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"Latar belakang: Kanker dapat mengaktifkan sistem koagulasi penderitanya, sehingga berada dalam keadaan hiperkoagulabilitas. Komplikasi tromboemboli merupakan penyulit pada penderita kanker yang dapat dicetuskan oleh tindakan pengobatannya. Komplikasi trombosis pada kanker payudara stadium IV cukup tinggi. Belum ada data dasar gambaran hemostasis pada wanita penderita karsinoma payudara stadium lanjut di Indonesia belum ada.Tujuan: Mengetahui proporsi hiperkoagulasi dan hiperagregasi trombosit serta sebaran faktor-faktor stadium, status menopause, dan status pemberian kemoterapi pada penderita karsinoma payudara duktal invasif stadium lanjut. Mengetahui perbedaan nilai rerata parameter koagulasi (PT, aktivitas protrombin, aPTT, D-dimer), dan fibrinogen serta proporsi hiperagregasi trombosit pada wanita penderita karsinoma payudara duktal invasif stadium lanjut dibanding wanita normal.Metodologi: Disain penelitian studi potong lintang, subyek penelitian wanita penderita karsinoma payudara duktal invasif stadium lanjut dan wanita normal, memenuhi kriteria inklusi. Hiperkoagulasi dinilai melaui pemeriksaan PT, aktivitas protrombin, aPTT, dan D-dimer serta menilai reaktivitas/agregasi trombosit.Hasil: Diperoleh sampel 27 orang wanita penderita karsinoma payudara duktal invasif stadium lanjut dengan rerata usia 46,22 tahun, dan 27 orang wanita kontrol normal (bukan penderita kanker) dengan rerata usia 43,11 tahun. Penderita karsinoma payudara dengan status premeopouse 52% postmenopouse 48%, stadium IIIB+IIIC 59% std IV metastasis 41%, mendapat kemoterapi 56% dan tidak mendapat 44%. Didapatkan proporsi hiperkoagulasi pada wanita penderita karsinoma payudara duktal invasif stadium lanjut 67% dan proporsi hiperagregasi trombosit 48%. Proporsi hiperkoagulasi (82%) dan hiperagregasi trombosit (64%) cenderung tinggi pada wanita penderita karsinoma payudara duktal invasif stadium IV metastasis. Terdapat perbedaan bermakna nilai rerata D-dimer (p=0,010) dan fibrinogen (p=0,023), serta tidak terdapat perbedaan proporsi hiperagregasi trombosit antara wanita penderita karsinoma duktal invasif stadium lanjut dengan wanita normal.Kesimpulan : Proporsi hiperkoagulasi pada wanita penderita karsinoma payudara duktal invasif stadium Ianjut sebesar 67% dan hiperagregasi trombosit 48%. Hiperkoagulasi dan hiperagregasi trombosit cenderung tinggi pada penderita karsinorna duktal invasif stadium IV metastasis. Terdapat perbedaan rerata nilai D-dimer dan fibrinogen, serta tidak terdapat perbedaan proporsi hiperagregasi trombosit antara wanita penderita karsinoma duktal invasif stadium lanjut dan wanita normal."

"Hemostatic disorders, which could cause (venous or arterial) thrombosis or bleeding, are often found during hospital care. Common manifestations of thrombosis arc inner vein thrombosis, cardiac infarct, stroke, or even recurrent miscarriage. In addition to hemorrhological detect, certain clinical conditions such as diabetes mellitus or hypercholesteroJemia are risk factors that also play a role in the hemostasis system.The hemostasis system depends on vascular en-dothelial conditions, platelet function (in this case platelet aggregation), coagulation function, anti-coagulation, fibrinolysis, and anti-fibrinolysis. If one of these conditions or functions is disturbed, the hemostatic system may also be disturbed."

"Systemic lupus erythematosus (SLE) as a chronic autoimmune disease with multi-organ involvement often occurs in women of childbearing age. We report a case of active SLE in a-23 year old woman who presented with multi-organ involvement, including pericardia! effusion, severe anemia that caused congestive heart failure, and kidney involvement. ANA and ami ds DNA were positive. The patient was treated with intravenous digoxin followed by a daily dose of oral digoxin, ROmg/day of furosemide, 600 ml packed red cell transfusion, and !.5 mg/kg bodyweight/day of prednisan. The patient was discharged in good condition on the I5'h day of hospitalization."

"Latar belakang dan tujuanBahan berbahaya dalam kebakaran dapat mempengaruhi kesehatan petugas pemadam. Bahan kimia yang terkandung dalam asap kebakaran akan terserap kedalam tubuh dan mempengaruhi fungsi organ-organ tubuh, di antaranya adalah peningkatan kadar hemoglobin darah. Penelitian ini bertujuan untuk melihat pengaruli pajanan asap kebakaran terhadap peningkatan kadar hemoglobin darah pada tim pemadam kebakaran.MetodePenelitian ini menggunakan disain studi kasus-kontrol terhadap 120 subjek terdiri dari 40 kasus kadar Hb tinggi dan 80 kontrol dengan memadankan umur. Subjek penelitian adalah anggota pasukan, sopir mobil pemadam, kepala regu dan kepala peleton pemadam kebakaran. Tingkat pajanan dihitung secara skoring terhadap faktor-faktor yang terkait pajanan.Hasil dan kesimpulanFaktor-faktor pajanan yang diteliti yaitu umur, masa dinar, jabatan, lama pemadaman, frekuensi pemadaman, pemakaian masker dan kebiasaan merokok, secs statistik tidak ada hubungan yang bermakna dengan kadar Hb (p> 0,05). Hipotesis tingkat pajanan asap yang tinggi mempunyai risiko kadar Hb tinggi lebih besar dibanding tingkat pajanan rendah, ditolak. Tingkat pajanan tidak berhubungan bermakna secara statistik dengan kadar Hb (p >0,05).

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Background and objective

The exposure of fire smokes contained hazardous substances ;potentially effect firefighter's health. The cumulative effect of these substances can abnormally increase the haemoglobine level. This study is aimed at finding the associations of fire smokes exposure to high haemoglobine level and its risk factors.

Methods. This study design was a case-control study involving sample of 120 subjects consisted of 40 cases of high I-lb level and 80 controls. The exposure levels offire smokes were scored for exposure related factors.

Results and conclusions. The exposure factors included age , periode of job, job position, length of service, frekuency of service, masker usage, and smoking habit were no statistical significant association to high Hb level (p>0,05). The hypotesis stated the high exposure level offire smokes have higher risks :3f Hb level than low exposure level alit was rejected . The level of exposure was no statistically significant association with Hb level (p>0, 05)."

"Latar belakang. Gagal jantung dan aritmia merupakan penyebab kematian tersering pada penderita thalassemia R. Gangguan fungsi jantung, khususnya disfungsi diastolik merupakan komplikasi dini pada jantung akibat muatan besi berlebih (iron overload). Kadar feritin serum sampai saat ini masih secara luas digunakan sebagai parameter muatan besi berlebih (iron overload).Tujuan. Mengetahui perbedaan kadar feritin serum antara penderita thalassemia j3 dewasa yang mengalami dan tidak mengalami disfungsi diastolik ventrikel kiri, dan mengetahui besar proporsi disfungsi diastolik pada penderita thalassemia 13 dewasa.Metodologi. Penelitian ini merupakan studi potong lintang untuk melihat perbedaan kadar feritin serum (sebagai parameter iron overload) pada penderita thalassemia 13 dewasa yang mengalami disfungsi diastolik dibandingkan dengan yang tanpa disfungsi diastolik, serta untuk mendapatkan proporsi disfungsi diastolik pada penderita thalassemia 3 dewasa. Analisis terhadap variabel-variabel yang diteliti menggunakan uji-1 independen untuk mendapatkan perbedaan rerata kadar feritin serum antara kedua kelompok.Hasil. Dari penelitian ini 30 orang penderita thalassemia 13 dewasa, laki-laki 13 orang, perempuan 17 orang, didapatkan rerata usia 25,9 tahun dengan rentang usia antara 18-38 tahun. Rerata Hb sebesar (7,5g%, SB I,4g%) dengan rentang kadar Hb antara 5,2 - 9,9 g%. Rerata kadar feritin serum sebesar (5590ng1m1, SB 4614,7 nglml) dengan rentang kadar, feritin antara 296,4 - 15900 nglml. Tidak terdapat perbedaan rerata kadar feritin antara penderita yang mengalami disfungsi diastolik dibandingkan dengan yang tidak mengalami disfungsi diastolik. Proporsi disfungsi diastolik pada thalassemia 13 dewasa pada penelitian ini sebesar 70%.Kesimpulan. Tidak terdapat perbedaan rerata kadar feritin antara penderita yang mengalami disfungsi diastolik dibandingkan dengan yang tidak mengalami disfungsi diastolik. Proporsi disfungsi diastolik pada thalassemia 13 dewasa pada penelitian ini sebesar 70%.

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Background. Heart failure and aritmia is the major cause of death in 3 thalassemia major. Heart dysfunction, especially diastolic dysfunction in ji thalassemia seems to be an early involvement of the heart due to iron overload. Serum ferritin level as a parameter of iron overload still widely use for evaluation in 13 thalassemia.

Objectives. To know the mean difference of serum ferritin level between adult 13 thalassemia patients who have left ventricular diastolic dysfunction and who do not have Ieft ventricular diastolic dysfunction, and to obtain the proportion of diastolic dysfunction in adult 13 thalassemia patients.

Methods. This cross-sectional study was conducted to see the mean difference of Serum ferritin. IeVel'(as a parameter of iron overload) in adult P'thalassemia who have left ventricular diastolic dysfunction and who do not have left ventricular diastolic dysfunction and to know the proportion of diastolic dysfunction among adult 13 thalassemia. The independent t-test was used to analyze the variables to obtain the mean difference of serum ferritin level between the two groups.

Results. Thirty adult P thalassemia patients, 13 were male and 17 were female had been enrolled into this study. The age of the patients ranged from 18 to 38 years old, and the average-age was 25,9 years. The Hb level ranged from 5,2 to 9,9 g% and the mean was (7,5g%, SD 1,4g°/o). The serum ferritin level ranged from 296,4 to 15900 nglml, and the mean was (5590ng/ml, SD 4614,7 nglml). There was no significance mean difference serum ferritin level in patients who had diastolic dysfunction and those who do not have diastolic dysfunction. The proportion of diastolic dysfunction in adult 13 thalassemia patients in this study was 70%.

Conclusions. There was no significannce mean difference serum ferritin level in patients who had. diastolic dysfunction and those. who. did, not have diastolic dysfunction . The proportion of diastolic dysfunction in adult thalassemia 3 patients in this study was 70%."

"Latar Belakang: Cisplatin merupakan kemoterapi efektif dengan spektrum luas. Efek terapeutiknya bertambah bermakna pada peningkatan dosis. Namun aplikasi dosis tinggi (>50 mg/m2) dibatasi nefrotoksisitasnya yang berat.Tujuan: Mempelajari efek cisplatin terhadap aktivitas eritropoiesis, kadar eritropoietin dan fungsi ginjal pasien tumor padat ganas.Metode dan Cara : Studi pre & post sejak Nopember 2004 sampai Januari 2005 dilakukan pada 14 pasien kanker tumor solid (KNF, Osteosarkoma, Ca paru) yang mendapat rejimen kemoterapi mengandung cisplatin dosis 70-100 mg/m2. Pengambilan sampel dilakukan pra, pasta kemoterapi 1 dan II, dengan rentang 21 hari. Analisis univariat dilakukan terhadap usia, Janis kelamin, Janis tumor dan stadium klini.k Dilakukan analisis bivariat pads komponen eritropoiesis, kadar EPO dan TKK hitung..Hasil : Didapatkan tumor solid berupa karsinoma nasofaring (88,24%), osteosarkoma (5,88%) dan adenokarsinoma pare (5,88%). Di mana stadium III (70,6%) dan stadium IV (29,4%). Didapatkan penurunan nilai Hb bermakna pasca siklus 110,74% (p = 0, 029)_ Pasca siklus H, Hb turun 1% (p = 0,37). Evaluasi pasca 2 siklus, lib turun 7,7% (p 0, 035). Hasil yang sama didapatkan pada nilai Ht, pasca kemoterapi siklus I (p = 0,03) dan pasca 2 siklus (p = 0, 008). Sedangkan pasca siklus II tidak bermakna (p = 0,594). Jumlah eritrosit pasca siklus I turun 13% (p = 0,00) dan pasca siklus II turun 8,7% (p = 0,00). Jumlah eritrosit turun 20,8% pasca 2 siklus (p = 0,00). Pasca 2 siklus, indeks retikulosit turun 1,59% (p = 0,975). Kadar eritropoietin pasca siklus I turun 12,7% (p = 0,73), pasta siklus II turun 20% (p = 0,03). Pasca 2 siklus didapatkan penurunan eritropoietin 30% (p = 0,925). TKK hitung mengalami penurunan pasta siklus 112,65% (p = 0,052) dan Il 0,4% (p = 0,157). Pasca 2 siklus TKK hitung turun sebesar 13% (p = 0,052). Terdapat korelasi lemah antara eritropoietin dan jumlah eritrosit pasca siklus H. Tidak didapatkan korelasi antara eritropoietin dengan Hb, indeks retikulosit dan TKK hitung.Kesimpulan: Pemberian cisplatin dosis tinggi (70-100 mg/m2) menyebabkan penurunan eritropoiesis, TKK hitung. Penurunan kadar eritrbpoietin tidak berkorelasi gagal ginjal akut Penurunan jumlah eritrosit disebabkan pula oleh rendahnya nilai eritropoeitin.

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Background: Cisplatin (Cis diaminodichloro Platinum II) is known as an effective broad spectrum anti tumor. Even though, the nephrotoxicity is one of serious side effects. The accumulation of toxic effects against to tubules area, where erythropoietin is produced, causes acute renal failure and anemia.Purpose: To study the effect of 2 cycles cisplatin against erythropoiesis, erythropoietin level and creatinine clearance at patients with solid tumor cancer.Methods: Pre and post study was done to 14 solid tumor cancer patients that receive high dose cisplatin regiment (70-100 mglm2). Hb, Ht, erythrocyte count, erythropoietin level and calculated creatinin clearance test were determined before each cycle. Age, sex, tumor type, clinical stages were evaluated Statistical analysis was done with student T and Wilcoxon Rank and Pearson correlation.Results: Tumors were NPC 88.24%, Adeno Ca 5.88% and Osteosarcoma 5.88%. Clinical stage Ili 70.6% and IV 29.4%. There were decline level among groups after 1" cycle in Hb (10.74%, p=O.029), Ht (7.6%, p=0.03), erythrocyte count (13%, p=0.OO), erythropoietin level (12.7%, p=4.73) and creatinin clearance (12.65%, p4'.1052). After 2°d cycle, there were decline in Hb (1%, pl.37), Ht (1.46%, p 4l.59), erythrocyte count (8.7%, p=0.00), erythropoietin level (20%, p.03) and creatinin clearance (0.4%, p 0.15).Reticulocyte index was not reduce after 1" and 2"d cycle. After 2 cycles assessment, there were decline level in Hb (7.7%, p=0.035), Ht (48.7%, p=0.008), erythrocyte count (20.8%, p=0.00), erythropoietin level (30%, p4.).92) and creatinin clearance (13%, p=0.022).There is a low correlation between erythropoietin level and erythrocyte count after 1 s` (r-0,397, p=0,159) and 2nd cycle (r x.46, p l.09). Variable's correlation between erythropoietin level and Hb, reticulocyte index, erythrocyte count did not reach statistical significance.Conclusion: High dose cisplatin (70-100 mglm2) cause decrease in eritropoiesis process and creatinin clearance. Decreasing erythropoietin level is not affected by acute renal failure. Low erythrocyte count is also caused by low level of erythropoietin."

"Latar Belakang. Status fungsional merupakan komponen esensial pengkajian paripuma pasien geriatri. Sesungguhnya pada usia lanjut bukan hanya usia harapan hidup yang penting, tetapi bagaimana usia lanjut dapat menjalani sisa kehidupannya dengan baik dan optimal. Untuk itu usia lanjut harus bisa melakukan ADL secara mandiri. Untuk menilai ADL dasar diperlukan alat ukur yang andal, sahih dan Iuas dipakai. Indeks ADL Barthel merupakan alat ukur yang banyak dipakai. Suatu alat ukur yang baik untuk dapat dipalcai luas hares melalui uji keandalan dan kesahihan. Di Indonesia Indeks ADL Barthel belum pernah diuji keandalan dan kesahihannya.Tujuan. Membuktikan bahwa kuesioner Indeks ADL Barthel merupakan intrumen ukur yang andal dan sahih untuk menilai status fungsional dasar usia lanjut Indonesia.Metodologi. Dirancang suatu studi validasi. Prosedur yang dilakukan adalah pada hari pertama kunjungan semua pasien dilakukan anamnesis, pemeriksaan fisik, pengisian formulir kuesioner indeks ADL Barthel dan indeks ADL Katz serta pada hari 7 --14 kunjungan dilakukan pengisian ulangan formulir kuesioner ADL Barthel.Hasil. Telah dilakukan pengambilan data dari 100 responden, nilai ICC ADL Barthel tiap-tiap butir, dan nilai total ADL Barthel didapatkan sangat baik (> 0,75), kecuali untuk butir mengendalikan rangsang buang air besar dengan ICC 0,645 hasilnya baik (0,4 -- 0,75). Keandalan internal consistency penelitian ini diperoleh nilai Cronbach a 0,938. Uji kesahihan eksternal ADL Barthel dibandingkan ADL Katz dianalisis dengan uji Spearman correlation coefficient menunjukkan hubungan bermakna (pc0,01), yaitu antara butir dan nilai total ADL Barthel dengan butir dan nilai total ADL Katz. Hanya hubungan butir mengendalikan rangsang buang air km-II ADL Barthel dengan butir makan ADL Katz yang bermalma dengan (p<0,05). Kesahihan konstruksi ADL Barthel diuji dengan Spearman correlation coefficient dan melihat nilai rho (r) masing masing butir. Hasil yang didapatkan semua butir berhubungan bermakna dengan nilai total (p<0,001). Semua butir mempunyai nilai r > 0,3.Simpulan. Kuesioner ADL Barthel merupakan instrumen ukur yang andal dan sahih serta dapat digunakan untuk mengukur status fungsional dasar usia lanjut Indonesia.

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Background. Status functional is essential component of comprehensive geriatric assessment. Actually in addition to longevity, the important thing for elderly is to live the rest of their life as good and as optimal as possible. To live their life as good and as optimal as possible, the elderly should do the basic ADL independently. To measure basic ADL performance of elderly, measurement tool which is valid, reliable and commonly used is needed. Barthel index is the measurement tool which commonly used. For a good instrument to become commonly used, it should be tested for reliability and validity. In Indonesia Barthel index hasn't been tested for reliability and validity.Objectives. To verify that Barthel index form is an accurate tool to measure basic functional status in elderly population Indonesia.Methods. A validation study was arranged. On the first day of visit, all patients were subjected to anamnesis and physical examination. Barthel index form and Katz index form were filled on the first visit, which were repeated on day 7 through day 14 of visits.Results. There were 100 respondents in this study. Intra class correlation coefficient (ICC) Barthel index for each dimension, total score Barthel index were found to be excellent (>0.75) with the exception of controlling bowels with ICC 0.645 (good). The internal consistency was found to have Cronbach a 0.938. Compared to Katz index, the external validity of Barthel index was found to be significant (p<0.01) using Spearman correlation coefficient. The construct validity was found to be significant (p<0.001)Conclusion. Barthel index form is an reliable and valid tool which is recommended to measure basic functional status in elderly population Indonesia."

"ABSTRAKLatar belakang. Pada penderita thalassemia yang telah lama mendapat transfusi, nilai hemoglobin pasca transfusi tidak bertahan sesuai dengan yang diharapkan. Telah dilaporkan mengenai terbentuknya aloantibodi dan autoantibodi pada penderita thalassemia, yang kemungkinan menyebabkan hemoglobin tidak bertahan pasca transfusi.Tujuan. Penelitian ini bertujuan untuk mencari faktor-faktor yang berhubungan dengan kegagalan mempertahankan hemoglobin pasca transfusi pada penderita thalassemia, terkait dengan terbentuknya aloantibodi dan autoantibodi terhadap eritrosit.Metodologi. Studi potong lintang di poliklinik Hematologi Onkologi Medik IPD RSCM bulan Juli-September 2012 pada penderita thalassemia dewasa yang tergantung transfusi, tanpa penyakit autoimun lain. Dilakukan pemeriksaan sampel darah dengan teknik column gel aglutination untuk melihat adanya aloantibodi dan autoantibodi. Sebelas sel panel reagen digunakan untuk mendeteksi dan mengidentifikasi aloantibodi. Aloantibodi dan autoantibodi positif didefinisikan sebagai pemeriksaan IAT dan DAT yang positif. Dilakukan analisis bivariat antara aloantibodi dan autoantibodi dengan jenis kelamin, jenis rhesus, kadar feritin, jenis kelasi besi, dan aloantibodi.Hasil. Dari 88 subjek, didapatkan 37,5% subjek nilai hemoglobin pasca transfusi tidak bertahan seperti yang diharapkan. Dari 33 subjek tersebut didapatkan aloantibodi dan autoantibodi positif masing-masing 78,6% dan 72,7%. Dari 24 pasien dengan autoantibodi didapatkan 25% dengan derajat hemolitik yang secara klinis bermakna. Aloantibodi positif berhubungan dengan terbentuknya autoantibodi (p < 0,000). Aloantibodi positif [odss ratio (OR) = 26,32; p < 0,000), autoantibodi positif (OR = 11,99; p < 0,000), dan feritin > 3000 ng/ml (OR = 6,36; p < 0,042) berhubungan dengan kegagalan mempertahankan hemoglobin pasca transfusi.Simpulan. Proporsi hemoglobin pasca transfusi tidak bertahan sesuai dengan yang diharapkan pada penderita thalassemia dewasa sebesar 37,5%. Proporsi terbentuknya aloantibodi dan autoantibodi pada kelompok tersebut sebesar 78,6% dan 72,7%. Faktor yang berhubungan dengan kegagalan mempertahankan hemoglobin pasca transfusi adalah aloantibodi positif, autoantibodi positif, dan feritin > 3000 ng/ml. Aloantibodi positif berhubungan dengan terbentuknya autoantibodi.

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ABSTRACTBackground. In transfusion dependent thalassemia patients who has got repeated transfusion for a period of time, the haemoglobin level after transfusion could not be maintained appropriately to be expected. The production of erythroyte alloantibody and autoantibody in transfusion dependent thalassemia patients has been reported before. These antibodies were probable related to the failure on maintaning haemoglobin level after transfusion.Objective. To find related factors of failure on maitaining haemoglobin level after transfusion in adult transfusion dependent thalassemia patients related to erythroyte alloantibody and autoantibody production.Material and Methods. Cross sectional study of adult transfusion dependent thalassemia patient without others autoimune disease at Haematology and Medical Oncology outpatient clinic in Cipto Mangunkusumo hospital from July to September 2012 was done. The specimen was subjected to erythroyte alloantibody and autoantibody evaluation by column gel agglutination technique. Eleven cell reagent panel were used in screening and identification of alloantibody and autoantibody respectively. Positive alloantibody is defined as positivity of indirect antiglobulin test and positive autoantibody is defined as positivity of direct antiglobulin test. Statistic analysis between erythrocyte alloantibody and autoantibody positivity and sex, type of rhesus, feritin level, type of iron chelation, and alloantibody were done.Results. From 88 subjects, there were 37,5% thalassemia patients that did not maintain haemoglobin level after transfusion. From 33 of those subjects, there were 78,6% subjects with alloantibody and 72,7% subjects with autoantibody. From 24 patients with autoantibody, there were 25% subjects with severe hemolytic anemia that clinically significant. Positif alloantibodi related to autoantibody production (p < 0,000). Positive alloantibody [odds ratio (OR) = 26,32; p < 0,000], positive autoantibody (OR = 11,99; p < 0,011), and feritin level > 3000 ng/ml (OR = 6,36; p < 0,042) related to failure on maintaining haemoglobin level.Conclusion. The proportion of failure on maintaining haemoglobin level in adult thalassemia patients were 37,5%. The proportion alloantibody and autoantibody production in adult thalassemia patients that failure on maintaining haemoglobin level were 78,6% and 72,7% respectively. Related factors of those were positive alloantibody and autoantibody, and feritin level > 3000 ng/ml. Positive alloantibody related to autoantibody production."

"ABSTRAKk Latar Belakang: Proses destruksi trombosit pada pasien trombositopenia imun primer diduga terutama terjadi melalui perantaraan antibodi terhadap glikoprotein permukaan trombosit. Antibodi anti-GPIIb/IIIa dan anti-GPIb/IX merupakan antibodi yang spesifik terhadap trombosit dan megakariosit. Beragamnya karakteristik klinis serta respon terapi pada pasien trombositopenia imun dipikirkan dipengaruhi oleh heterogenitas kompleks glikoprotein spesifik. Belum ada data tentang profil antibodi antiglikoprotein permukaan trombosit pada pasien trombositopenia imun primer dewasa.Tujuan: Mengetahui profil antibodi antiglikoprotein permukaan trombosit pada pasien trombositopenia imun primer dewasa.Metode: Penelitian ini merupakan studi potong lintang dengan subjek pasien trombositopenia imun primer dewasa di RSUPN Cipto Mangunkusumo pada bulan Maret-Oktober 2013. Variabel yang diteliti adalah antibodi anti-GPIIb/IIIa dan anti-GPIb/IX dengan teknik MAIPA direk.Hasil: Didapatkan 40 subjek selama penelitian. Sebanyak 10 subjek dengan diagnosis trombositopenia imun primer newly diagnosed yang belum mendapatkan terapi dan 30 subjek trombositopenia imun primer persisten/kronik yang sudah atau pernah mendapatkan terapi di Poliklinik Hematologi Onkologi Medik Departemen Ilmu Penyakit Dalam RSUPNCM selama penelitian. Median usia seluruh subjek adalah 24,5 tahun (rentang 17-55) dengan 82,5% subjek berjenis kelamin perempuan. Tujuh puluh persen subjek memiliki skor ITP Bleeding Score (IBLS) 2. Persentase respon komplit, respon, dan tidak respon terhadap terapi kortikosteroid adalah 42,5%, 45%, dan 12,5%. Pada kelompok trombositopenia imun kronik/persisten proporsi antibodi anti-GPIIb/IIIa adalah 20/30 dengan median optical density (OD) 0,461(rentang 0,093-2,116) dan proporsi antibodi anti-GPIb/IX adalah 25/30 dengan median OD 0,507(rentang 0,190-1,924). Pada kelompok trombositopenia imun newly diagnosed proporsi antibodi anti-GPIIb/IIIa adalah 7/10 dengan rerata OD 0,802±0,71 dan proporsi antibodi anti-GPIb/IX adalah 8/10 dengan rerata OD 0,82±0,57.Simpulan: Sebesar 85% pasien trombositopenia imun primer memiliki antibodi anti-GPIIb/IIIa dan anti-GPIb/IX. Terdapat proporsi respon terhadap terapi yang hampir sama antara subjek yang memiliki maupun tidak memiliki antibodi anti-GPIIb/IIIa dan anti-GPIb/IX.

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ABSTRAKBackground: Platelet destructions in immune thrombocytopenia was mediated by autoantibodies against platelet antigen. Antibody anti-GPIIb/IIIa and anti-GPIb/IX were two major antibodies spesific for platelet and megakaryocytes. The diversity of clinical characteristics and therapeutic responses was thought to be influenced by heterogeneity of spesific glycoprotein complexes. There were no data about antiplatelet antibody profile in adult primary immune thrombocytopenia (ITP).Objectives: To find out antiplatelet glycoprotein antibody profile in adult primary immune thrombocytopenia.Methods: This is a cross sectional study of adult primary immune thrombocytopenia patients who attend Hematology Medical Oncology Polyclinic Internal Medicine Department Cipto Mangunkusumo Hospital in March to October 2013. Antibodies against the platelet GPIIb/IIIa and GPIb/IX were performed by direct MAIPA technique.Results: A total of 40 patients who had been diagnosed with primary immune thrombocytopenia attended to Polyclinic Hematology Medical Oncology Internal Medicine Department Cipto Mangunkusumo Hospital during the study. The subjects divided in two groups, 10 subjects with newly diagnosed ITP, and 30 subjects with persistent or chronic ITP. Median age for this study is 24,5 (17-55) years, with 82,5% were female. Seventy subjects have ITP Bleeding Score (IBLS) 2. Response to corticosteroid therapy in all subjects were complete response 42,5%, response 45%, and no response 12,5%. In persistent/chronic ITP group proportion of anti-GPIIb/IIIa is 20/30 with median optical density (OD) 0,461(0,093-2,116) and proportion of anti-GPIb/IX is 25/30 with median OD 0,507(0,190-1,924). In newly diagnosed ITP group proportion of anti-GPIIb/IIIa is 7/10 with mean OD 0,802±0,71 and proportion of anti-GPIb/IX is 8/10 with mean OD 0,82±0,57.Conclusion: Eighty five percent of primary immune thrombocytopenia have antibody anti GPIIb/IIIa and anti GPIb/IX. In response to therapy, there were similary response between subjects that with and without antibody anti-GPIIb/IIIa and anti-GPIb/IX."