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Abstrak :
Systemic lupus erythematosus (SLE) as a chronic autoimmune disease with multi-organ involvement often occurs in women of childbearing age. We report a case of active SLE in a-23 year old woman who presented with multi-organ involvement, including pericardia! effusion, severe anemia that caused congestive heart failure, and kidney involvement. ANA and ami ds DNA were positive. The patient was treated with intravenous digoxin followed by a daily dose of oral digoxin, ROmg/day of furosemide, 600 ml packed red cell transfusion, and !.5 mg/kg bodyweight/day of prednisan. The patient was discharged in good condition on the I5'h day of hospitalization.

Abstrak :
Sistemik Lupus Eritematosus (SLE) merupakan penyakit kronis yang dapat dirasakan oleh pasien dengan SLE seumur hidup. Manifestasi klinis dari SLE berbeda-beda pada tiap individu, sehingga dibutuhkan perawatan yang tepat agar komplikasi yang parah dapat diminimalisasi. Discharge planning merupakan solusi untuk perawatan anak ketika sudah pulang ke rumah. Discharge planning bertujuan untuk memberikan  pembekalan perawatan di rumah sehingga orangtua atau keluarga dapat merawat pasien secara mandiri. Karya Ilmiah ini ditulis dengan tujuan memberikan informasi tentang hasil implementasi discharge planning pada anak dengan SLE. Metode yang digunakan untuk oenulisan karya ilmiah ini menggunakan studi kasus pada anak dengan SLE yang diberikan intervensi discharge planning sejak pasien pertama kali masuk dan dilakukan pemantauan selama lima hari  dengan pemberian asuhan keperawatan. Hasil discharge planning menunjukkan peningkatan keterampilan orangtua dan keluarga dalam merawat anak dengan SLE yang dibuktikan dengan hasil observasi selama masa perawatan. Sehingga, discharge planning tepat digunakan untuk pasien dengan SLE dalam perawatan lanjutan di rumah sehingga pasien dengan SLE dapat meningkatkan kualitas hidupnya dan mencegah kejadian eksaserbasi berat dan komplikasi yang parah. Discharge planning yang dilakukan memberikan dampak yang positif bagi pasien dan keluarga.

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Systemic Lupus Erythematosus (SLE) is a chronic disease. Clinical manifestations of SLE vary in each, so proper care is needed so that severe complications can be minimized. Discharge planning is a solution for childcare when they have returned home. Discharge planning aims to provide debriefing at home so parents or families can take care of patients independently. This Scientific Work was written to provide information about the results of discharge planning implementation in children with SLE. The method used for writing scientific papers uses case studies on children with SLE who are given discharge planning intervention since the patient first entered and monitored for five days with the provision of nursing care. The discharge planning results show an increase in parental and family skills in caring for children with SLE as evidenced by the results of observation during the treatment period. Thus, discharge planning is appropriate for patients with SLE in continuing care at home so that patients with SLE can improve their quality of life and prevent severe exacerbations and complications. Discharge planning carried out had a positive impact on patients and families.

Abstrak :
ABSTRAK
Lupus nephritis (LN) is involvement of the kidney in patient with systemic lupus erythematosus (SLE) and one of the most common target organ in SLE. The diagnosis of LN will significantly impact the clinical outcome and therapy of the patient. Therapy regiment of LN is divided into two stages, induction and maintenance treatment. The main objective of the induction therapy is to achieve complete or partial remission as soon as possible since it is correlated with better prognosis and fewer relapse incidence. In the maintenance stage, the main aim of the therapy is to maintain the remission status and avoid future relapse. It is also important to evaluate the effectiveness of the therapy as it will affect the duration and the regiment therapy being used. Corticosteroid, cyclophosphamide, mycophenolate mofetil, azathrioprine, cyclosporine and tacrolimus are example of drugs used in LN therapy. Currently, studies are being conducted to evaluate and develop targeted drug therapy to further add treatment options for LN.

Abstrak :
ABSTRAK
Lupus merupakan penyakit kronis yang menimbulkan stres. Keluarga sebagai Iingkungan terdekat berperan dalam membantu orang dengan lupus (selanjutnya disebut odapus) untuk mengatasi strcsnya_ Bantuan yang diberikan keiuarga disebut dcngan dukungan sosial_ Penelitian ini bertujuan untuk mendapatkan gambaran tentang persepsi odapus terhadap dukungan sosial yang diterima dari keluarga. Penelitian ini menggunakan metode kualitatifi Tiga odapus diwawancara mengenai persepsi mereka terhadap dukungan emosional, instrumental, penghargaan, informasi dan jejming yang diterima dari keluarga. Anggota kcluarga odapus juga diwawancara untuk melihat persepsi mereka mengenai dukungan sosial yang diberikan Dari analisis terhadap hasil wawancara disimpulkan bahwa: 1) odapus mempersepsi positif hila dulcungan sosial sesuai dengan kebutuhannya; 2) odapus mempersepsi bahwa keluarga adalah sumber dukungan sosial utama; 3) odapus berharap bahwa sumber dukungan sosial memberi dukungan atau persetujuan terhadap gagasan tentang kemampuan mengatasi penyakit dan pengasuhan anak yang dititipkan pada keluarga.

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ABSTRACT
Lupus is a chronic illness causing stress. Family as the closest unit plays an important role in helping a lupus patient overcoming her stress. The help offered by family is called social support. The purpose ofthe research was to obtain a description on lupus patients? perception on the social supports provided by their families. The research used a qualitative method. Three lupus patients were interviewed on their perception on emotional, instrumental, esteem and social network supports. A total of three family members were also interviewed on the social supports they provided for the sick family members. The conclusion ofthe research is 1) The patients perceived positively the social supports that met their needs; 2) The patients perceived that families are the main source of social supports; 3) The patients hoped that their families supported or agreed with their ideas of handling sickness and of child caring.

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Abstrak :
ABSTRACT
Background. Indonesia has the second highest tuberculosis (TB) prevalance in the world. In this TB endemic country, immunocompromised patients, in particular SLE patients are at increased risk of gaining infection. Therefore, it is crucial to identify the risk factors of TB in SLE patients to help clinicians and patients to prevent occurence of TB. Methods. We conduct a case control study of 24 SLE patients with active TB infection and compare it with 24 age and sex matched SLE controls. Data were collected from Cipto Mangukusumo National Hospital from 2012-2016. SLE diagnosis is based on ACR 2012 criteria and all site of TB were included. Patients with comorbidites (diabetes, HIV, CKD) are excluded. Results. Cumulative steroid dose of 2,115±1,368 mg for the last three months significantly correlate with the occurence of TB (p<0.048). Lupus nephritis and administration of pulse steroid in three months elevate the risk of TB (OR=13, OR=9). High level of ESR (81±39 mm/h) compared to control (42+26 mm/h) is associated with the developement of TB. The proportion of extrapulmonary tuberculosis is 33%. Conclusion. Increasing the awareness and cautiousness of SLE patients with these risk factors, especially in TB endemic countries are important to prevent TB.

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ABSTRACT
Latar Belakang. Indonesia merupakan negara dengan prevalensi tuberkulosis tertinggi kedua di dunia. Dalam negara endemik tuberkulosis ini, pasien dengan imunokompromi secara kususnya pasien SLE mempunyai resiko lebih tinggi untuk terkena infeksi TB. Maka itu, adalah penting untuk mengidentifikasi faktor resiko TB pada pasien SLE untuk membantu klinisi dan pasien guna mencegah Tuberkulosis. Metode. Kami melakukan sebuah studi kasus-kontrol dengan 24 pasien SLE yang mempunyai infeksi TB aktif dan membandingkannya dengan 24 kontrol matching umur dan usia. Data didapatkan dari rumah sakit nasional Cipto Mangukusumo dari 2012-2016. Diagnosis SLE berdasarkan kriteria ACR tahun 2012 dan semua situs infeksi TB diinklusikan. Pasien dengan komorbiditas (diabetes, HIV, CKD) dieksklusi. Hasil. Dosis kumulatif kortikosteroid 2,115±1,368 mg selama tiga bulan terakhir berkorelasi secara signifikan dengan kejadian infeksi TB (p<0.048). Keberadaan lupus nefritis dan administrasi pulse kortikosteroid dalam kurun waktu tiga bulan meningkatkan risiko infeksi TB (OR=14, OR=9). Tingginya kadar LED (81±39 mm/h) dibandingkan dengan kontrol (42+26 mm/h) juga berkontribusi secara positif dalam kejadian infeksi TB. Proposi TB ekstrapulmoner adalah 33%. Kesimpulan. Penting untuk meningkatkan kesadaran dan kewaspadaan terutama pada daerah endemik TB, terhadap pasien SLE dagan faktor risiko diatas upaya mecegah terjadinya TB.

Abstrak :
Kepatuhan pasien Lupus Eritematosus Sistemik (LES) berperan penting dalam mencapai aktivitas penyakit yang terkontrol. Penelitian ini bertujuan untuk mengetahui prevalensi ketidakpatuhan, faktor-faktor yang berhubungan dengan ketidakpatuhan, dan hambatan minum obat pada pasien LES. Data potong lintang diperoleh dari pasien Poliklinik Alergi-Imunologi RSUPN Dr. Cipto Mangunkusumo secara konsekutif pada Juli–Agustus 2023. Dilakukan evaluasi terhadap ketidakpatuhan pengobatan (self-report medication-taking behaviour measure for thai patients scale; MTB-Thai), komorbiditas, jumlah obat, aktivitas penyakit (skor MEX-SLEDAI), depresi (Hospital Anxiety and Depression Scale; HADS), dan hambatan lain dalam pengobatan (Identification of Medication Adherence Barriers Questionnaire; IMAB-Q 30). Data kategorik dianalisis dengan uji Chi-square atau Fisher, sedangkan data numerik dianalisis dengan uji Mann-Whitney. Dari 100 pasien LES dewasa, mayoritas merupakan perempuan (97%), dewasa muda (61%), menamatkan pendidikan tinggi (48%), dan memiliki aktivitas penyakit remisi˗ringan (90%). Median (IQR) jumlah obat yang dikonsumsi 6 (5–8). Prevalensi ketidakpatuhan minum obat mencapai 27%. Tingkat pendidikan pasien ditemukan berhubungan dengan ketidakpatuhan (pendidikan menengah vs. pendidikan tinggi, 59,3% vs. 40,7%; p=0,035). Pasien yang tidak patuh memiliki skor hambatan minum obat yang lebih tinggi secara signifikan (p<0,001). Hambatan yang paling banyak dialami pasien yang tidak patuh adalah kekhawatiran terhadap efek samping dan mudah terdistraksi dari mengonsumsi obat-obatan. ......Medication adherence among patients with systemic lupus erythematosus (SLE) is essential to achieve controlled disease activity. This study aimed to investigate the prevalence of non-adherence, associated factors, and medication adherence barriers among patients with SLE. Cross-sectional data were obtained from consecutive patients at Allergy-Immunology Clinic Cipto Mangunkusumo Hospital between July–August 2023. Evaluation was conducted on medication non-adherence (self-report medication-taking behavior measure for thai patients scale), comorbidities, number of medications, disease activity (MEX-SLEDAI score), depression (Hospital Anxiety and Depression Scale), and other adherence barriers (Identification of Medication Adherence Barriers Questionnaire-30). Categorical data were analyzed with Chi-square or Fisher test, while numerical data were analyzed with Mann-Whitney test. Of 100 adult SLE patients, most were female (97%), young adult (61%), completed higher education (48%), and had remission˗mild disease activity (90%). The median (IQR) number of medications consumed was 6 (5–8). The prevalence of medication non-adherence was 27%. Patient's educational level was found to be associated with non-adherence (secondary education vs. higher education, 59.3% vs. 40.7%; p=0.035). Non-adherent patients had significantly higher medication adherence barrier scores (p<0.001). The most common barriers experienced by non-adherent patients were concerns about harmful side effects and easily distracted from taking medications.