Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar belakang: Pemfigus merupakan penyakit autoimun yang ditandai lepuh pada kulit dan/atau mukosa akibat adanya imunoglobulin terhadap permukaan sel keratinosit. Kortikosteroid KS merupakan pilihan terapi utama. Dipikirkan pemfigus berhubungan dengan sindrom metabolik SM secara langsung maupun tidak langsung. Tujuan: Mengetahui proporsi SM pada pasien pemfigus dan faktor-faktor yang berhubungan di Rumah Sakit Cipto Mangunkusumo RSCM. Metode: Studi potong lintang pada bulan September November 2016 di Poliklinik Kulit dan Kelamin RSCM. Subjek dianamnesis, dilakukan pengukuran tekanan darah dan lingkar abdomen, lalu dilanjutkan pengambilan darah untuk pemeriksaan kadar trigliserida, high density lipoprotein HDL, serta gula darah puasa. Hasil: Didapatkan 30 subjek dengan rerata usia 41,6 10,3 tahun dan sebagian besar perempuan. Sebanyak 23 subjek 76,7 terdiagnosis pemfigus vulgaris dan 7 subjek 23,3 pemfigus foliaseus. Median durasi penyakit adalah 31 bulan. Median lama penggunaan steroid adalah 16,5 bulan. Ditemukan SM pada 40 dari total SP. Didapatkan proporsi obesitas sentral adalah 63,3 , hipertensi 50, hipertrigliseridemia 50, hiperglikemia 23,3, dan hipo-HDL 43,3. Simpulan: Ditemukan proporsi yang sama antara laki-laki dan perempuan di kelompok SM. Tidak ditemukan perbedaan bermakna jenis kelamin, tipe pemfigus, usia, lama sakit, dan lama penggunaan steroid antara kelompok SM dan tidak SM.

---

Background: Pemphigus is an autoimmune bullous disease characterized by blistering skin and or mucosa caused by presence of immunoglobulin against keratinocyte cell surface. Corticosteroid is the main therapy. Pemphigus has been related to metabolic syndrome MS lately.

Objective: Determine MS proportion in pemphigus patients and its associated factors.

Methods: This cross sectional study was conducted in September November 2016 in Dermatovenereology Outpatient Clinic in Cipto Mangunkusumo Hospital. Subjects history was taken then blood pressure, and abdominal circumference were measured. Patients trigliceryde, high density lipoprotein HDL, and fasting blood glucose level were also measured.

Results: There are 30 subjects with age mean 41,6 10,3 years and mostly women, 23 patients 76,7 are diagnosed as pemphigus vulgaris while 7 patients 23,3 are pemphigus foliaceus. Disease duration mean in all patients is 31 months and steroid duration mean is 16.5 months. MS was found in 40 subjects. Proportion of central obesity is 63,3, hypertension 50, hypertriglyceridemia 50, hyperglycemia 23,3, and hipo HDL 43,3.

Conclusion The same proportion of men and women are found in MS group. There is no statistically significant difference found in gender, pemphigus subtype, age, disease duration, and steroid usage duration between two groups."

"Mucous membrane pemphigoid (MMP) also known as cicatricial pemphigoid is a chronic autoimmune subepithelial blistering disease primarily affecting people over 50 years old. MMP may affect any mucosal surface which is particularly oral mucosal, conjungtiva, esophagus, or larinx is involved. MMP rarely occurs in children and adolescents, but several cases of MMP affecting 2 to 18 years old patients have been reported in previous studies. In this paper we reported a case of MMP in an eighteen year old male patient who had been diagnosed with oral mucous membrane pemphigoid by anamnesis, clinical feature, histopathology. The patient was treated with systemic corticosteroid, topical corticosteroid, oral rinse and multivitamins. Until recently corticosteroid remains as the most effective and the drug of choice to treat pemphigoid lesions. Clinicians need to pay attention in using this drug because of its potential side effect."

"Latar Belakang: Pada cedera kranioserebral sedang dan berat terjadi stimulasi aksis HPA, aktivasi sel imunokompeten yang menyebabkan pelepasan mediator inflamasi. Peningkatan sitokin menyebabkan stimulasi aksis HPA yang menyebabkan terpacunya pelepasan barman kortisol oleh korteks kelenjar adrenal. Beberapa penelitian menunjukkan semakin tinggi kadar kortisol dalam plasma pada penderita cedera kranioserebral maka semakin buruk prognosis karena tingginya mortalitas.Metode: Studi porospektif tanpa kelompok pembanding untuk melihat hubungan kadar kortisol dalam darah pada onset < 48 jam terhadap keluaran kematian dan hidup selama 3 hari perawatan pada penderita cedera kranioserebral dengan skala koma glasgow 3-12.Hasil: Dari 64 subyek, terdapat 54,7% subyek mati pada 3 hari perawatan pertama. Rerata kadar kortisol darah subyek adalah 32,88+10,16 µg/dl, sedangkan rerata nilai SKG adalah 9,17+2,49. Terdapat hubungan yang bermakna antara kadar kortisol dengan nilai SKG dimana pada nilai SKG 3-6 kadar kortisol dalam darah paling tinggi (p<0.05). Rerata kadar kortisol pada keluaran mati lebih tinggi bermakna dibadingkan dengan keluaran hidup yaitu 44,38+8,87 µg/dl (p<0.05). Titik potong kadar kortisol untuk kematian adalah 31,1 µg/dl, spesifisitas 94,3% dan sensitifitas 96,6%. Pada nilai SKG 3-8, 85,7% subyek mati. Terdapat hubungan yang bermakna antara nilai SKG dengan keluaran mati.Kesimpulan: Keluaran kematian pada penderita cedera kranioserebral menunjukkan kadar kortisol dalam darah yang Iebih tinggi dan nilai SKG yang lebih rendah dibandingkan dengan keluaran hidup.

---

Background: There are many processes in moderate and severe head injury, such as HPA axis stimulation, immuno-competent cell activation that cause releasing of inflammation mediator. Increasing of cytokine causes HPA axis stimulation and triggers cortisol release by adrenal cortex. Previous studies showed that the increasing of plasma cortisol related with poor outcome in head injury patient.

Methods: Prospective study without control in head injury patients with GCS 3-12 and onset less than 48 hours. The aim of this study was to see relation between blood cortisol level and outcome in three days of hospitalization.

Results: From 64 subjects, there are 54.7% subjects who died within 3 days of hospitalization. Mean of blood cortisol is 32.88+10.16 µg/dl, while mean of GCS is 9.17+2.49. There is significant correlation between blood cortisol level and GCS which is blood cortisol level is highest in subjects with GCS 3-6 (p<0.05). Mean cortisol level in poor outcome subjects is significantly higher (44.38+8-87 p.gldl) than good outcome subjects (p<0.05). Cut-off point of cortisol level for poor outcome is 31.1 µg/dl with 94.3% specificity and 96.6% sensitivity. In GCS 3-8 group, 85.7% subjects have poor outcome. There is significant correlation between GCS and poor outcome.

Conclusion: Moderate and severe head injury patient with poor outcome show higher blood cortisol level and lower GCS compare with patient with good outcome."