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INDONESIA
Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
Published by Perhimpunan Dokter Spesialis Patologi Klinik Indonesia
ISSN : 08544263     EISSN : 24774685     DOI : https://dx.doi.org/10.24293
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience
Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) is a journal published by “Association of Clinical Pathologist” professional association. This journal displays articles in the Clinical Pathology and Medical Laboratory scope. Clinical Pathology has a couple of subdivisions, namely: Clinical Chemistry, Hematology, Immunology and Serology, Microbiology and Infectious Disease, Hepatology, Cardiovascular, Endocrinology, Blood Transfusion, Nephrology, and Molecular Biology. Scientific articles of these topics, mainly emphasize on the laboratory examinations, pathophysiology, and pathogenesis in a disease.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 1,183 Documents
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PROTEIN REKOMBINAN 38 KDA MYCOBAKTERIUM TUBERKULOSIS DAPAT MENGIMBAS PEMBUATAN INTERLEUKIN-2 DAN INTERFERON-γ LIMFOSIT T DI KULTUR SEL MONONUKLEAR DARAH TEPI Maimun Z Arthamin; Singgih Pujo Wahono; Antiek Primardianti; Ati Rastini; Tri Wahju Astuti; Tri Yudani Mardining Raras; Francisca S Tanoerahardjo
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 2 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i2.1119

Abstract

Tuberculosis (TB) is caused by Mycobacterium tuberculosis (M.tb) and is one of the significant mortality causes WHO (2012). Theprimary immune response in TB pathogenesis is Cell Mediated Immunity (CMI), roled by T lymphocytes. Interleukin-2 (IL-2) is a growthfactor for T lymphocytes. Gamma Interferon is the key cytokine in M.tb infection control, synthezised by T lymphocytes. An effectivevaccination strategy is achieved by giving vaccine which is able to stimulate T lymphocytes in synthezising cytokines. The 38 kDa M.tbprotein is potential in the vaccine development program, because it has specific epitopes for T lymphocytes. The aim of this study was toknow how to determine that the 38 kDa recombinant protein of M.tb Malang strain could induce cellular immune response by IL-2 andIFN-γ synthezised by T lymphocytes. The study was carried out by an experimental in vitro study on PBMC from healthy endemic subjects,those having TB contact, and the TB patients themselves. PBMC from subjects was cultured with 38 kDa recombinant protein of M.tbMalang strain, with PPD and without any protein. The analysis of IL-2 and IFN-γ used flowcytometry. The result showed that the highestpercentage of IL-2 was found in the culture with 38 kDa recombinant protein of M.tb Malang strain, in healthy endemic (p=0.000)and in those who had TB contact (p=0.000). the highest percentage of IFN-γ was found in the culture with 38 kDa recombinant proteinof M.tb Malang strain, in healthy endemic (p=0.007) and those who had TB contact (p = 0.105). The 38 kDa recombinant proteinof M.tb Malang strain was able to induce IL-2 and IFN-γ synthezised by TCD3+ lymphocytes from healthy endemic subjects and thosewho had TB contact.
ANALISIS POLA HUMAN LEKOCYTE ANTIGEN (HLA) KELAS I PADA PENDERITA DEMAM BERDARAH DENGUE POPULASI INDONESIA DI JAWA TIMUR F.M. Judajana; Paulus Budiono; Indah Nuraini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 18, No 2 (2012)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v18i2.1008

Abstract

The incidence of Dengue Haemorrhagic Fever (DHF) is obvious rapidly increasing and it may have existed previously, and specificfactors precipitating of the diseases can be identified in Indonesia population. These include environmental changes, demographic factors,host immunity, micro organism variant and drug resistance suggesting that infection will continue to emerge, probably increase andemphasizes the urgent need for effective surveillance. The Immunology approach of Dengue Haemorrhagic Fever as emerging diseaseshas been advanced on two major fronts. First, the elucidation of the basic mechanisms associated antigen recognition, elimination,rejection and immunological protection from recurrence. Secondly, to solve the clinical problem (diagnostic, therapeutic and prevention)the application of the knowledge of immunological memory to diseases is used as a tool. Over expressed emerging pathogens such asmolecularly defined mutated antigen; this antigen as a target of specific immune reaction and has been encountered as a danger signal.The current studies have shown that few immune competent cells (activated T cells and B cells) are exposed to antigen. The immuneconsequence of infectious tissue induced Major Histocompatibility Complex (MHC)/Human Leukocyte Antigen (HLA) molecules expressionon antigen presenting cell and have also shown, that an immunological reaction occurs in all organs in response to a number of diseases.However, most infectious diseases express MHC/HLA class II molecules, in order to recognize the new mutated antigen and also expressthe MHC/HLA class I molecules in order to eliminate those antigen. Progress in the genetic dissection of infectious diseases will also comefrom the complementary analysis of the various biological and clinical phenotypes associated with a given infectious agent, stronglysuggesting that host factors play an important role in susceptibility or resistance to infection. In order to know the regulation processbetween different types of pathogen and the host immune system, as well as the regulation factor of the cross talk between the differentcomponents of the immune response in human as the host, it is important to get an understanding of the immune genetic system. Thisresearch work is aimed at the locating and identifying the HLA class I which encode the protein as immune-component to be involvedin the pathogenesis of DHF as a viral infection base on the examination on 20 DHF patients and have already examined the HLA-A, -Bas HLA class I with the DNA typing-PCR. The results analysis with Chi square with Yates‘s Correction and the relative risk (Wolf rule)is HLA-A*11,-A*24 and HLA-B*15,-B*18 has specific association with DHF on Indonesia population in East Java. The evidence of theinfluence of the immune genetics marker to the DHF is provided by the following observations: (1) the level of infection often differsgreatly among infected subjects, (2) some infected subjects do not develop clinical disease, (3) the clinical manifestations of diseaseseverity, time to onset, duration of disease etc, may differ greatly among symptomatic patients. This finding opens the path to developeffective means of immunotherapy and improved the diagnosis for lesions, in order to apply the current strategies for the developing ofimmunodiagnostic, immunotherapy-based treatment through an infected target cell or developed new effective vaccines.
LIBMAN-SACKS ENDOCARDITIS IN A SYSTEMIC LUPUS ERYTHEMATOSUS MALE PATIENT Fauqa Arinil Aulia; Sidarti Soehita
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1358

Abstract

ABSTRACTPreliminary: Libman-Sacks endocarditis (verrucous vegetations, marantic, or nonbacterial thrombotic endocarditis) is a rare cardiac manifestation in SLE. The objective was to describe Libman-Sacks endocarditis in a SLE male patient.Case: A 21-year-old male was admitted to the hospital with shortness of breath, epigastric pain, oral ulcer, discoid lesions, and knee joints pain since 3 months before. He worked as a paper mill employee and was exposed to instruments radiating UV rays for 2 years. Antibiotics initiation was given due to an infective endocarditis suspicion. Vital signs were as follows: temperature 37oC, heart rate 110beats/minute, respiratory rate 30breaths/minute, blood pressure 100/80mmHg, and SaO2 99% with nasal oxygenation. Cardiac examination showed regular rate and rhythm with diastolic murmur at left ICS III and upper left sternal border. Lower extremities showed pitting edema. Laboratory results: hemoglobin 9.6g/dl, RBC 3.6x106/μl, hematocrit 30.8%, WBC 0.88x103/μl, platelet count 22x103/μl, BUN 74.0mg/dl, serum creatinine 1.6mg/dl, ESR 24mm/h, CRP 1.2mg/dl, C3 <16.4mg/dl, C4 8mg/dL, ANA test indeterminate (23.84), and anti dsDNA negative (7.4WHOunits/mL). Chest X-Ray showed mitral heart configuration with right ventricle and left atrium enlargement, pneumonia, and right pleural effusion. ECG showed normal sinus rhythm, left ventricular hypertrophy with repolarization abnormality, and prolonged QT wave. A 2-D echocardiogram showed an evidence of vegetation on aortic and pulmonary valve.Discussion: Based on the American College of Rheumatology SLE Criteria, low complement level, and evidence of vegetation on aortic and pulmonary valve, the patient was diagnosed as Libman-Sacks Endocarditis.Conclusion: The diagnosis should be confirmed by antiphospholipid antibodies examination.Key Words:
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.
HYPERCOAGULABILITY IN PATIENTS WITH LUNG CANCER UNDERGOING CHEMOTHERAPY Mariani Mariani; Herman Hariman; Noni Sari Soeroso
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 3 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i3.1404

Abstract

There is evidence that in the case of malignancies including lung cancer, that there is hypercoagulability. In spite of this, it is still not clear whether the course of chemotherapy alters the risk. This study aimed to investigate whether there was state of pre-thrombosis and hypercoagulability in patients with lung cancers and the underlying effect of chemotherapy during the treatment. Twelve lung cancer patients were recruited. Their stages and clinical performances were determined. The blood sample was taken before the chemotherapy, shortly after the first- and third-chemotherapy cycles, for the investigation of D-dimer, platelet count, PT (INR), ratios of APTT, and TT. The chemotherapy protocols vary from one patient to the others as well as between the 1st and the 3rd chemotherapy regimens although most of the protocols consist of carboplatin + gemcitabine or carboplatin + paclitaxel. From the thrombosis view of point, they were all asymptomatic and remained so during the period of investigation. Thrombosis is defined as an increase of D-dimer and hypercoagulability as finding one or more of PT (INR), ratio APTT, ratio TT <1.0. The trend of the result in the three sampling points was carried out by ANOVA, while Wilcoxon test for small samples did univariate analysis between two investigations. The result of PT, APTT, and TT indicating hypercoagulability showed that they remained unchanged until the third cycle of chemotherapy (p>0.05). The platelets of patients dropped significantly; median (range) 422 to 287 x 109/L before the chemotherapy to the end of the third cycle respectively. The D-Dimer of patients remained unchanged, however when it was investigated by univariate analysis in the group with D-Dimer >500 ng/mL, this group showed a decreased D-Dimer towards the end of the third cycle (p <0.05). This study demonstrated that there was hypercoagulability in patients with lung cancers before the chemotherapy until the 3rd cycle of chemotherapy. The course of chemotherapy did not alter hypercoagulability. However, in the group where pre-thrombosis had already happen as evidenced by high D-dimer (>500 ng/mL), the chemotherapy showed benefit regarding of reduction of the D-dimer which may lead to the possible breakdown of the existing thrombus.
KADAR PENERIMA TRANSFERIN TERLARUT (sTFR) DI PENDERITA HIV/AIDS DENGAN ANEMIA Indrati AR; Van Crevel R; Sumantri R; Wisaksana R
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 15, No 3 (2009)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v15i3.963

Abstract

Anemia is the most common hematologic abnormality associated with HIV which affecting 60 to 80 percent of patients in the latestage of the disease. The presence of anemia is associated with increased of morbidity and mortality in patients with HIV infection. Irondeficiency, chronic inflammation and antiretroviral treatment (ACT) may cause HIV associated anemia. The differentiation of irondeficiency anemia from chronic disease anemia is a diagnostic challenge. Maybe it is helpful in soluble transferrin receptor (sTfR), thecleaving of the extra cellular domain related to transferrin receptor. Because the elevated sTfR concentration is a marker of tissue irondeficiency and increased marrow erythropoietin activity. The aim of this study was to examine the diagnostic value of soluble transferrinreceptor level in anemia patients with HIV/AIDS. The Study was the part of the IMPACT (Integrated Management for Prevention, Controland Treatment of HIV/AIDS) baseline and cohort study. The study started since September 2007 in RSUP Hasan Sadikin Bandung.There were 179 HIV/AIDS patients with anemia included in this study. Complete blood count, reticulocytes, feritin, soluble transferringreceptor and hsCRP were tested in these patients. It was found that the mean of sTfR in HIV patients with anemia were 1238.42U/mL(304.5-30435). sTfR had a low correlation with MCV (r -0.174), feritin (r -0.65) and absolute reticulocyte counting (r 0.172). Feritinhad moderate and significant correlation with hsCRP (r:0.429; p 0.00). There was no significant difference of sTfR level between thepatients without ART, with Zidovudin and d4T (p 0.81). There was no significance difference of sTfR concentration between the low andnormal MCV level (p 0.341). sTfR can not differentiate the source of anemia in patients with HIV/AIDS. It can be concluded so far thatchronic disease and inflammation as reflected by the elevated hsCRP level and use of zidovudine are the main cause of anemia.
NILAI UREUM, KREATININ, DAN PENYINGKIRAN KREATININ DI PENDERITA PENYAKIT GINJAL MENAHUN (KRONIK) I. Ismail; Mutmainnah .; Hardjoeno .
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 13, No 3 (2007)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v13i3.910

Abstract

Chronically Kidney Disease (CKD) is still a health problem with a high incidence, complex aetiology, and often without complaintsor clinical symptoms except in the terminal stadium. To know the distribution of CKD according to age, sex group, aetiology, determiningstage of CKD based on creatinine clearance value, a retrospective study was conducted on 88 patients of CKD at Wahidin SudirohusodoPublic Hospital of Makassar from January to December 2004. The diagnosis of CKD was based on serum ureum value (ModifiedBarthelot), serum creatinine value (Jaffe) and creatinine clearance value (Cockroft Gault). Chronically Kidney Disease was found morefrequent in men 59.09% (52 of 88). The peak age prevalence was between 50 to less than < 60 years 29.55%. The eldest patient was 83years while the youngest was 16 years. The most fragment aetiology of CKD was hypertension 18.18% (16 of 88). Based on creatinineclearance values the medium group, severe group, and renal failure group were the age group respectively 3.41%, 19.32% and 77.27%.The prevalence of CKD is found more frequent in 50 less than 60 years of age. Hypertension seems to be the more predominant aetiology,and staging based on creatinine clearance value showed that most patients were in the renal failure group.
SARI CenTeLLA ASIATICA ASLI BALI MENINGKATKAN SEKRESI TuMouR neCRoSIS FACToR ALPHA (TNF-a) PADA MENCIT YANG DIINFEKSIKAN SALMoneLLA TYPHI I Nyoman Wande; Sianny Herawati; Ida Ayu Alit Widhiartini; I Wayan Putu Sutirta Yasa; Tjokorda Gede Oka; Ni Made Linawati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 20, No 3 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v20i3.477

Abstract

Tumour necrosis factor alpha (TNF-α) is a cytokine produced by macrophages and other mononuclear cells, is a good antibacterial agent against Salmonella spp, especially Salmonella typhi. Centella asiatica is an alternative drug that is expected as an immunostimulant in patients with typhoid fever. Comparing the effectiveness of Centella asiatica extract the original Bali as an immunostimulant and without stimulants in mice infected Salmonella typhi in terms of TNF-α secretion. This study is an experimental study with a post test only with control group design. A total of 20 mice were divided into 4 groups. The first and second groups each given Centella asiatica extract 75 mg/20 g bw (0.5 cc) and without a given extract for 4 weeks. Both groups were inoculated orally Salmonella typhi 106 per mL of bacteria in the second week. The third and fourth groups were given thiamphenicol with Centella asiatica extract 75 mg/20 g bw (0.5 cc) and thiamphenicol without any extract for 4 weeks respectively. Both groups were inoculated orally Salmonella typhi 106 per mL of bacteria in the first day. All groups terminated on fourth week and examination levels of TNF-α by ELISA and gall culture. The mean levels of TNF-α in groups (1–4) is 86.10±2.67 pg/mL, 32.81±11.33 pg/mL, 35.87±3.90 pg/mL and 19.21±2.19 pg/mL respectively. Based on the examination of the gall cultures this study showed positive results in the first and second groups, while a negative result on the third and fourth groups. Based on the One way ANOVA analysis on levels of TNF-α, there are significant differences between the first group with the second group (p<0.05), and between the third and fourth groups also found significant differences (p<0.05) increased levels of TNF-α in mice with Salmonella typhi infection given Centella asiatica extract.
INTERLEUKIN-8 RELATED WITH BONE MINERAL DENSITY (Interleukin-8 terkait Kepadatan Mineral Tulang) Yurdiansyah Latif; Uleng Bahrun; Ruland Pakasi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 3 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i3.1238

Abstract

Osteoporosis merupakan salah satu penyebab cacat pada usia lanjut karena kebahayaan patah tulang yang disebabkannya. Mulaiusia 50 tahun kemungkinan mengalami patah tulang bagi perempuan adalah 40%‚ sedangkan bagi laki-laki 13%. Angka prevalensiosteopeni di Indonesia sebesar 41‚7% dan osteoporosis sebesar 10‚3%. Hal ini berarti dua dari lima penduduk memiliki kebahayaan untukterkena osteoporosis. Interleukin-8 diduga berperan dalam merangsang pembuatan Receptor Activator of NF KappaB Ligand (RANKL)mRNA di osteoblast yang mengikat reseptor RANK di osteoklast yang berperan dalam penurunan kepadatan mineral tulang. Kajianini bertujuan untuk mengetahui kadar Interleukin-8 dan hubungannya dengan kepadatan mineral tulang yang normal, osteopeniadan osteoporosis secara penentuan. Penelitian dilakukan secara potong lintang selama masa waktu antara bulan Mei 2012−Mei 2013menggunakan data primer pemeriksaan kadar Interleukin-8 dan kepadatan mineral tulang pada perempuan yang berusia antara 30−60tahun di Makassar. Data dianalisis dan diolah dengan uji Anova. Kadar interleukin-8 lebih tinggi di densitas mineral tulang (DMT)osteoporosis dibandingkan dengan DMT yang normal dan osteopenia dengan kadar IL-8 pada DMT normal 48,72±12,81, osteopenia55,68±13,75, osteoporosis 62,06±24,45. Hubungan antara IL-8 pada perempuan dengan DMT yang normal dibandingkan denganosteoporosis memperoleh nilai p=0,03, perempuan dengan DMT normal dengan osteopenia p=0,51 dan perempuan osteopenia denganosteoporosis p=0,62. Didasari telitian ini, dapat disimpulkan bahwa terdapat hubungan bermakna antara peningkatan kadar IL-8dengan kepadatan mineral tulang yang berkurang di kelompok perempuan osteoporosis dibandingkan dengan kelompok DMT yangnormal. Para peneliti berpendapat untuk meneliti lanjutan dengan memperhatikan ciri indeks masa tubuh di sampel penelitian.
RESISTENSI TERHADAP METHICILLIN (METHICILLIN RESISTANT) STAPHYLOCOCCUS AUREUS DI INSTALASI RAWAT INAP Wildana .; Nurhayana Sennang; Benny Rusli
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 17, No 1 (2010)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v17i1.1047

Abstract

Methicillin Resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen worldwide. MRSA infection typically aggravatesthe patient condition. MRSA infection increases morbidity and mortality. The study was aimed to find out the MRSA occurrence inDr. Wahidin Sudirohusodo Hospital Makassar patients during July 2008–June 2009. A retrospective study was performed using datafrom the medical records including the results of culture and antimicrobial susceptibility test in Dr. Wahidin Sudirohusodo HospitalMakassar. Among 1082 results of the culture test, 5.2% were identified as Staphylococcus aureus, consist of 51.8% MSSA (MethicillinSensitive Staphylococcus aureus) and 48.2% MRSA. Most of the MRSA patients were treated in orthopaedic surgery (30%), internal(22%), and paediatric (19%) wards. Based on the clinical conditions, most of the patients were in post surgery care (44.4%), pneumonia(18.5%), and diabetic foot (7.5%). All of the MRSA isolates were multiresistant (resistant to three or more antimicrobials) but 96%remain sensitive to vancomycin. It was concluded that most of MRSA patients were staying in the orthopaedic surgery ward. Based onthis clinical condition, most of the patients were in the post surgery care. All of the MRSA isolates were multiresistant, but most of themremain sensitive to vancomycin.

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