Acta medica Indonesiana最新文献_第8页

Conn Syndrome with Hyperthyroidism and Refractory Hypokalemia: A Case Report. 康氏综合征合并甲亢和难治性低钾血症1例报告。

IF 0.6

Acta medica Indonesiana Pub Date : 2025-10-01

Tamara Audrey Kadarusman, Satria Agung Maulana Fahmi, Rusdiyana Ekawati

{"title":"Conn Syndrome with Hyperthyroidism and Refractory Hypokalemia: A Case Report.","authors":"Tamara Audrey Kadarusman, Satria Agung Maulana Fahmi, Rusdiyana Ekawati","doi":"","DOIUrl":"","url":null,"abstract":"Conn syndrome is an adrenal gland adenoma that causes primary hyperaldosteronism, with a prevalence of <1% in the world population. Therefore, this case report presents a patient with Conn syndrome co-existing with hyperthyroidism. A 26-year-old female was admitted with muscle spasms in the left arm and muscle weakness in both legs for a day, palpitations, excessive sweating, nocturia, polyuria, and polydipsia. The patient had a history of hyperthyroidism for 10 years and routinely took anti-hypertension (Nifedipine), anti-thyroid, and potassium supplements. Physical examination showed the presence of hypertension. In addition, laboratory examinations revealed hypokalemia, slightly elevated FT4. The patient showed a high level of ARR (Aldosterone-Renin ratio; >30 ng/dL), consistent with primary hyperaldosteronism. Since abdominal USG revealed no abnormality, abdominal MRI with contrast was performed and showed an adenoma in the left adrenal gland. During admission, the patient had refractory hypokalemia despite various efforts to correct the defect. An anti-hypertension drug was then administered, particularly a mineralocorticoid antagonist receptor (Spironolactone). After the treatment, the patient had manageable hypertension and a normal potassium serum level, with no symptoms. Subsequently, discharge was then granted after 9 days of treatment, with a surgery schedule. Conn syndrome with hyperthyroidism can cause refractory hypokalemia, which transforms into a challenge in patient management. With early detection and management, the outcome of this case is manageable.","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"57 4","pages":"525-530"},"PeriodicalIF":0.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Typhoid Fever in Indonesia: Pitfalls in the Diagnosis of Typhoid Fever. 印度尼西亚的伤寒：伤寒诊断中的陷阱。

IF 0.5

Acta medica Indonesiana Pub Date : 2025-10-01

Eric Ricardo Yonatan, Adeline Pasaribu, Leonard Nainggolan, Khie Chen Lie

{"title":"Typhoid Fever in Indonesia: Pitfalls in the Diagnosis of Typhoid Fever.","authors":"Eric Ricardo Yonatan, Adeline Pasaribu, Leonard Nainggolan, Khie Chen Lie","doi":"","DOIUrl":"","url":null,"abstract":"Typhoid fever remains a major public health issue in Indonesia, with its true burden likely underreported due to diagnostic challenges. The clinical manifestations of typhoid fever are often nonspecific and overlap with other endemic febrile illnesses such as dengue, leptospirosis, and rickettsial infections, leading to frequent misdiagnosis. Although blood culture and PCR are the gold standards, their limited accessibility in Indonesia has resulted in reliance on suboptimal diagnostic tools such as the Widal test and TUBEX TF. Recent advances, including the Nelwan Score and CRP-based differentiation, have shown promise in improving early clinical screening. Furthermore, antibody-based proteomic diagnostics offer enhanced accuracy but remain largely confined to research settings. A combined approach utilizing validated clinical scores, affordable biomarkers, and selective use of serological tests is essential to improve diagnostic accuracy and patient care. Misdiagnosis not only endangers patient outcomes but also contributes to inappropriate antibiotic use, accelerating the emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) Salmonella Typhi. Resistance to first-line antibiotics and fluoroquinolones has been increasingly reported in Indonesia, although some regions still demonstrate preserved susceptibility. Cautious and evidence-based antibiotic prescribing is therefore critical to mitigating resistance. This article underscores the urgent need to strengthen diagnostic strategies and antimicrobial stewardship to address the persistent challenge of typhoid fever in Indonesia.","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"57 4","pages":"559-569"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Complicated Thoracic Empyema of Serotype 23F Streptococcus pneumoniae in an Adult Patient. 成人血清23F型肺炎链球菌并发胸脓肿1例。

IF 0.6

Acta medica Indonesiana Pub Date : 2025-10-01

Indra Yovi, Dodi Safari, Nur Afrainin Syah, Dewi Anggraini, Rosantia Sarassari, Yustinus Maladan, Ayummi Azzahrah, Nicholas Gilbert Pelawi, Aisyah Elliyanti

{"title":"Complicated Thoracic Empyema of Serotype 23F Streptococcus pneumoniae in an Adult Patient.","authors":"Indra Yovi, Dodi Safari, Nur Afrainin Syah, Dewi Anggraini, Rosantia Sarassari, Yustinus Maladan, Ayummi Azzahrah, Nicholas Gilbert Pelawi, Aisyah Elliyanti","doi":"","DOIUrl":"","url":null,"abstract":"We report a case of thoracic empyema in a 61-year-old male patient, a heavy smoker with malignancy undergoing chemotherapy. The patient's clinical symptoms included shortness of breath, productive cough, fever, and chest pain. This patient had never received antibiotics before. Streptococcus pneumoniae was isolated from a bedside culture of empyema fluid collected through thoracentesis. The empyema fluid was cultured on chocolate agar plates and in aerobic and anaerobic culture bottles. The isolate was identified as serotype 23F, a vaccine strain with sequence type 17532. The isolate was resistant to chloramphenicol, tetracycline, and cotrimoxazole. The patient clinically improved with the administration of combined intravenous ceftriaxone and levofloxacin antibiotics, along with chest tube drainage via thoracostomy. This is the first report of thoracic empyema caused by S. pneumoniae in an adult in Indonesia. Serotype 23F is multi-resistant with low invasiveness, typically causing infections in patients with underlying health conditions. The pneumococcal conjugate vaccine covers it; thus, it usually occurs in areas with low vaccine coverage. Our findings support the importance of improving adult pneumococcal vaccination coverage in Indonesia.","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"57 4","pages":"503-507"},"PeriodicalIF":0.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictors of Technical and Clinical Success of ERCP in Patients with Biliary Obstruction: A Study from a Tertiary Referral Center in Indonesia. ERCP在胆道梗阻患者技术和临床成功的预测因素：来自印度尼西亚三级转诊中心的研究。

IF 0.6

Acta medica Indonesiana Pub Date : 2025-10-01

Tony Darmadi, Achmad Fauzi, Dadang Makmun, Hamzah Shatri, Djoa Theadora Rebecca Santoso

{"title":"Predictors of Technical and Clinical Success of ERCP in Patients with Biliary Obstruction: A Study from a Tertiary Referral Center in Indonesia.","authors":"Tony Darmadi, Achmad Fauzi, Dadang Makmun, Hamzah Shatri, Djoa Theadora Rebecca Santoso","doi":"","DOIUrl":"","url":null,"abstract":"Background: Endoscopic retrograde cholangiopancreatography (ERCP) is a primary therapeutic modality for managing malignant and benign biliary obstruction. Technical success (TS) and clinical success (CS) of modality are essential indicators of procedural efficacy, which is influenced by various patient- and procedure-related factors. Therefore, this study aims to evaluate the TS and CS rates of ERCP and identify their predictors in patients with biliary obstruction at a tertiary referral center in Indonesia.Methods: A retrospective analysis was conducted on patients with biliary obstruction who underwent therapeutic ERCP at Cipto Mangunkusumo Hospital between January 2022 and December 2024. Patients with diagnostic ERCP or prehepatic/parenchymal jaundice were excluded.Results: A total of 259 patients were included (49.4% female, mean age 50.6 years) in this study. The results show that the TS rate is 96.5%, with multivariate analysis identifying ulcerative fragile papillary mass (AOR 0.075; P=0.001) as an independent negative predictor. Meanwhile, the CS rate is 88%, with pre-ERCP bilirubin >3 mg/dL (AOR 8.545; P<0.001) and previous ERCP stenting/pre-cutting (AOR 0.330; P=0.037) being independent predictors. Distal malignant obstruction causes a higher pre-ERCP bilirubin level (P=0.025) of >3 mg/dL (OR 6.116; P=0.011).Conclusion: ERCP showed high technical and clinical success rates in managing biliary obstructions. TS was negatively predicted by ulcerative fragile papillary mass. CS was positively predicted by pre-ERCP bilirubin >3 mg/dL and negatively by prior stenting or pre-cutting. These findings should be taken into consideration when planning and delivering ERCP to achieve better outcomes.","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"57 4","pages":"474-484"},"PeriodicalIF":0.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patients with Systemic Lupus Erythematosus with Anxiety or Depression: Clinical Characteristics, Food Intake, and Gut Microbiota Profile. 焦虑或抑郁的系统性红斑狼疮患者：临床特征、食物摄入和肠道菌群特征

IF 0.5

Acta medica Indonesiana Pub Date : 2025-07-01

Meutia Gebrina, Alvina Widhani, Rudi Putranto, Murdani Abdullah, Ikhwan Rinaldi, Samsuridjal Djauzi, Franciscus Dhyanagiri Suyatna, Beti Ernawati Dewi, Andi Yasmon, Susan Rahayu, Amalia Shabrina

{"title":"Patients with Systemic Lupus Erythematosus with Anxiety or Depression: Clinical Characteristics, Food Intake, and Gut Microbiota Profile.","authors":"Meutia Gebrina, Alvina Widhani, Rudi Putranto, Murdani Abdullah, Ikhwan Rinaldi, Samsuridjal Djauzi, Franciscus Dhyanagiri Suyatna, Beti Ernawati Dewi, Andi Yasmon, Susan Rahayu, Amalia Shabrina","doi":"","DOIUrl":"","url":null,"abstract":"Background: Depression and anxiety are prevalent among patients with systemic lupus erythematosus (SLE), and gut microbiota may be a contributing factor. This study aimed to investigate the clinical characteristics, food intake, and gut microbiota profiles of SLE patients with anxiety or depression.Methods: An analysis of secondary data was conducted. The primary study was conducted at Cipto Mangunkusumo Hospital, Jakarta, Indonesia, in 2017-2018. The inclusion criteria were: a diagnosis of SLE, age 18‒60 years, and gastrointestinal symptoms. The data collected included clinical data, food intake, anxiety and depression scores, SLE disease activity, and stool samples. Sequencing of the 16S rRNA gene was performed to profile the gut microbiota using DNA was extracted from the stool samples.Results: After excluding those with incomplete data, 41 patients were analyzed. Among the subjects, 53.66% and 14.63% had anxiety and depression, respectively. SLE patients with anxiety were significantly more likely to harbor Bacteroides compared to those without anxiety (33.45% vs. 9.78%; p=0.02) and had lower levels of complement C3 (78.72 vs. 100.85 mg/dL; p=0.03). SLE patients with anxiety or depression had significantly lower fat intake compared to those without these conditions (38.78 vs. 48.43 g/day; p=0.04, and 31.48 vs. 45.27 g/day; p=0.04). A significant correlation was observed between the proportion of Bacteroides and SLE disease activity (p=0.02).Conclusion: SLE patients with anxiety showed a significantly higher proportion of Bacteroides and a lower C3 level compared to those without anxiety. Fat intake was significantly lower among SLE patients with anxiety or depression compared to those without either condition.","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"57 3","pages":"295-305"},"PeriodicalIF":0.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Performance of Red Cell Distribution Width-to-Platelet Ratio as a Screening Tool of Liver Fibrosis Based on Transient Elastography in Chronic Hepatitis B Infection. 基于瞬时弹性成像的慢性乙型肝炎感染中红细胞分布宽度与血小板比作为肝纤维化筛查工具的性能

IF 0.5

Acta medica Indonesiana Pub Date : 2025-07-01

Muhammad Begawan Bestari, Nareswara Anugrah Widi Marbun, Nenny Agustanti

{"title":"Performance of Red Cell Distribution Width-to-Platelet Ratio as a Screening Tool of Liver Fibrosis Based on Transient Elastography in Chronic Hepatitis B Infection.","authors":"Muhammad Begawan Bestari, Nareswara Anugrah Widi Marbun, Nenny Agustanti","doi":"","DOIUrl":"","url":null,"abstract":"Background: Identifying liver fibrosis is crucial for initiating antiviral therapy for hepatitis B infection. Liver biopsy is the gold standard for assessing the degree of fibrosis. However, a liver biopsy is an invasive procedure that carries some risks. This study aimed to evaluate the diagnostic capabilities of the red cell distribution width-to-platelet ratio (RPR) and compare its efficacy for determining the degree of fibrosis in patients with chronic hepatitis B infection with that of the aspartate aminotransferase-to-platelet ratio index (APRI) and the Fibrosis-4 index (FIB-4).Methods: This was a retrospective study conducted on patients with chronic hepatitis B infection who had transient elastography results at the Gastroenterology Hepatology Clinic, Dr. Hasan Sadikin General Hospital, Bandung, between January and December 2024. Statistical analysis was performed using receiver operating characteristic curves to determine the diagnostic values and cutoff points of the RPR, APRI, and FIB-4 to detect liver fibrosis based on Transient Elastography in patients with Chronic Hepatitis B infection.Results: A total of 114 patients with chronic hepatitis B infection were included in this study (42 with significant fibrosis and 72 with nonsignificant fibrosis). The area under the curve (AUC) of the RPR was 0.873 (p < 0.001) with a cutoff point of >0.0538, whereas the AUCs of the APRI and FIB-4 were 0.833 (p < 0.001) and 0.746 (p < 0.001), respectively.Conclusion: The RPR has a higher diagnostic performance than the APRI and is superior to the FIB-4 in assessing the degree of fibrosis in patients with chronic hepatitis B infection. The RPR is a simple and cost-effective test and has the potential to be a screening tool for patients with hepatitis B infection.","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"57 3","pages":"341-345"},"PeriodicalIF":0.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Factors Associated with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) Related Mortality at Dr. Sardjito Hospital in Indonesia. 印度尼西亚Sardjito医生医院与人类免疫缺陷病毒/获得性免疫缺陷综合症（艾滋病毒/艾滋病）相关死亡率的相关因素。

IF 0.5

Acta medica Indonesiana Pub Date : 2025-07-01

Yanri Wijayanti Subronto, Doni Priambodo Wijisaksono, Hamid Helmi

{"title":"Factors Associated with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) Related Mortality at Dr. Sardjito Hospital in Indonesia.","authors":"Yanri Wijayanti Subronto, Doni Priambodo Wijisaksono, Hamid Helmi","doi":"","DOIUrl":"","url":null,"abstract":"Background: By 2019, the human immunodeficiency virus (HIV) had infected approximately 3.8 million people in Southeast Asia and caused 120,000 deaths. In Indonesia, despite periodic fluctuations, the incidence of HIV/AIDS continues to rise annually. Although antiretroviral therapy (ART) has substantially extended the lives of people living with HIV/AIDS (PLWHA), various risk factors continue to influence treatment outcomes. This study aimed to identify the risk factors significantly associated with mortality among PLWHA undergoing ART therapy at RSUP Dr. Sardjito Hospital, Yogyakarta, Indonesia.Methods: In a retrospective cohort design, we reviewed sociodemographic and clinical data of all adult PLWHA (aged ≥18 years) who initiated ARV therapy at RSUP Dr. Sardjito Hospital between January 2008 and December 2021. Patients with incomplete baseline data or those referred from other facilities were excluded. The final cohort was categorized into surviving and deceased groups. Univariate and multivariate logistic regression analyses were conducted to determine the factors linked to mortality, and survival probabilities were estimated using Kaplan-Meier curves.Results: Out of 1,591 patients included in the study, 199 died during the follow-up period. Univariate analysis revealed that age over 45 years, tuberculosis status, low CD4+ count, occupation, and advanced clinical stage of HIV/AIDS were significantly associated with mortality. Multivariate analysis further demonstrated that low CD4+ count, employment status, and, most notably, advanced clinical stage (stages 3 and 4) were independent predictors of death. The survival probabilities at 1 and 5 years were 89% and 87%, respectively.Conclusion: Occupation, CD4+ count, and clinical stage critically influence mortality in PLWHA on ART therapy, with advanced clinical stage being the most significant. Early diagnosis and prompt ART initiation are essential to enhance survival.","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"57 3","pages":"306-313"},"PeriodicalIF":0.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Complete Atrioventricular (AV) Block as a Cardiac Complication of Rheumatoid Arthritis: A Rare Case Report. 完全房室传导阻滞作为类风湿关节炎的心脏并发症：一个罕见的病例报告。

IF 0.5

Acta medica Indonesiana Pub Date : 2025-07-01

Christian Johan, Fatih Anfasa, Adityo Susilo, Johanda Damanik, Rudy Hidayat, Sumariyono Sumariyono, Rm Suryo Anggoro Kusumo Wibowo, Anna Ariane, Faisal Parlindungan, Abirianty Priandani Araminta

{"title":"Complete Atrioventricular (AV) Block as a Cardiac Complication of Rheumatoid Arthritis: A Rare Case Report.","authors":"Christian Johan, Fatih Anfasa, Adityo Susilo, Johanda Damanik, Rudy Hidayat, Sumariyono Sumariyono, Rm Suryo Anggoro Kusumo Wibowo, Anna Ariane, Faisal Parlindungan, Abirianty Priandani Araminta","doi":"","DOIUrl":"","url":null,"abstract":"Atrioventricular block (AVB) is a rare complication of rheumatoid arthritis (RA). Complete AVB in people with RA significantly increases cardiovascular morbidity and doubles the mortality risk. We report on a 48-year-old woman presenting with dyspnea and peripheral edema, with symptoms of polyarthritis for 3 years. Physical findings included bradycardia, bilateral rales, and finger deformities consistent with RA. Electrocardiography featured complete AVB, and a thoracic computed tomography scan showed a mosaic appearance with fibrosis, bronchiectasis, and partial atelectasis of the lungs. Further tests showed elevated levels of C-reactive protein, rheumatoid factor, and several inflammatory cytokines. Transient followed by permanent pacemaker placement was performed along with pharmacological treatments, including intravenous (IV) methylprednisolone pulse therapy and IV tocilizumab. Cardiac involvement in RA usually takes the form of pericardial effusion, heart failure, myocarditis, and coronary artery disease. Complete AVB is a rare but important extra-articular involvement in RA that warrants early recognition and treatment with a pacemaker, anti-inflammatory drugs, and disease-modifying antirheumatic drugs.","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"57 3","pages":"368-373"},"PeriodicalIF":0.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Atherogenic Dyslipidaemia in Diabetes: Burden and Challenges. 糖尿病的动脉粥样硬化性血脂异常：负担和挑战。

IF 0.5

Acta medica Indonesiana Pub Date : 2025-07-01

Ketut Suastika

引用次数: 0

Hyperbilirubinemia with Unusual Dermatologic Signs: A Diagnostic Puzzle. 高胆红素血症与不寻常的皮肤症状：一个诊断难题。

IF 0.5

Acta medica Indonesiana Pub Date : 2025-07-01

Supriono Supriono, Zahra Safira, Andika Agus Budiarto, Mochamad Fachrureza, Syifa Mustika, Bogi Pratomo Wibowo

{"title":"Hyperbilirubinemia with Unusual Dermatologic Signs: A Diagnostic Puzzle.","authors":"Supriono Supriono, Zahra Safira, Andika Agus Budiarto, Mochamad Fachrureza, Syifa Mustika, Bogi Pratomo Wibowo","doi":"","DOIUrl":"","url":null,"abstract":"Jaundice, characterized by yellow discoloration of the skin, mucous membranes, and sclera, results from hyperbilirubinemia and is uncommon in adults. Its occurrence often signals serious underlying conditions. Hyperbilirubinemia may also present with cutaneous manifestations, including xerosis, hyperpigmented plaques, and erythematous rashes. A 47-year-old woman presented with hyperbilirubinemia, transaminitis, and cutaneous manifestations, including hyperpigmented plaques on the face, erythematous rashes on the hands and feet, and yellowish discoloration of the skin. Despite extensive evaluation, including viral hepatitis screening, autoimmune markers, and imaging, a definitive diagnosis remained elusive. The clinical features and laboratory findings suggested Primary Biliary Cholangitis (PBC) as the most likely diagnosis, although further confirmation through advanced serological testing and liver biopsy was needed. Treatment with ursodeoxycholic acid (UDCA) and high-dose oral methylprednisolone showed clinical improvement but persisted in transaminitis with a normal ultrasonographic appearance. This case emphasizes the importance of recognizing cutaneous signs in systemic diseases and the need for a comprehensive diagnostic approach in resource-limited settings.","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"57 3","pages":"380-386"},"PeriodicalIF":0.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0