Background Anemia of chronic disease (ACD) is commonly found in patients with chronic inflammation or infection. By examining soluble transferrin receptor or bone marrow iron, ACD was found in 80% of anemic adult tuberculosis (TB) patients. Iron profile, another tool to differentiate ACD from iron deficiency anemia (IDA), is both less expensive and less invasive. Few studies have been reported on iron profiles of anemic children with TB in Indonesia.Objective We aimed to use iron profiles to determine the proportion of ACD in anemic children with tuberculosis.Methods A cross-sectional study on anemic children with TB who came to Cipto Mangunkusumo Hospital and Tebet Puskesmas (community health center) was performed in September-November 2010. Iron profiles included the measurements of serum iron (SI), total iron binding capacity (TIBC), transferrin saturation (TF), and serum ferritin (SF).Results Our study comprised of 66 subjects, with a median age of 3.8 years (6 months–18 years). Most subjects had normal SI (85%), normal TIBC (71%), low transferrin saturation (51%), and normal SF (71%). Only 10 children had iron homeostasis disorder and 6 of these were diagnosed as having ACD. Thus, iron profiles failed to prove that iron metabolism was disturbed. The profile of children with organ-specific TB was more consistent with ACD compared to the profile of childhood TB. [SI 29.1 (11-83) vs 44 (10-151) μg/dL; TIBC 239.3 (100.80) vs 299.0 (58.51) μg/dL; TF 18.3 (4-100) vs 15 (1-53) %; and SF 154 (34.9-655) vs 36.1 (2.5-213.4) μg/L].Conclusion The proportion of ACD (9%) diagnosed by using iron profiles was not as high as previously reported. Further research using newer techniques is needed to detect ACD in anemic children with TB. [
Background: Sepsis is the leading cause of morbidity and mortality in children worldwide, with around 75,000 inpatients each year and nearly 50% dying in pediatric hospitals. Acute lymphoblastic leukemia (ALL) in childhood is a malignancy originating from lymphoid progenitor cells, usually at the age of 2–6 years. Children with ALL contribute 30% to childhood cancer cases under 15 years old. Sepsis in pediatric patients increases mortality significantly. A previous study showed that the prevalence of sepsis in pediatrics is still high. Thus, this study aims to report ALL patients with sepsis in our institution.Methods: This study was a descriptive cross-sectional study at the National Cancer Center (NCC) - Dharmais Cancer Hospital. We recruited acute lymphoblastic leukemia (ALL) patients aged 2-18 years with suspected or documented sepsis based on Systemic Inflammatory Response Syndrome (SIRS) by The International Consensus Conference on Pediatric Sepsis. The data were collected by medical records from January 2014 to December 2018.Results: A total of 94 pediatric patients in the study included 57 males and 37 females with an average age of 5 years. The age range was 1–18 years with a median age of 5 years. The prevalence of sepsis in pediatric with ALL was 11 patients (11.7%) and 45.5% of deaths. The clinical conditions were as follows: abnormal temperature (8 [72.7%]), abnormal blood pressure, systolic (7 [63.6%]) and diastolic (7 [63.6%]), abnormal pulse rate (9 [81.8%]), abnormal respiratory rate (8 [72.7%]), and normal saturation (6 [54.5%]). We also did a laboratory check followed by all sepsis patients who had abnormal leukocytes (11 [100%]), and abnormal lymphocytes count (8 [72.7%]).Conclusions: The mortality rate and prevalence of sepsis in children with ALL in our institution are still high. Further prospective studies are required to explore the risk factors and predictors of sepsis based on its severity and adherence of health workers to implement guidelines on patients with sepsis in the hospital.
Sindrom nefrotik (SN) merupakan penyakit ginjal yang paling sering ditemukan pada anak. Pernberiansteroid sebagai terapi SN telah terbukti efektif untuk mencapai kondisi remisi (94%) namun insidens relapsmasih tinggi, yaitu hampir 60%. Untuk tata laksana SN pada anak di Indonesia, Unit Kerja KoordinasiNefrologi Ikatan Dokter Anak indonesia telah menyusun konsensus sesuai dengan rekomendasi empirisInternational Study for Kidney Disease in Children (ISKDC). Terapi inisial diberikan prednison dosis penuh60 mg/m2 LPB/hari selama empat minggu dilanjutkan dengan dosis 40 mg/m2 LPB/hari selang sehariselama empat minggu (terapi standar). Makalah ini membahas perbandingan terapi standar dengan terapiinisial yang diperpanjang atau dikombinasi dengan obat imunosupresif lain, apakah terapi alternatif inidapat mengurangi kejadian relaps tanpa meningkatkan efek samping. Kesimpulan dari telaah ini adalahprednison inisial yang diperpanjang terbukti dapat menurunkan kejadian relaps tanpa meningkatkan efeksamping yang berarti. Alternatif lain yaitu kombinasi prednison dengan siklosporin A yang tampaknya jugsmenjanjikan hasil yang balk
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