Background: Systemic Lupus Erythematosus (SLE) is an autoimmune disease with wide range of clinical symptoms. The patients frequently complain musculoskeletal involvement during the active state of the disease. Musculoskeletal manifestation in SLE patients is an important sign in making early diagnosis and monitoring treatment response. This study aims to determine the presentation of musculoskeletal involvement of SLE patients in Dr. Hasan Sadikin General Hospital Bandung.Methods: a descriptive cross-sectional quantitative study done by interviewing SLE patients concerning musculoskeletal manifestation as the primary data and tracking their medical record as the secondary data. Study was conducted between September to November 2016 in Rheumatology Clinic Dr. Hasan Sadikin General Hospital Bandung.Result: Ninety-seven SLE patients, 91 females (93,81%) and 6 males (6,19%), were enrolled in this study with mean age 35.12 (±10.91) years. The three highest proportions of muskuloskeltal manifestations were arthritis of the knee (84,5%), myalgia of upper back(40,2%), and muscle weakness (15,5%). We did not find any Jaccoud’s Arthropathy (JA) and tendinitis manifestation. Osteoporosis were occured in 4 patients (4,12%), whereas gout arthritis, spondytlitis, osteoarthritis, rotator cuff syndrome, and rhupus wereonly occured in one patient (1,03%), respectively.Conclusion: The common musculoskeletal manifestation in SLE patients were arthritis of knee, myalgia of upper back, and muscle weakness. Only small portion of patients suffered from osteoporosis, gout arthritis, spondytlitis, osteoarthritis, rotator cuff syndrome, and rhupus.Keyword: musculoskeletal manifestation, musculoskletal involment, SLE
Latar Belakang Anemia normositik normokrom terjadi pada 60% hingga 80% pasien HIV. Anemia dapat menurunkan survival, mempercepat progresivitas penyakit, dan meningkatkan mortalitas pada pasien HIV. Pemberian asupan tinggi protein dan multiple micronutrient supplement diperlukan untuk memperbaiki kadar hemoglobin dan mencegah perburukan anemia. Laporan Kasus Seorang pasien berjenis kelamin laki-laki, umur 25 tahun dikonsulkan dari bagian penyakit dalam dengan diagnosis HIV stadium III untuk terapi nutrisi. Keluhan utama asupan makan berkurang sejak satu bulan terakhir akibat nafsu makan berkurang. Pasien mengeluh batuk, sesak, dan demam. Pasien tersebut memiliki riwayat berganti pasangan, dan sedang dalam pengobatan OAT hari ketiga. Asupan 24 jam 769 kkal. Dari pemeriksaan laboratorium, didapatkan anemia (Hb 9,5 g/dl), deplesi berat sistem imun (TLC 613/µL), dan hipoalbuminemia (2,1 g/dl). Status gizi pasien ini adalah gizi kurang berdasarkan ukuran lingkar lengan atas (73% LLA). Terapi nutrisi diberikan melalui oral dengan energi 2200 kkal, protein 2gr/kgBBI/hari(17%), karbohidrat 50% dan lemak 33% berupa makanan lunak, buah, dan susu formula. Suplementasi yang diberikan adalah zinc 20mg/24jam, vitamin A 6000/24jam, vitamin B1 100 mg/24jam, vitamin B6 200 mg/24jam, vitamin B12 200 µg/24jam, vitamin C100mg/24jam, dan ekstrak ikan gabus 2kapsul/8jam. Setelah perawatan selama 13 hari, pasien dipulangkan dengan status gizi: gizi kurang (IMT 18,36kg/m2), anemia (Hb 11,6 g/dl), deplesi berat sistem imun (TLC 462/µL), dan hipoalbuminemia (3,1 g/dl). Kesimpulan Terapi nutrisi yang adekuat dapat memperbaiki anemia pasien HIV stadium III.
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