AbstrakLupus Eritematosus Sistemik (LES) merupakan penyakit autoimun kompleks yang menyerang berbagai sistem tubuh. Salah satu manifestasi LES adalah vaskulitis, yaitu inflamasi pada dinding pembuluh darah. Vaskulitis sekunder akibat LES terjadi pada beberapa pasien LES dengan gambaran yang bervariasi. Gambaran vaskulitis yang tersering pada LES adalah vaskulitis kutaneus. Dilaporkan seorang perempuan 26 tahun yang telah dikenal dengan LES, datang dengan keluhan bintik-bintik merah di kedua tungkai dan lengan yang tidak gatal dan tidak nyeri. Dilakukan biopsi pada lesi kulit dengan hasil tampak pada jaringan kulit dengan epidermis yang mengalami atrofi, hyperkeratosis, ketotik plague, terdapat daerah dengan penebalan membrana basalis. Dibawah dermis tampak sebukan sel radang perivasikuler, terdapat limfosit dan beberapa leukosit PMN. Gambaran tersebut sesuai dengan gambaran discoid lupus erythematosus dan vaskulitis. Discoid lupus erythematosus merupakan salah satu bentuk dari lupus eritematosus kutaneus dan merupakan bentuk yang tersering. Pada kasus ini vaskulitis muncul menunjukkan kambuh atau aktifnya penyakit LES yang telah diderita pasien selama 2 tahun. Hal tersebut ditunjukkan dengan jumlah skor MEX SLEDAI 6 dan skor SLEDAI 12. Pasien diberikan terapi dengan metil prednisolon intravena 2x125 mg selama 3 hari serta hidroksiklorokuin 1x200 mg per oral. Respon yang baik terlihat pada hari rawatan keenam dengan berkurangnya manifestasi vaskulitis secara signifikan.Kata kunci: lupus eritematosus sistemik, vaskulitisAbstractSystemic lupus erythematosus (SLE) is a complex autoimmune disease involving many systems in one’s body. One of SLE manifestations is vasculitis, an inflammation of the vessel wall. Secondary vasculitis caused by SLE happened in few SLE patients with various manifestations. The most common SLE vasculitis is cutaneous vasculitis. It has been reported a female patient (26 years old) who was known with SLE, with red spots on both her legs and arms without feeling itchy or painful. Skin biopsy was done to the patient and the result was an appearance in skin tissue with the atrophic epidermis, hyperkeratosis, ketotic plague, thickening area of membrana basalis. In dermis underneath, was distributed inflammation cells perivascular, with lymphocyte and numerous PMN leukocyte. This appearance corresponds with discoid lupus erythematosus and vasculitis. Discoid lupus erythematosus is one most common cutaneous lupus erythematosus. In this case, the occurrence of vasculitis demonstrated an active disease of SLE. Disease activity was assessed with MEX SLEDAI and SLEDAI scores, which are 6 and 12 consecutively. The patient was given intravenous methylprednisolone 125 mg twice a day for 3 days and oral hydroxychloroquine 200 mg once daily. A good response was found in the sixth day with significant improvement of her skin lesions.Keywords: systemic lupus erythematosus, vasculitis
Objective: Systemic lupus erythematosus (SLE) is a complex autoimmune disease involving many systems. Highest incidence and prevalence of SLE is found in Northern America 23.2/100,000 population/year and 241/100,000 population. According to sex differences, SLE is predominantly occurs in women than men with ratio 15:1 to 22:1. This discrepancy often causes delay in diagnosing SLE in male patients. Method: Case report. Result: We reported a male patient aged 21 years with pain of his joints, hyperpigmentation lesions on his face, alopesia, oral ulcers and decrease of body weight. Laboratory results showed increases in AST, ALT and D-Dimer, and from ANA Profile examination we got several positives results such as RNP/Sm (RNP/Sm) (++), Sm (Sm) (+), Ro-52 recombinant (52) (+), PCNA (PCNA) (+), DsDNA (DNA) (+), Nucleosome (NUC) (+), Histone (HI) (++), Ribosomal-P-protein (RIB) (+++) dan AMA-M2 (M2) (+). This patient met SLE criteria based on ACR 1997, SLICC 2012 and EULAR/ACR 2018. Patient was given oral methyl prednisolone 16-16-8 mg and VTE prophylaxis with subcutaneous heparin 2x5000 IU. Conclusion: SLE occurs rarely in male patients than female patients and has more diverse manifestations.
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