Introduction: Osteoarthritis is a degenerative joint disease which affects joint cartilage. As many as 80% patients movement are limited and 25% of them can not even perform daily activities. Osteoarthritis is one of the ten most disabling diseases in developed countries. Due to its chronic and progressive nature, socio-economic impacts in many developed and developing countries are enormous. The purpose of this study is to determine the profile of patients with osteoarthritis in the Orthopedic Department of RSUD Dr. Soetomo Surabaya (Dr. Soetomo General Hospital)Method: This is descriptive observasional research. Questionnaires data were obtained from all patients in the Department of Trauma and Orthopedic of RSUD Dr. Soetomo Surabaya during September 1, 2016 until October 31, 2016. Thirty five subjects with osteoarthritis were analyzed for the study. The variables observed in the patient profile include sex, age, body mass index, type of osteoarthritis, Kellgren-Lawrence scoring system, and knee osteoarthritis severity index.Result: The result shows that 43% of the samples were aged 60-69 years, 83% of the samples were female, 37% of the samples had an I BMI obesity, 60% of samples had bilateral osteoarthritis, and 77% of samples from primary osteoarthritis. A total of 15 of 53 knee samples had class III, and 15 of 53 knee samples also had class I, and as many as 21 of the 35 samples had a "very severe" clinical gradation. These results may be due to patients who have low grade gradation clinics and have received medical attention at the level I health facility or II.Conclusion: From the results of this study, it can be concluded that age, sex, BMI, Kellgren-Lawrence assessment system, index severity of patients Lequesne osteoarthritis in RSUD Dr. Soetomo Surabaya is in conformity with research that has been done in many places and theories that exist.Keywords: Knee osteoarthritis, age, gender, Kellgren-Lawrnce scoring system, knee osteoarthritis severity index

Several key player factors, such as cytokine and complement, play an important role in the pathogenesis of systemic lupus erythematosus (SLE). The purpose of this study was to reveal the association between complement 3 (C3), complement 4 (C4), interleukin-6 (IL-6), and transforming growth factor-β (TGF-β) with SLE disease activity, renal damage, and hematological activity in patients with naïve SLE. The Laboratory of Clinical Pathology Dr. Soetomo General Hospital in Surabaya performed all laboratory examinations on thirty women with naïve SLE. The SLE diagnosis is based on ACR criteria (1998 revised criteria) from Dr. Soetomo General Hospital Surabaya, Indonesia, and the systemic lupus activity measurement (SLAM) score is used to assess the disease activity. The correlation was statistically tested using the Spearman and Pearson tests. The differences in cytokine and complement levels are between SLE severity groups using the two-way Anova and Kruskal–Wallis. The unpaired T-test and Mann–Whitney test were used to determine the differences between the relatively normal and the more severe groups of organ damage and hematological activity. All tests were two-tailed, analyzed with GraphPad Prism 9 for windows, and a p value of less than 0.05 was considered statistically significant. This study found a significant decrease in C3 (20.2, 16.4–24.2 mg/dL) and C4 (7, 6–14.3 mg/dL) and an increase in IL-6 (35.60 ± 7.43 mg/dL) and TGF-β (311.1 ± 290.8 mg/dL) in the group of severe patients with SLAM scores >30. Although there is no significant relationship between SLAM and renal impairment or hematologic activity, patients with higher SLAM had a significant decrease in complement; this complement decrease was also significant in patients with higher leukocyte counts. An insignificant increase in cytokines was also observed in patients with higher SLAM. Patients with high serum creatinine levels had a significant increase in TGF-β, whereas those with a faster ESR had a significant increase in IL-6. In conjunction with complements evaluation, assessment of the cytokine profile may become a promising marker for reliable diagnosis and treatment of SLE in the future.

Background: Cardiovascular complication remains the long-term complications in spondyloarthritis (SpA). Previous studies revealed that metabolicsyndrome is the risk factor of cardiovascular in SpA patients. Previous studies also revealed that the prevalence of the metabolic syndrome is 34.9–45.7% in SpA patients. However, previous studies also revealed the controversy of the correlation of SpA’ disease activity with metabolic syndrome.Aim: The aim of the study was to investigate the correlation of SpA’ radiographical damage measured with a modified Stoke Ankylosing SpondylitisSpinal Score (mSASSS) score with metabolic syndrome in SpA patients, which routinely visited Rheumatology Outpatient Department in Dr. SoetomoGeneral Hospital.Methods: An observational study with cross-sectional design with consecutive sampling technique was conducted in July–October 2018. All SpApatients who fulfilled the inclusion criteria were included in this study. Data analysis was performed with SPSS v21.0.Results: There were 33 SpA patients (10 males and 23 females) included in this study. The average age was 48.18±12.27 years-old. The averagemSASSS score was 24,36 (K:0.93, p:0.00). Metabolic syndrome was diagnosed in 54.5% patients with 100% patients had central obesity, 66.7% hadincreased blood pressure, 61.5% had impaired fasting glucose, 55.6% had increased triglycerides, and 77.8% had decreased high-density lipoproteincholesterol. Positive correlation between mSASSS score and metabolic syndrome was observed (r:0.510, p:0.002).Conclusion: A correlation between SpA disease activity measured with mSASSS score and metabolic syndrome was observed. Therefore, routinemetabolic syndrome screening is strongly suggested for SpA patients.

Background: Spondyloarthritis (SpA) is a chronic inflammatory disease characterized by enthesitis, sacroiliitis, and axial joint involvement. Although the association of HLA with SpA has been widely reported, there have been no studies of HLA type in the Indonesian population within the last 20 years. This study aims to identify the HLA type in SpA patients at Dr. Soetomo General Hospital, Indonesia. Methods: This study used a cross-sectional analytical design with samples that met the criteria for SpA according to the 2009 ASAS. The clinical scores used in this study were mSASSS, BASFI, ASDAS, and Schober. Genetic identification using PCR was performed followed by sanger sequencing to determine the HLA type in the patient. DNA sequences were aligned with BLAST, and a phylogenetic tree was created using MEGA 11. Descriptive and comparative analyzes were performed using GraphPad Prism 9. Results: This study founded four types of HLA in SpA patients at Dr. Soetomo General Hospital, that is HLA-B with six alleles; -B*2704 (12.86%), -B*2705 (1.43%), -B*2706 (1.43%), -B*1802 (4.28%), -B*57v (1.43%), -B*35 (2.86%), HLA - C (21.43%), and HLA - K (52.83%). Clinical scoring of HLA-C and HLA-K indicated severe and progressive disease activity. The HLA-K had the highest mSASSS (26, 95% CI: 22–28), while HLA-C had the highest BASFI score (60, 95% CI: 55–68), the lowest Schober score (12, 95% CI: 10–14), and the shortest duration of illness (22, 95% CI: 12–36). There is no significant difference in the ASDAS score among types. Conclusions: The most common HLA types found in SpA patients at Dr. Soetomo were HLA-C and HLA-K, with the most progressive disease activity indicated by poor mSASSS, BASFI, ASDAS, and Schober scores with a short duration of illness.

Introduction: Psoriatic arthritis is a spondyloarthropathy subtype with a broad clinical spectrum and diverse symptoms. The use of biological disease-modifying antirheumatic medications (DMARDs), such as TNF inhibitors is recommended as pharmacological therapy for PSA in cases of axial involvement and high disease activity level. Since Indonesia has the second-highest tuberculosis (TB) cases globally, and patients receiving TNF inhibitors have an elevated risk of latent TB reactivation, evaluation of latent TB before starting TNFi is necessary and challenging. Case Presentation: A 63-year-old male psoriatic arthritis patient with bilateral hip joint osteoarthritis, bilateral knee effusions and bilateral frozen shoulder. The patient also had coronary heart disease with a history of underwent coronary artery bypass graft (CABG), diabetes mellites type 2 and confirmed latent TB. Psoriatic arthritis had high activity based on the Bath Ankylosing Spondylitis Disease Activity (BASDAI) score and Ankylosing Spondylitis Disease Activity Score (ASDAS). TNF inhibitor treatment started a month after latent TB treatment. The patient responded satisfactorily to the TNFi treatment, as demonstrated by clinical evaluation and decreased disease activity. Latent TB treatment was continued for up to six months, followed by latent TB activity monitoring during TNFi administration to prevent latent TB reactivation. Conclusion: This case highlights the challenges in management of axial psoriatic arthritis patients with high disease activity, concomitant latent TB infection, and early extra-articular symptoms of cardiovascular disease.