BackgroundHenoch-Schönlein purpura (HSP) is the most common vasculitis in children, characterized by triad of symptoms; palpable purpura without thrombocytopenia, abdominal pain, and arthritis. Renal involvement often occur in children with HSP. No data on the renal involvement of children with HSP in Indonesia, especially West Java.ObjectiveTo evaluate renal involvement in children with HSP.MethodsRetrospective study was conducted in children with HSP in Department of Child Health, Hasan Sadikin Hospital, from 2006 to 2011. Characteristics and clinical manifestations was reviewed from medical record. HSP was diagnosed by American College of Rheumatology 1990 criteria or European League Against Rheumatism/Pediatric Rheumatology International Trials Organization/Pediatric Rheumatology European Society 2008.ResultsThere were 128 patients, consisting of 82 male (64.9%) and 46 female (35.1%) with ratio 1.8:1. Mean age was 7.9 ± 2.9 years old which range from 6 month to 15 years. Peak morbidity was between 5-10 years old. Prevalence of HSP in Hasan Sadikin Hospital tend to raise from 2.7/100,000 in 2008 to 5.2/100,000 in 2010. In most patients (71%) purpura was the first symptom. Seventy-one patients (44.5%) had arthritis and 89 patients (69.5%) had abdominal pain, while renal involvement was in 28 patients (21.8%). Gastrointestinal manifestations tend to manifest in patients less than 5 years old (p = 0.267), while renal involvement tend to manifest in age group 11-15 years old (p = 0.015) with odds ratio 3.1 (95% confidence interval, 1.2-8.1).ConclusionRenal involvement in children with HSP is more common in age group 11 to 15 years old.

AbstrakJuvenile idiopathic arthritis (JIA) merupakan penyakit reumatik kronik tersering pada anak yang terjadi sebelum usia 16 tahun. Penelitian ini bertujuan mengevaluasi profil penderita yang didiagnosis JIA. Dilakukan penelitian deskriptif retrospektif terhadap penderita JIA yang datang ke Divisi Alergi Imunologi Departemen Ilmu Kesehatan Anak Rumah Sakit Dr. Hasan Sadikin Bandung pada periode Januari 2006-Oktober 2011 berdasarkan rekam medis. Didapatkan 28 penderita JIA terdiri atas 10 anak laki-laki dan 18 anak perempuan, dengan rentang usia 2-14 tahun, usia rata-rata 8,25±3,62 tahun. Sebanyak 14 penderita JIA merupakan tipe oligoartritis persisten, 6 tipe sistemik, 5 tipe poliartritis, dan terdapat 1 orang penderita poliartritis tipe dewasa. Pada pemeriksaan laboratorium, didapatkan 2 penderita dengan faktor reumatoid positif dan 14 penderita negatif. Terapi yang diberikan obat antiinflamasi nonsteroid sebagai protokol terapi standar, steroid, dan disease modifying anti-rheumatic drugs (metotreksat). Terdapat 3 penderita meninggal yang semuanya merupakan tipe sistemik. Simpulan, sebagian besar JIA merupakan tipe oligoartritis persisten, lebih banyak ditemukan pada anak perempuan dibandingkan dengan laki-laki. Kasus kematian terjadi pada JIA tipe sistemik. Sebagian besar penderita memberikan respons yang baik terhadap protokol terapi standar. [MKB. 2012;44(2):101-5]. Kata kunci: Anak, juvenile idiopathic arthritis, subtipe Distribution of Juvenile Idiophatic Arthritis Subtypes in Bandung AbstractJuvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children which begin before 16 years of age. The objective of this study was to evaluate the profile of patients who diagnosed as JIA. The descriptive retrospective study was done to patients with JIA who came to Allergy Immunology Division, Department of Child Health Dr. Hasan Sadikin Hospital Bandung during January 2006-October 2011 period, based on the medical records. There were 28 patients with JIA consisted of 10 boys and 18 girls, age ranged 2-14 years, with mean age of onset of 8.25±3.62 years. There were 14 patients with persistent oligoarthritis type, 6 patients with systemic type, 5 patients with polyarthritis type and 1 patient with polyarthritis adult type. The laboratory data showed 2 patients with positive rheumatoid factor and 14 patients were negative. Non-steroidal anti-inflammatory drugs as standard protocol therapy, steroids and disease modifying anti-rheumatic drugs (methotrexate) were used for treatment. There were 3 patients with systemic type death. In conclusions, most of JIA cases were persistent oligoathritis type, girls more than boys, and all death cases were systemic JIA. Most of cases had satisfactory therapeutic outcomes with standard protocol therapy. [MKB. 2012;44(2):101-5].

Purpose The use of soy-based infant formula has increased widely in infants with cow's milk allergy (CMA). This study aimed to provide evidence on the growth pattern of CMA infants fed with soy-based infant formula in an Indonesian setting. Methods A multi-site, intervention study was conducted among full-term and normal birth weight CMA infants. Within six months, the subjects were provided with a soy-based infant formula. Weight, height, and head circumference were measured at baseline, weeks 4, 8, 12, 16, 20, and 24. Adverse events were recorded by scoring atopic dermatitis and symptom-based clinical scores. Results Based on the World Health Organization growth chart, we found that most of subjects had normal nutritional status for weight-for-age, length-for-age, weight-for-length, and head-circumference-for-age. There were statistically significant differences between baseline and end-line for weight-for-age, length-for-age, weight-for-length, and head circumference-for-age nutritional status. No allergic symptoms or intolerance toward soy formula were observed at the end of the intervention period. Conclusion These results show that infants fed with soy-based infant formula have a normal pattern of growth.

Latar belakang.Henoch Schonlein purpura (HSP) dengan keterlibatan ginjal memiliki prognosis yang lebih buruk, dan infeksi gigi merupakan faktor risiko terbanyak terjadinya HSP dengan keterlibatan ginjal. Tujuan.Menganalisis hubungan antara riwayat infeksi gigi dan terjadinya HSP dengan keterlibatan ginjal pada anak.Metode.Penelitian retrospektif dengan rancangan potong lintang terhadap 146 anak yang didiagnosis HSP berdasarkan kriteria American College of Rheumatology(ACR) sertaEuropean League Against Rheumatism(EULAR), Pediatric Rheumatology International Trials Organization(PRINTO), dan Pediatric Rheumatology European Society(PRESS). Penelitian dilakukan di Divisi Alergi-imunologi Departemen Ilmu Kesehatan Anak Rumah Sakit Hasan Sadikin Bandung, periode Januari 2006− Desember 2012. Data pasien diambil dari rekam medis dan dianalisis menggunakan uji Chi square.Hasil.Didapatkan 146 anak dengan HSP, 93(63,7%) laki-laki dan 53(36,3%) perempuan dengan rasio 1,8:1. Rerata usia pasien 8,05±2,9 tahun. Sembilan puluh dua pasien (63%) diduga mengalami infeksi sebagai pencetus terjadinya HSP. Didapatkan 41 pasien HSP dengan keterlibatan ginjal (28%), yaitu proteinuria 6 (14,6%), hematuria 9 (22,0%), serta proteinuria dan hematuria 26 (63,4%) Infeksi gigi merupakan faktor pencetus terbanyak dibandingkan dengan faktor pencetus lainnya pada HSP dengan keterlibatan ginjal, yaitu 25 pasien (61%) dengan p=0,025; Odd ratio(OR) 2,7 (1,1–6,4) dengan interval kepercayaan 95%.Kesimpulan. Anak dengan riwayat infeksi gigi memiliki risiko tinggi untuk terjadi HSP dengan keterlibatan ginjal.