BACKGROUND:Midkine (MK) induces inflammation and could inhibit inducible regulatory T cell differentiation. These reports suggest that MK may play a role in the pathogenesis of autoimmune disease including SLE, but data about MK in SLE patients was still limited, and the role of Midkine in SLE is largely unknown.AIM:The purpose of this study was to compare serum level MK in SLE patients and control, also analysed the relationship between the serum MK level and disease activity in SLE.METHODS:This cross-sectional study was conducted in Adam Malik Hospital from January-June 2017. Diagnosis of SLE was established according to the Systemic Lupus International Collaborating Clinics (SLICC) classification criteria, and disease activity was assessed using the Mexican Systemic lupus erythematosus disease activity index (MEX-SLEDAI). Subjects with evidence of malignancy and systemic disease (pulmonary, kidney, liver, metabolic disorder, etc.) were excluded. Data analysis was performed using SPSS 22nd version. P < 0.05 was considered statistically significant.RESULTS:There were 90 subjects and divided into 2 groups: SLE patients group (n=40) and healthy control groups (n = 50). Midkine levels were increased in the serum of SLE patients compared by health control. There was a significant difference in the median serum Midkine levels between SLE patients and healthy control (P < 0.001). Elevated Midkine serum levels were a significant difference between active disease and remission (P = 0.018).CONCLUSION:Elevated Midkine serum level could be a marker of SLE disease activity and have a role in the pathogenesis of SLE.

Bone loss is one of the emerging extra-articular manifestations of rheumatoid arthritis. TNF-α is the main inflammatory cytokine that can directly increase bone resorption. However, its role in bone formation is still unknown, especially related to secreted frizzled-related protein 1 (SFRP-1), an osteoblast inhibitor. This study examines the correlation between TNF-α and SFRP-1, with a bone turn over marker (CTX and P1NP). This is a cross-sectional study with 38 subjects of premenopausal female patients with RA. This study found that 60.6% of the patients were in remission or low disease activity. The median of TNF-α was 10.6 pg/mL, mean of SFRP-1 was 9.29 ng/mL, mean of CTX was 2.74 ng/mL, and the median of P1NP was 34.04 pg/ml. There is positive correlation between TNF-α and P1NP (r = 0:363, p = 0:026), also between SFRP-1 and P1NP (r = 0:341; p = 0:036). A low level of TNF-?, high level of SFRP-1, high level of CTX, and low level of P1NP in this study indicate a high bone turn over process, with dominant resorption activity in premenopausal female patients with RA.

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Background. Diabetes is a major health problem worldwide including in Indonesia. There is a close relationship between diabetes and cardiovascular disease, with cardiovascular events being the most prevalent cause of morbidity and mortality in diabetic patients. Therefore, it is important to assess cardiovascular risk in patients with diabetes in order to conduct appropriate preventive strategies. Various methods have been developed to assess the degree of cardiovascular risk, one of which is the Jakarta Cardiovascular Score, a scoring method that has been adapted for the Indonesian community. This study aims to describe the profile of cardiovascular risk in diabetes patients at Universitas Sumatera Utara Hospital. Methods. A descriptive, cross-sectional study was conducted in the internal medicine outpatient clinic at Universitas Sumatera Utara Hospital. All subjects were diabetic patients who had not developed any cardiovascular complications. The risk of cardiovascular disorders was assessed using the Jakarta Cardiovascular Score. Data were collected through medical records, interviews, and physical examinations. Results. There were 64 subjects in this study. The majority of subjects (81.3%) were classified as high risk for cardiovascular disease. Conclusion. Most patients with diabetes have a high degree of risk of cardiovascular disease.

Vaccination is a very important measure for the prevention of various infections worldwide including the recent COVID-19 disease. However, until now the COVID-19 vaccine with various platforms has not been clinically tested on autoimmune inflammatory rheumatic disease (AIIRD) patients, due to caution against possible side effects and unknown efficacy. Several recent studies proved that there is increased risk of SARS-CoV-2 infection in AIIRD patients and moreover, those patients also have worse COVID-19 outcomes.  Thus, patients with AIIRD should be prioritized for vaccination because they have an increased burden of infections, including COVID-19. Many studies showed that inactivated/non-live vaccine is safe for AIIRD patients and do not cause disease exacerbations. We conclude that benefits of vaccination greatly outweigh the risks of infection and therefore, COVID-19 vaccines can also be administered safely in stable AIIRD patients.

Background: Rheumatoid arthritis (RA) is one of the systemic inflammatory autoimmune diseases. A number of previous studies showed the potency of Protein Tyrosine Phosphatase Non-Receptor Type 22 (PTPN22) 1858c>T gene polymorphism with the incidence of rheumatoid arthritis. Objective: To know the relationship of PTPN22 1858C>T gene polymorphism with disease activity score-28 (DAS-28) in rheumatoid arthritis patients at H. Adam Hospital Medan. Method: 69 rheumatoid arthritis patients were conducted in this study by consecutive sampling who were treated at H. Adam Malik General Hospital, Medan from February-August 2022. The PTPN22 gene polymorphism was genotyped using polymerase chain reaction. Results: Majority of the subject in the study was female, around 65 people (94.2%). The mean age of the subjects was 42.35 ± 12.28 years old. The most ethnic group was Batak with 34 people (49.3%). Mean DAS-28 score was 3.45 ± 0.79. All CC genotypes and C alleles were found in 69 (100%) subjects. Statistical analysis found no correlation between PTPN22 1858C>T gene polymorphism and DAS-28 score with p value <1.0 Conclusion: PTPN22 1858C>T gene polymorphism has no significant relationship DAS-28 in rheumatoid arthritis. Keywords: PTPN22 1858C>T gene polymorphism, Disease Activity Index-28, rheumatoid arthritis