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Characteristics of Patients with Autoimmune Rheumatic Disease in the Era of COVID-19 Pandemic in Indonesia Rudy Hidayat; Harry Isbagio; Anna Ariane; Faisal Parlindungan; Laniyati Hamijoyo; I Nyoman Suarjana; Dwi Budi Darmawati; Rakhma Yanti Hellmi; Gede Kambayana; IA Ratih Wulansari Manuaba; Awalia Awalia
Indonesian Journal of Rheumatology Vol. 12 No. 1 (2020): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v12i1.159

Abstract

Background Coronavirus Disease 2019 (COVID-19) could be fatal in high-risk patient including autoimmune rheumatic patients. Nowadays, the management of these patients becomes dilemma because the use of steroids and disease-modifying anti-rheumatic drugs could suppress the immune system however, poor control of the underlying disease increases the infection risk. Understanding the characteristics of these patients in the COVID-19 pandemic is essentials to establish management guidelines and identify patients who are more susceptible to COVID-19. This study aimed to determine the characteristics of autoimmune rheumatic patients in the era of COVID-19 pandemic in Indonesia. MethodA descriptive study using national scale survey method was conducted. The subjects were autoimmune rheumatic patients in Indonesia and recruited using consecutive sampling. The variables evaluated in this study were demographic data, history of disease, current medications taken, daily activities in the COVID-19 pandemic, and also data related to COVID-19. The surveys distributed in online form to patients with autoimmune rheumatic disease in Indonesia. ResultTotal participants in this study were 570 patients, mostly women (93.9%), aged <60 years old (97.2%), and diagnosed with systemic lupus erythematosus (62.8%). Glucocorticoid (70.2%) especially low dose glucocorticoid (52.6%) is the most medication taken by patients. A 30.5% of patients is taking hydroxychloroquine/chloroquine and 88.1% of them have good compliance. During COVID-19 pandemic, 76.5% respondents still do normal activities/work and only 53.2% use personal protective equipment. Eleven of 541 respondents had positive PCR test and confirmed to COVID-19. The risk of COVID-19 infection based on British Society of Rheumatology (BSR) scoring system showed that 57.9%, 28.6%, and 13.5% patients in high, moderate and low risk, respectively. ConclusionPatients with autoimmune rheumatic diseases might be more susceptible to COVID-19 than the general population. Interplay of aging, therapies and disease-specific factors, comorbidities and the proper use of personal protective equipment seem to contribute. Keywords :autoimmune rheumatic disease, characteristic, COVID-19, Indonesia
Diagnostic Problem in a Patient with Tuberculosis Arthritis Dicky Febrianto; Awalia Awalia
Current Internal Medicine Research and Practice Surabaya Journal Vol. 4 No. 1 (2023): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cimrj.v4i1.42289

Abstract

Extra-pulmonary tuberculosis (TB) remains a big public health problem worldwide. Although TB most commonly affects the lungs, any organ or tissue can be involved. TB arthritis is a rare form of extra-pulmonary TB. TB arthritis usually manifests as mild and non-specific arthritis. A 35-year-old male was admitted to the emergency room of Dr. Soetomo General Academic Hospital Surabaya due to pain of left knee since two days prior to admission. His symptom began on previous six months with the swelling of the left knee that gradually worsened so that he had an antalgic gait. Radiological examination of left knee joint showed inflammatory arthritis, accompanied by joint effusion and soft tissue swelling. USG examination of the left knee showed the presence of non-specific left knee arthritis. Patient underwent debridement. Anatomical pathology examination of the tissue obtained at the time of debridement, showed the TB granulomatous inflammation. The Ziehl-Nielson stain of left knee tissue also showed the TB granulomatous inflammation. Patient was then treated with analgesics and anti-TB drugs. The intensive phase of anti-TB therapy was planned to be 2 month, then evaluated and followed by continuation phase for about 7 months. The knee joint is the third most common site of osteoarticular TB after spine and hip. Insidious onset of pain which, in some patients may be present for years, is the usual presentation. The joint is usually warm, and wasting of the thigh muscles is usually marked. Synovial hypertrophy and effusion are present in most patients. The gold standard for diagnosis of TB arthritis is synovial biopsy, with positive results in 80% of cases. It shows caseating granulomas, lymphocytes, and giant cells with caseation, which are characteristics of TB arthritis. Synovial biopsy is generally recommended in any arthritis where clinical evaluation and routine investigations do not give a clear diagnosis.