood showed spontaneous agglutinations at room temperature, however this did not occur by maintaining temperature at 37° C. Different complete blood count results were shown between agglutinated blood and absent of agglutination blood samples. As anti-I, anti-i, and/or anti-H was suspected, agglutinations for anti-A and anti-AB occurred by using ABO forward grouping test, whereas reverse grouping showed agglutinations for A, B, and O cells. Protein electrophoresis showed increase of alpha- 1 and gamma globulin; decrease of renal function; slightly increase of indirect bilirubin; and suspected Extended Spectrum Beta-Lactamase (ESBL) Klebsiella pneumoniae. The diagnosis of this case was community acquired pneumonia and suspected ESBL. Cold agglutinins affected CBC evaluations mostly shown in the erithrocyte index, nevertheless this could prevented by maintaining at physiologic body temperature. Infection could induce activation of cold agglutinins.
PERBANDINGAN PEMERIKSAAN TRIGLISERIDA METODE GLYCEROL BLANKING DAN NON GLYCEROL BLANKING PADA SIROSIS HEPATIS Sri Widyaningsih; Leonita Anniwati; Juli Soemarsono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 1 (2012)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v19i1.393

Abstract

Liver cirrhosis is a chronic liver disease with fibrosis and impairment of function. In liver disease increasing endogenous free glycerol has been found which constitutes a source of interference in the measurement of (TG). The aim of this study is to compare the glycerol blanking (TG-GB) which does not interfere with endogenous free glycerol to non glycerol blanking (TG-NGB) method in measuring TG in liver cirrhosis patients. In this study, sera were obtained from 22 liver cirrhosis and 30 healthy persons. All sera were measured for TG using TMS 1024i (Tokyo Boeki Medical System) with glycerol blanking (TG-GB) to non glycerol blanking (TG-NGB) method. In addition to this study, measurement of free glycerol was also compared to difference calculated TG-NGB and TG-GB in liver cirrhosis patients. The mean of TG-GB and TG-NGB measurements from healthy persons was 115.30±70.35 mg/dL and 121.27±67.14 mg/dL (p=0.108), respectively. The mean of TG-GB and TG-NGB measurements from liver cirrhosis patients was 101.09± 78,55 mg/dL and 120.91±79.44 mg/dL (p<0.0001). There was a significant difference between TG-GB and TG-NGB, and there was no significant difference between measurement of free glycerol to difference calculated TG-NGB and TG-GB in liver cirrhosis (p=0.784). However, there was a significant correlation between TG-GB and TG-NGB in healthy persons and liver cirrhosis patients. (p<0.0001). The measurement of TG-GB is more accurate than TG-NGB method in liver cirrhosis patients.
IMMATURE PLATELET FRACTION DI DEMAM DENGUE DAN DEMAM BERDARAH DENGUE (Immature Platelet Fraction in Dengue Fever and Dengue Hemorrhagic Fever) Izzuki Muhashonah; Juli Soemarsono; Puspa Wardhani; Aryati Aryati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 1 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i1.1257

Abstract

Thrombocytopenia is a hematological abnormality found in the majority of Dengue Virus Infection cases with manifestations suchas Dengue Fever (DF) and Dengue Hemorrhagic Fever (DHF). Bone marrow response to the decrease in platelets is by increasingthrombopoiesis which can be identified by Immature Platelet Fraction (IPF) examination as an indirect indicator of bone marrow responseto thrombocytopenia. The examination of IPF in venous blood was performed on 29 subjects who met the 1997 WHO criteria, carriedout from January until August 2012. The EDTA blood samples were examined twice, on the day of their admittance and two days later,based on a flowcytometry principle using Sysmex XE-2100. The IPF was derived from the immature platelet ratio against the total numberof platelets (IPF %). The test results were statistically analyzed by using SPSS 20. It was found, that IPF in DHF compared between thefirst and the third day of their admittance was statistically significantly different with p = 0.033 compared to DF with p = 0.444. ThePearson’s correlation showed an inverse correlation between IPF and platelets with r = -0.675 and p = 0.01. The statistical analysisrevealed a significant difference in IPF between moderate- and mild-thrombocytopenia on the first and third day of their admittance withp = 0.014 and 0.001, respectively. Based on this study it can be concluded that IPF can be used to indicate the bone marrow response inboth DF and DHF related to thrombocytopenia.