GM. Volumen 131, Suplemento Nº2. Abril 2023






Comisiones Científicas para el bienio 2022-2024



Special Issue: Hot Topics in Internal Medicine

Muhammad Miftahussurur

For the past years, COVID-19 has drawn attention and has become a global burden. It affected almost all countries around the world and has had a catastrophic effect resulting in over 278 million cases and 5.4 million deaths worldwide. Not only does it cause pulmonary complications, but it also affects other organ systems. Within this special issue, a systematic review by Gianto et al. highlighted the need to consider acute kidney injury when managing COVID-19 patients as it contributed and/or correlated with disease severity, prognosis, and mortality. In addition, COVID-19 can also aggravate the severity of concomitant diseases, as presented by Kandinata et al. showing that hypoglycemia in a patient suffering from insulinoma and hydrocephalus was amplified by COVID-19.


Characteristics of Pregnant Women with Thyroid Disorders at Wahidin Sudirohusodo Hospital Makassar

Prema Hapsari Hidayati, Irmayanti, Masita Fujiko, Mochammad Erwin Rachman, Syafira Ananda Marendengi

Backgrounds: At least 2 %-3 % of pregnant women experience thyroid dysfunction, which affects the health of the mother and baby. There is still little research on pregnant women with thyroid disorders. Aim: Investigating the characteristics of pregnant women with thyroid disorders in Dr. Wahidin Sudirohusodo Hospital Makassar.

Ultrasonography Profiles in Patients with Asymptomatic Hyperuricemia

Awalia, Tigor Yeheskiel, Rosy Setiawati, Paulus Rahardjo, Arinditia Triasti Putri

Backgrounds: Asymptomatic hyperuricemia (AHU) patients mostly do not develop gouty arthritis. The best procedure to investigate whether they have MSU deposition has not been established. We report our preliminary study about ultrasonography on AHU patients. Methods: In this cross-sectional study, we enrolled asymptomatic hyperuricemia patients who matched the gout classification criteria of the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) (2015). Six joints were examined per patient by ultrasonography including the first metacarpophalangeal (MCP) joints, first metatarsophalangeal (MTP) joints, and trochlear knees to determine pathological findings which may demonstrate clinically silent urate deposits in asymptomatic hyperuricemia individuals.

Effect of White Rice Substitution with Sorghum Rice on Beta Cell Function and Insulin Resistance in Prediabetes

Teguh Rahardjo, Soebagijo Adi Soelistijo, Sony Wibisono Mudjanarko

Background: Decrease in the function of beta cells and insulin resistance (IR) is found in prediabetes. Sorghum rice is a staple food substitute for white rice which has low GI and GL, high fiber, rich in polyphenols which can improve IR and beta cell function. This study aims to analyze the effect of sorghum rice on beta cell function and IR in prediabetes.

Correlation of Dynamic D-dimer Levels with Mortality in COVID-19 Patients with Type 2 Diabetes Mellitus

Rusdi Zakki Aminy, Sony Wibisono Mudjanarko, Hermina Novida

Background: Hypercoagulation characterized by elevated D-dimer has been reported in COVID-19 patients. This condition is aggravated in Type 2 Diabetes Mellitus (T2DM) patients through various mechanisms. This study aimed to analyze the correlation of dynamic D-dimer levels with mortality in COVID-19 patients with T2DM.

COVID-19 and autoimmune rheumatic diseases

Ayu Arifta Putri, Awalia, Musofa Rusli

Background: Coronavirus disease 2019 (COVID-19) was declared a pandemic since it rapidly spread worldwide. COVID-19 has various manifestations, ranging from asymptomatic to life-threatening conditions. During the pandemic, patients with autoimmune rheumatic diseases (ARD) were included in the population at risk. In addition, the use of immunosuppressants or disease-modifying antirheumatic drugs (DMARDs) was considered to increase the susceptibility to infection. Studies have reported that COVID-19 and ARD have similarities in their clinical findings and immune responses. This study aims to understand the profile of patients with ARD infected with COVID-19 at Dr. Soetomo Hospital in 2020–2022.


Characteristics of COVID-19 Patients who Developed Acute Kidney Injury and Its Association with Mortality: A Systematic Review

Evan Kurniawan Gianto

Introduction: AKI incidence reported in COVID-19 patients is increasing with contradictory study results about AKI development with increased mortality. This study was conducted to assess a possible correlation between risk factors that led to AKI and increased mortality. Methods: A total of eight articles found through an online database published between 2020 and 2021 were used. A total of 9 455 patients with COVID-19 were divided into AKI and non-AKI.

Elevated Systemic Immune – Inflammation Index for Predictor of Ulcerative Colitis: A Systematic Review and Meta-analysis

Noer Halimatus Syakdiyah, Hendy Bhaskara Perdana Putra, Noer Halimatus Sya’baniyah

Introduction: The Systemic Immune-inflammation Index (SII) is a simple, non-invasive, and low-cost parameter that has been studied to predict ulcerative colitis (UC). However, the result remains inconclusive. Therefore, this study aimed to confirm the utilization of SII in UC. Methods: A systematic search was conducted. The inclusion criteria were articles that investigated the relationship between SII and UC and reported a specific cut-off value, specific sensitivity, specificity, and area under the curve (AUC). The odds ratio (OR) and mean difference (MD) using a 95 % confidence interval (CI) were used.


A Rare Case of Insulinoma in a Patient with Hydrocephalus and COVID-19

Stefanus G. Kandinata, Sony W. Mudjanarko

Insulinoma is a rare entity, in which neuroglycopenia symptoms of recurrent hypoglycemia are often confused with the neuropsychiatric disorder, especially in a patient with hydrocephalus. Hypoglycemia leads to a proinflammatory and procoagulant state, which may worsen the COVID-19 prognosis. We report a case of a 25-year-old woman with an initial presentation of seizure. No previous medical history and drugs were recorded. Intravenous dextrose is administered as low blood sugar was evident but no marked improvement in consciousness was observed.

Cardiac Tamponade: A Rare Manifestation of Lung Cancer. A Case Report

Vania Azalia Gunawan, Muhammad Noor Diansyah, Putu Niken Ayu Amrita, Pradana Zaky Romadhon, Siprianus Ugroseno Yudho Bintoro, Ami Ashariati, Merlyna Savitri

Background: Malignancy is the most common cause of non-inflammatory pericardial effusion that is usually neglected. Metastatic involvement of the pericardium is reflecting the advanced stage of the disease and generally associated with poor outcomes.

Rare Manifestation of Acute Blindness in Ocular Toxoplasmosis: A Case Report

Dio Brimantyo, M. Vitanata Arfijanto

Introduction: Toxoplasmosis is one of the most common zoonoses worldwide. Clinical manifestations of ocular toxoplasmosis are highly specific. Atypical manifestations are not uncommon and are not always recognized as specific to ocular toxoplasmosis. Here, we present a rare manifestation of acute blindness in ocular toxoplasmosis in an immunocompetent patient.

Ovarian hyperstimulation syndrome with spontaneous bacterial peritonitis and thrombocytosis: A Case Report

Nurike Setiyari Mudjari, Rusdiyana Ekawati, Arianti, Annisa Zahra Mufida, Budi Widodo, Titong Sugihartono

Introduction: To date, severe Ovarian Hyperstimulation Syndrome (OHSS) that can be associated with mortality only occurred in 0.1 % – 2 % of all OHSS cases. This paper reports one of those rare cases accompanied by spontaneous bacterial peritonitis and thrombocytosis. Case Presentation: A 28-year-old female had OHSS as a complication of in-vitro fertilization. Clinical presentation fever, dyspnea, ascites, thrombocytosis, leukocytosis, and bilateral multiloculated cystic ovaries.

Arterioportal Fistula in Cirrhosis: A Case Report

Zulistian Nurul Hidayati, Budi Widodo

Introduction: Hepatic arterioportal fistula is a rare but treatable condition that may worsen pre-existing portal hypertension in cirrhosis patients. Embolization is the treatment of choice. Case Presentation: A 60-year-old woman with a 6-year history of liver cirrhosis presented with upper gastrointestinal bleeding and an impaired level of consciousness. Endoscopic examination revealed large fundal varices. Computed tomography angiography of the abdomen revealed an incidental arterioportal fistula without prior history of abdominal trauma or liver procedure.

Severe Norwegian Scabies Infection in Psoriatic Arthritis Patient with Naïve Hepatitis B and Sepsis: A Case Report

Dewinta Enggar Pramesthi, Lita Diah Rahmawati

Introduction: Norwegian scabies is an acute form of severe scabies infection seen in immunocompromised patients. Psoriasis arthritis (PsA) is a systemic autoimmune disease involving the synovial tissue and skin. Norwegian scabies with its complication that occurs in PsA patients can be difficult to diagnose and cause mortality if untreated. Case presentation: A 39-year-old woman came to Dr. Soetomo’s hospital with complaints of body aches, peeled white scales all over her body, and immobilization for months. Multiple macular erythemas that were covered by thick scales with indistinct borders and multiple ulcers with slough were found.

Liver Cirrhosis Patient with Complications of Hepatic Hydrothorax. Case Report

Amie Vidyani, Titong Sugihartono, Budi Widodo, Herry Purbayu, Ummi Maimunah, Ulfa kholili, Husin Thamrin, Muhammad Miftahussurur, Iswan Abbas Nussi, Poernomo Boedi Setiawan

Introduction: Hepatic hydrothorax is that occurs in individuals with decompensated cirrhosis of the liver. Approximately 5 % of cases of pleural effusion occur in patients with cirrhosis and ascites. Although quite rare, it is associated with higher morbidity and lower survival rates. The mechanism is not fully understood, but the most widely accepted pathogenesis involves the presence of portal hypertension, diaphragmatic defects, and negative intrathoracic pressure. In this case, the pleural effusion occurs because of the direct displacement of peritoneal fluid through the small openings in the diaphragm into the pleural space. We aimed to study its clinical features and natural history.

Small Vessel Vasculitis, an Uncommon Presentation of Systemic Lupus Erythematosus: A Case Report

Chandra Adi Irawan Primasatya, Awalia Awalia

Introduction: Systemic lupus erythematosus (SLE) has diverse clinical manifestations. Vasculitis is one of the clinical manifestations found in SLE. Vasculitis is present in different clinical forms, with purpura lesions seeming to be uncommon. Case Presentation: We report a case of a 20-year-old male SLE patient who developed purpura on his extremities. Histologically, the lesions were suggestive of leukocytoclastic vasculitis.

Arthritis in Leprosy: A Case Report

Aaron Tumewu, Awalia Awalia

Introduction: Despite the third most common manifestations of leprosy, musculoskeletal manifestations are still underdiagnosed in leprosy patients, causing progressing and disfiguring disabilities. Case Presentation: A 25-year-old woman presented with constant pain in both hands that had been worsening over the past month. She also reported progressive nodules over the face. Radiology revealed deformity of the second digit of her left hand and punch biopsy revealed a type II reaction of lepromatous leprosy. She later started treatment with oral steroids and a multibacillary leprosy regimen.

A Classic Dermatomyositis: A Case Report of Rare Idiopathic Inflammatory Myopathy

Satyawardhana, Awalia

Background: Dermatomyositis (DM) is a rare autoimmune disease and is one of the idiopathic inflammatory myopathies which predominately affects the skin and muscles. Its estimated incidence is less than 10 cases per million population with an overall female/male ratio is approximately 2:1. This case report presents a classic case of dermatomyositis in a male in Indonesia.

Immune Thrombocytopenic Purpura Secondary to Peritoneal Tuberculosis Patient with Anti-Tuberculosis Drug-Induced Liver Injury. A Case Report

Fitria Yulistiawati, Muhammad Vitanata Arfijanto

Introduction: Various haematological abnormalities commonly occur in active tuberculosis (TB) but immune thrombocytopenic purpura (ITP) secondary to extrapulmonary TB is exceedingly rare. Case presentation: We reported an 18-year-old male patient who presented with fever, abdominal pain, and thrombocytopenia. From the physical examination, there was found slight abdominal distention and diffuse tenderness. Peripheral blood smear and Immature Platelet Fraction (IPF) investigations were suggestive of ITP.

Autoimmune Hemolytic Anemia, Amoebic Dysentery, And Intracranial Hemorrhage as Rare Manifestations of Smoldering Multiple Myeloma: A Case Report

Dananti Kusumawindani, Merlyna Savitri, Muhammad Noor Diansyah, Putu Niken Amrita, Pradana Zaky Romadhon, Siprianus Ugroseno Yudho Bintoro, Ami Ashariati

Background: Smoldering multiple myeloma (SMM) is in asymptomatic stages before overt multiple myeloma (MM) but it also has an increased risk of thrombosis, infection, autoimmune, and hemorrhage. SMM is usually recognized coincidentally during the workup of a variety of symptoms.

Diagnostic Problem of Facial Malignancy in The Elderly: A rare case

Dita Taurini, Ami Ashariati, S. Ugroseno Yudho Bintoro, M. Noor Diansyah, Putu Niken Ayu Amrita, Merlyna Savitri, Pradana Zaky Romadhon

Introduction: Lymphoma can occur in adults and the elderly, this will affect the condition of both diagnosis and therapy. Plasmablastic lymphoma (PBL) is a subtype of diffuse large B-cell lymphoma (DLBCL), the case is rarely found and often overlaps the anatomical pathology picture similar to plasmacytoma. It is aggressive and often relapses.

The first case reported in Southeast Asia of Huge Frantz’s Tumor

Arianti, Nurike Setiyari Mudjari, Budi Widodo, Titong Sugihartono

Introduction: Solid pseudopapillary pancreatic tumor (Frantz’s Tumor) is a low-grade malignancy, that lacks clinical symptomatology. It was treatable with a favorable prognosis. Case presentation: A young female patient presented with increasing abdominal pain three years ago. Abdominal examination revealed a lump palpable. Contrast-enhanced Computed Tomography abdomen reported a solid mass measuring 13.9 cm x 13.2 cm x 8.9 cm from the pancreas with an enhancing cystic component. Fine-needle aspiration biopsy yielded a cellular sample comprising pseudopapillary neoplasm of the pancreas. A distal pancreatectomy was performed; she was discharged in satisfactory condition.

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