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All Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
Mabruratussania Maherdika
Department of Clinical Pathology, Faculty of Medicine, Diponegoro University/Dr. Kariadi Hospital, Semarang
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience

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Graves Disease (Thyroid Storm) with Polyautoimmune Disorders (Autoimmune Hemolytic Anemia and Probable Autoimmune Hepatitis) Mabruratussania Maherdika; Banundari Rachmawati; Andreas Arie Setiawan
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.v28i1.1745

Abstract

Graves' disease is caused by IgG antibodies that bind to the Thyroid Stimulating Hormone (TSH) receptor on the surfaceof the thyroid gland. These bonds drive the growth of stimulated thyroid follicular cells causing the glands to enlarge andincrease the production of thyroid hormones. Previous studies mention the association of HLA-B8 and HLA-DR3 withGraves' disease and the Cytotoxic T-lymphocyte-associated-4 (CTLA-4) gene on chromosome 2q33 as a result of reducingT-cell regulation, resulting in autoimmune disease. Autoimmune thyroid disease is often found together with otherautoimmune disorders (polyautoimmune). A 51-year-old male complained of dyspnea, yellowing of the body, and a lumpon the neck. One year ago, he was diagnosed with hyperthyroidism. Graves' disease was suspected due to a score of 22 forthe Wayne index, FT4 96.9 pmol/L, TSHs <0.01 μIU/mL, TRAb 10.8 IU/L, thyroid uptake test for toxic diffuse struma. Inaddition, the patient had atrial fibrillation and a thyroid storm with a Bruch Wartofsky index score of 65. Laboratoryexamination found normocytic normochromic anemia, thrombocytopenia, reticulocytosis, direct coomb test and autocontrol results positive one, SGOT 87 U/L, SGPT 59 U/L, alkali phosphatase 166 U/L, total bilirubin 38.13 mg/dL, directbilirubin 16.59 mg/dL, indirect bilirubin 21.54, LDH 318 U/L, establishing the diagnosis of Autoimmune Hemolytic Anemia(AIHA). Autoimmune hepatitis score: 15, so a diagnosis of probable autoimmune hepatitis was made.
Relationship between Body Anthropometric Measurement and Parathyroid Hormone in Female Subjects Mabruratussania Maherdika; Meita Hendrianingtyas
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 2 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i2.1796

Abstract

The distribution of fat tissue is related to the risk of metabolic diseases. Parathyroid Hormone (PTH) is an essential hormone for calcium homeostasis. According to several types of research, body fat affects PTH levels. Currently, Body Mass Index (BMI) is not the only parameter needed to identify the body fat distribution in accordance with chronic disease risks such as Waist Circumference (WC), Waist to Hip Ratio (WHR), and Waist to Height Ratio (WHtR). The study aimed to determine the relationship between body anthropometric measurement and PTH. A cross-sectional study was performed on a healthy population of 75 healthy female volunteers with a BMI ≥ 23 kg/m2. Waist circumference, WHR, WHtR, and BMI measurements were carried out and followed by the PTH fragment 1-84 (PTH1-84) test. Data were analyzed using the Spearman test with a significance of p<005. There was no significant correlation between PTH and WHR (r=0.057; p=0.628). There was weak correlation between PTH and BMI (r=0.268; p=0.020), WC (r=0.287; p=0.012) and WHtR (r=0.238; p=0.04). Body mass index, WC, and WHtR can be used as anthropometric parameters to determine PTH disorders
Graves Disease (Thyroid Storm) with Polyautoimmune Disorders (Autoimmune Hemolytic Anemia and Probable Autoimmune Hepatitis) Mabruratussania Maherdika; Banundari Rachmawati; Andreas Arie Setiawan
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.v28i1.1745

Abstract

Graves' disease is caused by IgG antibodies that bind to the Thyroid Stimulating Hormone (TSH) receptor on the surface of the thyroid gland. These bonds drive the growth of stimulated thyroid follicular cells causing the glands to enlarge and increase the production of thyroid hormones. Previous studies mention the association of HLA-B8 and HLA-DR3 with Graves' disease and the Cytotoxic T-lymphocyte-associated-4 (CTLA-4) gene on chromosome 2q33 as a result of reducing T-cell regulation, resulting in autoimmune disease. Autoimmune thyroid disease is often found together with other autoimmune disorders (polyautoimmune). A 51-year-old male complained of dyspnea, yellowing of the body, and a lump on the neck. One year ago, he was diagnosed with hyperthyroidism. Graves' disease was suspected due to a score of 22 for the Wayne index, FT4 96.9 pmol/L, TSHs <0.01 μIU/mL, TRAb 10.8 IU/L, thyroid uptake test for toxic diffuse struma. In addition, the patient had atrial fibrillation and a thyroid storm with a Bruch Wartofsky index score of 65. Laboratory examination found normocytic normochromic anemia, thrombocytopenia, reticulocytosis, direct coomb test and auto control results positive one, SGOT 87 U/L, SGPT 59 U/L, alkali phosphatase 166 U/L, total bilirubin 38.13 mg/dL, directbilirubin 16.59 mg/dL, indirect bilirubin 21.54, LDH 318 U/L, establishing the diagnosis of Autoimmune Hemolytic Anemia (AIHA). Autoimmune hepatitis score: 15, so a diagnosis of probable autoimmune hepatitis was made.
Relationship between Body Anthropometric Measurement and Parathyroid Hormone in Female Subjects Mabruratussania Maherdika; Meita Hendrianingtyas
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 2 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i2.1796

Abstract

The distribution of fat tissue is related to the risk of metabolic diseases. Parathyroid Hormone (PTH) is an essential hormone for calcium homeostasis. According to several types of research, body fat affects PTH levels. Currently, Body Mass Index (BMI) is not the only parameter needed to identify the body fat distribution in accordance with chronic disease risks such as Waist Circumference (WC), Waist to Hip Ratio (WHR), and Waist to Height Ratio (WHtR). The study aimed to determine the relationship between body anthropometric measurement and PTH. A cross-sectional study was performed on a healthy population of 75 healthy female volunteers with a BMI ≥ 23 kg/m2. Waist circumference, WHR, WHtR, and BMI measurements were carried out and followed by the PTH fragment 1-84 (PTH1-84) test. Data were analyzed using the Spearman test with a significance of p<005. There was no significant correlation between PTH and WHR (r=0.057; p=0.628). There was weak correlation between PTH and BMI (r=0.268; p=0.020), WC (r=0.287; p=0.012) and WHtR (r=0.238; p=0.04). Body mass index, WC, and WHtR can be used as anthropometric parameters to determine PTH disorders
Co-Authors Andreas Arie Setiawan Banundari Rachmawati Meita Hendrianingtyas