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Latar belakang. Thalassemia adalah kelainan bawaan sintesis hemoglobin, dan salah satu penyakit monogenetik paling banyak dijumpai. Di Indonesia diperkirakan akan lahir 2500 anak dengan thalassemia mayor setiap tahunnya. Berkat kemajuan penanganan medis, sebagian besar pasien akan mengalami pertumbuhan normal pada masa anak-anak namun selanjutnya akan terjadi gangguan pertumbuhan dan keterlambatan pubertas secara signifikan.Tujuan. Mengetahui gambaran tinggi badan, kecepatan tumbuh, usia tulang, kadar hemoglobin pretranfusi, dan kadar feritin serum pasien thalassemia.Metode. Laporan serial kasus pada anak yang menjalani rawat inap di Sub-bagian Hematologi Bagian Ilmu Kesehatan Anak FK UNUD/RSUP Sanglah Denpasar dari bulan Desember 2010-Februari 2011. Data yang diperoleh disajikan dalam bentuk tabel.Hasil. Limabelas subyek thalassemia mayor, berumur antara 1,9 tahun – 13,5 tahun, 7 laki-laki dan 8 perempuan. Dua anak berumur kurang dari 3 tahun dan 7 anak telah memasuki usia pubertas. Semua pasien telah menjalani terapi kelasi besi deferioksamin namun kualitasnya tidak memadai. Perawakan pendek ditemukan pada 4 anak (26%), semua subjek mempunyai kecepatan tumbuh <5 cm/tahun. Secara klinis satu orang dikategorikan sebagai pubertas terlambat. Kadar hemoglobin rata-rata pre-transfusi dapat dipertahankan ≥8 mg/dl (10), sisanya (5) memiliki hemoglobin rata-rata di bawah 8 mg/dl. Empat anak dengan feritin serum di atas 3000 ng/ml, dan semua subjek mempunyai perawakan pendek. Pada evaluasi radiologi manus sinistra 5 anak memiliki usia tulang terlambat. Kesimpulan. Perawakan pendek didapatkan pada 26% kasus dan semua subjek telah memasuki usia pubertas. Semua subjek mempunyai perawakan pendek dan memiliki kadar feritin serum >3000 ng/ml. Sari Pediatri2011;13(4):299-304.

IntroductionOsteoporosis in children is rare and usually secondary to an underlying disease process whose diagnosis may be difficult to detect. Etiological factors responsible for osteoporosis secondary to chronic illness include immobility, pubertal delay and other hormonal disturbances. Rarely, it can be a manifestation of acute lymphoblastic leukemia. Most of the reported bone fracture incidences associated with acute lymphoblastic leukemia occur during the course of the chemotherapy, not at the point of the first symptoms of leukemic disease, as happened with the case presented here.Case presentationA 7-year-old Asian Balinese boy presented with back pain. His anteroposterior pelvic radiograph showed osteoporotic bone. A bone age study revealed growth failure of his metacarpals, phalanges and sesamoid. His total bone mass density was 97% age-match. However, a peripheral blood smear showed normochromic anemia with thrombocytopenia. Immunophenotyping of his peripheral blood revealed no dominant markers, but a bone marrow aspiration confirmed a diagnosis of acute lymphoblastic leukemia.ConclusionsOsteoporosis was the only manifestation of the child’s underlying acute lymphoblastic leukemia. Leukemia was diagnosed when his bone marrow was found to contain more than 25% blasts. Because of leucopenia, the immunophenotype failed to reveal a dominant marker in this case, thus we were unable to classify the acute lymphoblastic leukemia.

Background Iron deficiency anemia (IDA) is the most common

Background: Childhood cancer is estimated to increase every year. Child cancer divided into leukemia and solid tumors. In RSCM Jakarta, the most common cancers are Acute Leukemia, Brain Tumor (10-15%), Retinoblastoma (10-12%), and other malignancies. This study aims to determine the characteristics of childhood cancer at Sanglah General Hospital Denpasar in the period 2008-2017.Method: A cross-sectional retrospective descriptive study was conducted by taking patient's medical records of leukemia and solid tumors data in children admitted to Sanglah General Hospital during 2008-2017. The parameters assessed in this study were the type of cancer in children, age, sex, or residence domicile. Data were analyzed with SPSS software version 17 for Windows.Results: The results obtained 410 pediatric cancer patients during the 2008-2017 time period, which consisted of 240 cases of leukemia (58.5%) and 170 cases of solid tumors (41.5%). Most cases were 0-5 years old (61.5%), males (50.7%), and domiciled in Bali (72.4%). Acute lymphoblastic leukemia (LLA) is the most common hematologic malignancy in children, which occupies 41.0% of total cancers proportion, followed by retinoblastoma (14.0%), malignant lymphoma (9.0%), and neuroblastoma (5.0%).Conclusion: Most cancers in children occur at the age of 0-5 years, male sex, and domicile in Bali. Besides, acute lymphoblastic leukemia (LLA) is the most common hematologic malignancy in children. Latar Belakang: Penyakit kanker anak diperkirakan meningkat setiap tahunnya. Kanker anak secara garis besar dibagi dua, yaitu keganasan darah (leukemia) dan tumor padat. DI RSCM Jakarta, kanker tersering yaitu Leukemia Akut, Tumor Otak (10-15%), Retinoblastoma (10-12%), dan keganasan lainnya.Penelitian ini bertujuan untuk mengetahui karakteristik kanker anak di RSUP Sanglah Denpasar dalam perioder 2008-2017.Metode: Penelitian deskriptif retrospektif potong lintang dilakukan dengan pengambilan data rekam medis pasien leukemia dan tumor padat anak yang menjalani perawatan di RSUP Sanglah Denpasar periode tahun 2008-2017. Parameter yang dinilai pada penelitian ini adalah jenis kanker pada anak, usia, jenis kelamin, maupun domisili tempat tinggal. Data dianalisis dengan piranti lunak SPSS versi 17 untuk Windows. Hasil: Hasil penelitian mendapatkan 410 pasien kanker anak selama rentang waktu 2008-2017 dimana terdiri atas 240 kasus leukemia (58,5%) dan 170 kasus tumor padat (41.5%). Sebagian besar kasus berusia 0-5 tahun (61,5%), berjenis kelamin laki-laki (50,7%), dan berdomisili di Bali (72,4%). Leukemia Limfoblastik Akut (LLA) merupakan keganasan hematologi tersering pada anak dimana menempati proposi 41,0% dari total kanker, diikuti Retinoblastoma (14,0%), Limfoma maligna (9,0%), dan Neuroblastoma (5,0%).Kesimpulan: Sebagian besar kanker pada anak terjadi pada usia 0-5 tahun, berjenis kelamin laki-laki, dan domisili di Bali. Di samping itu, Leukemia Limfoblastik Akut (LLA) merupakan keganasan hematologi anak tersering pada anak.

Background Global morbidities due to dengue viral infection increase yearly. The pediatric mortality rate from dengue shock syndrome (DSS) remains high. Early identification of the risk of recurrent shock may serve to increase awareness and reduce mortality. The Dengue Recurrent Shock Prediction Score (DRSPS) is a tool to predict recurrent shock in children with DSS, but the optimal cut-off point in our population is still unknown. Objective To assess the validity of the DRSPS by determining the optimal cut-off point that can be used in Indonesia Methods This cross-sectional prospective study was done at Sanglah Hospital, Denpasar, Bali, from January 2019. Risk of reccurent shock were classify based on DRSPS in all DSS patient, and they were observed whether they will experienced recurrent shock or not. Results Of 56 children with DSS, 27 subjects had recurrent shock and 29 subjects did not. The optimal DRSPS cut-off point was -189.9 for predicting recurrent shock, with 87.4% area under the curve (AUC), 81.5% sensitivity and 82.8% specificity. Conclusion The optimal cut-off point of DRSPS was -189.9 and it has good validity. The results of this study are expected not only to be used as the basis for further study, but to increase physician awareness in treating DSS patients.

BACKGROUND: Malignant Ovarian Germ Cell Tumors (MOGCT) most commonly occur in young women in the reproductive age group. Timely antenatal diagnosis and treatment of the tumour to enhance maternal and perinatal outcomes are the main challenges confronting the obstetrician and the gyne-oncologist. CASE PRESENTATION: Here we present three cases of pregnancy complicated with MOGCTs. The first case (immature teratoma) was complicated by maternal psychological symptoms consistent with stress and histopathological examination confirmed the diagnosis of premature ovarian failure (POF). The second case (dysgerminoma) preterm labour occurred as an obstetric complication, but the baby was born in good condition without IUGR. The third case (yolk sac tumour) treated with docetaxel (brexel)-carboplatin chemotherapy administration there was no maternal or fetal complication. At the end of the pregnancy and delivery, complete surgical staging and cytoreduction were performed, and no metastases were found. CONCLUSION: Optimal management strategies centre on a multi-disciplinary comprehensive team approach is critical resulting in better outcomes for the mother and the baby by avoiding complications.