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All Journal Jurnal Kedokteran Brawijaya Research Journal of Life Science Majalah Kesehatan FKUB Indonesian Journal of Rheumatology CRJIM (Clinical and Research Journal in Internal Medicine)
Suryana, Bagus Putu Putra
Rheumatology And Immunology Division, Department Of Internal Medicine, Brawijaya University School Of Medicine-Saiful Anwar General Hospital, Malang
Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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Erosive polyarthritis in multicentric reticulohistiocytosis mimics rheumatoid arthritis Suryana, Bagus Putu Putra; Puspitasari, L; Wahono, Cesarius Singgih; Kalim, H
Indonesian Journal of Rheumatology Vol 4, No 1 (2013)
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (428.563 KB)

Abstract

Multicentric reticulohistiocytosis (MRH) is a very rare multisystemic syndrome.1,2 The first case of MRH was described by Goltz and Layman in 1954 and so far only less than 200 cases have been reported.3-5 It is characterized by the insidious onset of polyarthritis that often evolves into a severe erosive deforming arthritis and characteristic skin lesions composed of nodules and plaques containing lipid-laden (periodic acidSchiff-positive) histiocytes and multinucleated giant cells.6 It most commonly affects the handsand cervical spine.7 MRH is also known as lipoid dermatoarthritis, lipoid rheumatism, and giant cell reticulohistiocytosis.4 MRH is occured due to infiltration of multinucleated giant cells and histiocytes into various tissues. The typical pictures include skin nodules and destructive polyarthritis.3 This entity is frequently mistaken for rheumatoid arthritis (RA).3 MRH is often associated with systemic complication and various types ofmalignancy. Therefore, sometimes it is considered a paraneoplastic syndrome
Correlation between anti-cyclic citrullinated peptide antibodies and the severity of clinical manifestation, laboratory manifestation, and radiological joint destruction in rheumatoid arthritis patients Suwito, Mat; Handono, Kusworini; Suryana, Bagus Putu Putra; Kalim, Handono; Wahono, Cesarius Singgih
Indonesian Journal of Rheumatology Vol 2, No 1 (2010)
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (207.499 KB)

Abstract

Background. The second generation anti-cyclic citrullinated peptide test (CCP2) displays sensitivity comparable to that of rheumatoid factor (RF) (approximately 80%) but with superior specificity (98%) . Several observations have indicated that early rheumatoid arthritis (RA) patients with positive anti-CCP may develop a more erosive disease than those without anti-CCP.Objective. The purpose of this cross-sectional study was to investigate the correlation between anti-CCP antibodies and clinical and laboratory parameters and radiological joint destruction in RA patients.Methods. We studied 31 patients with RA fulfilling the 1987 revised criteria of American College of Rheumatology in Rheumatology Clinic of Saiful Anwar General Hospital, Malang, Indonesia. Clinical parameters were collected such as age, sex, visual analog scale,disease duration and diseases activity score (DAS28-3(CRP)). Laboratory parameters were WBC, hemoglobin, platelet count, erythrocyte sedimentation rate, and Creactive protein. Analyzed autoantibody profiles were RF and anti-CCP (ELISA methode). Radiological jointdestruction was evaluated from bilateral postero-anterior manus x ray (Sharp score).Results. Anti-CCP antibodies were detected in 48.4% of RA patients with mean antibody concentration was 291.24±143.67 (range 16-523.8) units. Anti CCP level was significantly correlated with duration of RA (month) (p=0.04, r=0.371), RF level (p=0.002, r=0.542) andSharp score (p=0.048, r=0.358), but was not significantly correlated with other clinical and laboratory parameters.Conclusion. Anti-CCP level was correlated with duration of disease, RF, and Sharp score.
Chronic polyarthritis mimicking rheumatoid arthritis in a patient with leprosy Haribowo, A S; Suryana, Bagus Putu Putra; Handono, Kusworini
Indonesian Journal of Rheumatology Vol 2, No 1 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Currently leprosy is now still a global threat in the world even after the introduction of multidrug therapy (MDT), including in Indonesia.1 World Health Organization (WHO) data revealed that in 2002 there were 597,000 cases worldwide and the prevalence is only less than 1 every 10,000 populations.2 Nevertheless, the latest data showedthat 83% of leprosy cases concentrated in only 6 countries: Indonesia, India, Brazil, Madagascar, Myanmar, and Nepal.3 The most common manifestations of leprosyare cutaneous and neuritic manifestation. Rheumatologic manifestation is another common manifestation of leprosy.4-7 Prevalence of rheumatologic manifestation of leprosy is range from 1% to 77% of all leprosy patients.4-11 Study conducted by Mandal et al in India revealed that the prevalence of rheumatologic manifestation was 5.9%, in Brazil,6 another study by Pereira revealed the prevalence of 9.1%.5 Hadi, in Indonesia,showed the prevalence of arthritic manifestation was 7.5%.8 Rheumatologic  manifestations that can be found in leprosy are polyarthritis or oligoarthritis, soft tissue rheumatism, noninflammatory arthritis, and also enthesitis.4-7 We report a patient presenting with polyarthritis as the primary manifestation of leprosy.
Infeksi HIV Bersamaan dengan Systemic Lupus Erythematosus Sariningsih, Fajar; Suryana, Bagus Putu Putra; Ismanoe, Gatoet
Jurnal Kedokteran Brawijaya Vol 29, No. 3 (2017)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2017.029.03.14

Abstract

Munculnya Systemic Lupus Erythematosus (SLE) dan Human Immuno Deficiency Virus (HIV) yang terjadi secara bersamaan merupakan hal yang eksklusif. Tulisan ini melaporkan kasus HIV dan SLE yang terjadi bersamaan pada seorang wanita usia 50 tahun. Pasien mengalami keluhan yang mendukung adanya infeksi HIV dengan ditemukannya gejala diare kronis, penurunan berat badan, batuk-batuk, demam-demam, kelelahan badan, sariawan, nyeri sendi, dan allopesia. Pemeriksaan laboratorium yang mendukung diagnosis HIV pada pasien ini adalah peningkatan LED, tes determinan yang reaktif, dan penurunan CD4+. Pasien juga menderita SLE yang ditunjukkan dengan ditemukannya gejala allopesia (kerontokan rambut), sariawan yang tidak nyeri, sering menderita sakit sendi-sendi, demam yang hilang timbul tanpa penyebab jelas, riwayat trombositopenia (penurunan jumlah trombosit), penurunan berat badan. Hasil pemerikaan laboratorium immunologi yang mendukung diagnosis SLE adalah ANA test yang positif, ds DNA yang positif dan coombs test +2. Pemberian terapi antiretroviral dan chloroquin yang diberikan menunjukkan hasil perbaikan gambaran laboratorium dan gejala klinis pada bulan keempat pengobatan.Kata Kunci: Human Immuno Deficiency Virus (HIV), Systemic Lupus Erythematosus (SLE)
HUBUNGAN ANTARA PARAMETER KLINIS DAN LABORATORIS DENGAN STATUS REMISI PENYAKIT PADA PASIEN ARTRITIS REUMATOID YANG MENDAPAT TERAPI METOTREKSAT Putra Suryana, Bagus Putu; Sari, Retty Kharisma; Tamayanti, Wahyu Dewi; Hasanah, Dian
Majalah Kesehatan FKUB Vol 6, No 2 (2019): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (390.49 KB) | DOI: 10.21776/ub.majalahkesehatan.006.02.5

Abstract

Artritis reumatoid (AR) adalah penyakit autoimun yang etiologinya belum diketahui. Metotreksat adalah DMARD (disease-modifying antirheumatic drug) yang paling sering digunakan pada AR, namun respons  terhadap metotreksat bervariasi di antara populasi. Data mengenai faktor klinis dan laboratoris yang berhubungan dengan remisi pada AR yang diterapi dengan metotreksat masih tidak konsisten. Penelitian inibertujuan untuk mengetahui faktor-faktor klinis dan laboratoris yang berhubungan dengan remisi pada pasien AR yang mendapat terapi metotreksat. Data diperoleh dari pasien AR yang memenuhi kriteria ACR-EULAR 2010 dengan desain penelitian observasional dan pendekatan potong lintang. Data meliputi jenis kelamin, usia onset penyakit, durasi penyakit, indeks masa tubuh (IMT), tender joint count (TJC), swollen joint count (SJC), visual analog scale (VAS) nyeri, disease activity score (DAS)-28 awal, laju endap darah (LED), anti-cyclic citrullinated protein (CCP), dan rheumatoid factor (RF). Variabel dianalisis secara statistik dengan uji chi square dilanjutkan regresi logistik multipel. Penelitian ini melibatkan 88 pasien AR, terdiri dari 85,2% wanita (n = 75) dan 14,8% pria (n = 13), rerata usia 54,78±11,34. Proporsi remisi pasien adalah 26,1%. Dari analisis bivariat dengan uji chi square didapatkan variabel yang berhubungan bermakna terhadap remisi, yaitu usia onset (p = 0,037), VAS nyeri (p = 0,030) dan LED (p = 0,038). Dapat disimpulkan bahwa usia onset, VAS nyeri, dan LED  berhubungan bermakna dengan remisi penyakit pasien AR yang diterapi dengan metotreksat.   
HUBUNGAN ANTARA USIA, BODY MASS INDEX DAN JENIS KELAMIN DENGAN OSTEOPOROSIS Andarini, Sri; Suryana, Bagus Putu Putra; Praja, Dewangga Wahyu
Majalah Kesehatan FKUB Vol 7, No 1 (2020): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (595.993 KB) | DOI: 10.21776/ub.majalahkesehatan.2020.007.01.4

Abstract

Osteoporosis adalah penyakit tulang sistemik yang ditandai dengan massa tulang yang rendah dan kerusakan mikroarsitektur jaringan tulang yang mengakibatkan peningkatan kerapuhan tulang. Osteoporosis paling sering terjadi pada bagian femoral neck dan lumbar spine (L1-L4). Terdapat beberapa faktor risiko penyebab osteoporosis seperti usia, body mass index (BMI) dan jenis kelamin. Penelitian ini bertujuan untuk membuktikan kontribusi usia, BMI dan jenis kelamin berhubungan dengan terjadinya osteoporosis pada femoral neck dan lumbar spine (L1-L4). Penelitian ini menggunakan desain potong lintang. Populasi penelitian adalah seluruh pasien yang datang dan diperiksa di Poliklinik Osteoporosis RSUD. Dr. Saiful Anwar Malang berdasarkan rekam medis pada tahun 2012. Sampel diambil secara total sampling yaitu sebanyak 154 pasien. Peneltian ini menunjukkan bahwa faktor usia berhubungan dengan terjadinya osteoporosis pada lumbar spine (L1-L4) (p = 0,018), sedangkan BMI berhubungan dengan osteoporosis pada femoral neck (p = 0,000). Hasil analisis multiple logistic regression menunjukkan bahwa usia, BMI, dan jenis kelamin dapat memprediksi  terhadap terjadinya osteoporosis pada femoral neck (R2 = 0,155), dan osteoporosis pada lumbar spine (L1-L4) (R2 = 0,112). Dapat disimpulkan bahwa faktor usia berpengaruh terhadap osteoporosis pada lumbar spine (L1-L4) dan BMI berpengaruh terhadap osteoporosis femoral neck. Usia, BMI dan jenis kelamin secara bersama-sama berpengaruh terhadap osteoporosis femoral neck dan lumbar spine (L1-L4).
Effect of Chemotherapy and Hormonal Therapy on Bone Mineral Density in Patients with Breast Cancer in Saiful Anwar Hospital Malang Nurshanty, Ade; Wardhani, Shinta Oktya; Suryana, Bagus Putu Putra
Clinical and Research Journal in Internal Medicine Vol 1, No 1 (2020): New: The First Volume of Clinical and Research Journal in Internal Medicine
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2020.001.01.4

Abstract

Osteoporosis is an important health problem, and the number of patients who suffered from it is increasing. Breast cancer is a condition that has a  high risk of osteoporosis. Cancer induced bone disease results from the primary disease, metastatic process, or from therapies against the prime condition, causing bone fragility. Therefore, there are still different opinions regarding the therapeutic effect of breast cancer on bone mineral density. Aim: to determine the effect of chemotherapy and hormonal therapy on bone mineral density in patients with breast cancer in Saiful Anwar Hospital Malang. Method: this is a case-control study conducted in 30 patients with breast cancer who had undergone chemotherapy and hormonal therapy are compared to 30 patients without breast cancer as controls.  Bone Mineral Density (BMD) was measured by DEXA. Result: there are 53% of breast carcinoma patients having osteopenia and 13% having osteoporosis, with one patient has osteoporosis located in the femoral neck and three patients in lumbar (L1-L4). We obtain a significant T-score (p=0.02) in the great trochanter. Odds Ratio (OR) 0.233 with p = 0.008 showed a protective effect of chemotherapy and hormonal therapy for breast cancer to the bone density. Conclusion: the incidence of osteoporosis in the study was 13%, with the most location in the lumbar spine. Chemotherapy and hormonal therapy had a protective effect on BMD in patients with breast cancer in Saiful Anwar Hospital Malang.
Relationship between Disease Activity and Calcium Levels with Bone Mineral Density in Rheumatoid Arthritis Patients Megawanto, Nur Handy; Suryana, Bagus Putu Putra; Rosandi, Rulli
Clinical and Research Journal in Internal Medicine Vol 2, No 1 (2021): First Issue of 2021
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2021.002.01.2

Abstract

Background: Arthritis rheumatoid (AR) is a chronic inflammatory disease that mainly affects the joints. Decreased bone mass and osteoporosis are its complications. Several factors such as dietary calcium, disease activity, physical activity, vitamin D levels, steroids can affect bone mineral density values. Aim: The purpose of this study was to determine the relationship between disease activity, calcium levels and bone mineral densitometry in patients with arthritis rheumatoid. Methods: 23 AR patients based on the 2010 ACR criteria including the inclusion criteria with a cross sectional study approach that had bone mineral densitometry (BMD) data for the last 1 year. Blood samples were also taken to check the total calcium level, the characteristics of the baseline data were collected, and the disease activity was examined using the DAS 28 LED. The relationship between these factors and the bone mass density was analyzed using the Spearman test. The analysis result was considered significant if p <0.05. Results: The results showed that the basic characteristics of the subjects were 45,87 years old, body mass index 24,51 kg / m2, duration of illness 3,96 years, steroid dose 3,48 mg, disease activity 4.35 (moderate disease activity), anti CCP 333,87 U / ml, rheumatoid factor (RF) 10,18 IU / ml, methotrexate 12,17 mg, leflunomide 20 mg. There was no significant relationship between serum calcium levels and disease activity with BMD. However, there was a significant relationship between age and BMI with BMD in the femur neck (p = 0,043), lumbar 3 (p = 0,017) and lumbar 4 (p = 0,048). Conclusion: There is no relationship between disease activity and calcium levels with bone mass density values in AR patients except for age and BMI.
Potential of Topical Curcumin in Reduction of TNF-α expression and Synovium Hyperplasia on Wistar Rats of Rheumatoid Arthritis Model Ferri Widodo; Diana Lyrawati; Bagus Putu Putra Suryana
Research Journal of Life Science Vol 3, No 1 (2016)
Publisher : Lembaga Penelitian dan Pengabdian kepada Masyarakat, Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (777.494 KB) | DOI: 10.21776/ub.rjls.2016.003.01.6

Abstract

Rheumatoid arthritis is a chronic inflammatory autoimmune disease associated with articular and systemic effects. This disease affects synovial joints covered by a special tissue called synovium. Curcumin has a potent antioxidant, antiinflammatory agent, antiangiogenic and anticarcinogenic. Curcumin can downregulate the expression of various proinflammatory cytokines and is reported beneficial effects in arthritis, but has a poor solubility dan bioavailability as well. The purpose of this research was to study the potential of liposomes topikal curcumin in reducing athritis score, reducing the expression of TNF-α and histopathological synovium hyperplasia of hind paw on Wistar rats with CFA that had been treated with topical curcumin. In this study, rats were divided into 7 groups: positive control, negative control, rheumatoid arthritis with topical curcumin therapy of 90 mg/kg BW, rheumatoid arthritis with topical curcumin therapy of 110 mg/kg BW, rheumatoid arthritis with topical curcumin therapy of 200 mg/kg BW, rheumatoid arthritis with methotrexate therapy, rheumatoid arthritis with placebo therapy. Results from this experiment indicated that topical curcumin has no significant to the arthritis score, significantly effect to percentase expression of TNF-α (p<0.05) and could decrease synovium hyperplasia based on histophatology examination. It could be concluded that therapy of topical curcumin could decrease the expression of TNF- α and synovium hyperplasia in rheumatoid arthritis rat. 
Correlation between anti-cyclic citrullinated peptide antibodies and the severity of clinical manifestation, laboratory manifestation, and radiological joint destruction in rheumatoid arthritis patients Mat Suwito; Kusworini Handono; Bagus Putu Putra Suryana; Handono Kalim; Cesarius Singgih Wahono
Indonesian Journal of Rheumatology Vol. 1 No. 2 (2009): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (207.499 KB) | DOI: 10.37275/ijr.v2i1.22

Abstract

Background. The second generation anti-cyclic citrullinated peptide test (CCP2) displays sensitivity comparable to that of rheumatoid factor (RF) (approximately 80%) but with superior specificity (98%) . Several observations have indicated that early rheumatoid arthritis (RA) patients with positive anti-CCP may develop a more erosive disease than those without anti-CCP.Objective. The purpose of this cross-sectional study was to investigate the correlation between anti-CCP antibodies and clinical and laboratory parameters and radiological joint destruction in RA patients.Methods. We studied 31 patients with RA fulfilling the 1987 revised criteria of American College of Rheumatology in Rheumatology Clinic of Saiful Anwar General Hospital, Malang, Indonesia. Clinical parameters were collected such as age, sex, visual analog scale,disease duration and diseases activity score (DAS28-3(CRP)). Laboratory parameters were WBC, hemoglobin, platelet count, erythrocyte sedimentation rate, and Creactive protein. Analyzed autoantibody profiles were RF and anti-CCP (ELISA methode). Radiological jointdestruction was evaluated from bilateral postero-anterior manus x ray (Sharp score).Results. Anti-CCP antibodies were detected in 48.4% of RA patients with mean antibody concentration was 291.24±143.67 (range 16-523.8) units. Anti CCP level was significantly correlated with duration of RA (month) (p=0.04, r=0.371), RF level (p=0.002, r=0.542) andSharp score (p=0.048, r=0.358), but was not significantly correlated with other clinical and laboratory parameters.Conclusion. Anti-CCP level was correlated with duration of disease, RF, and Sharp score.
Co-Authors A S Haribowo Anna Ariane Anna Ariane Dian Hasanah Dian Hasanah Diana Lyrawati Endy Adnan Faisal Parlindungan Gatoet Ismanoe Handono Halim Handono Kalim Haribowo, A S Harry Isbagio Kalim, H Kusworini Handono Kusworini Handono Kusworini Handono Laniyati Hamijoyo Linda Kurniaty Wijaya Lya Rosita Mat Suwito Megawanto, Nur Handy Nursamsu Djais Nurshanty, Ade Praja, Dewangga Wahyu Pratama, Mirza Zaka Puspitasari, L Radiyati Umi Partan Rakhma Yanti Hellmi RM Suryo Anggoro Rudy Hidayat Rulli Rosandi Sari, Retty Kharisma Sariningsih, Fajar Shinta Oktya Wardhani, Shinta Oktya Sri Andarini Sumariyono Sumariyono Surya Darma Suwito, Mat Wahono, Cesarius Singgih Wahyu Dewi Tamayanti, Wahyu Dewi Widodo, Ferri Yulyani Werdiningsih