Rheumatic autoimmne disease for laymen
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A comprehensive talk about rheumatic autoimmune diseases for patients and family or people interested in understanding SLE, Systremic sclerosis, dermatomyositis, rheumatoid arthritis. Some slides in Bahasa Indonesia.
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Rheumatic autoimmne disease for laymen
- 2. Mengenal Reumatik AUTOIMUN RACHMAT GUNADI WAHJUDI DIVISI REUMATOLOGI ILMU PENYAKIT DALAM RSHS/ FK UNPAD
- 3. Rachmat Gunadi Wachjudi Lahir di Garut, 16-1-1955 Pendidikan : SD-SMA : Garut Dokter umum: FK UNSRI Palembang Internist: FK UNPAD / RSHS Bandung Fellowship : Royal Perth & Sir Charles Gairdner Hospital Subspesialis Reumatologi : FK UI / RSCM Jakarta Pekerjaan Kepala Departemen / SMF Ilmu Penyakit Dalam FK UNPAD/ RS Dr Hasan Sadikin Organisasi IDI, PAPDI, IRA, PEROSI, PERALMUNI, PESLI, APLAR
- 7. Rheumatic ailments 1% 1% 6% 4% 4% 69% 3%2% 10% Osteoartritis Lupus Eritematosus Sistemik Rheumatoid Artritis Gouty Artritis Spondiloartropati Sistemik Sklerosis Osteoporosis Soft Tissue Rheumatism Lain-lain
- 10. Rahmat Allah swt yang turun melalui Sinar Mata Hari Cholesterol from diet 7 dehydrocholesterol in the skin Sunlight converts 7- dehydrocholestero l to previtamin D3 Cholecalciferol (Previtamin D3) The liver converts previtamin D to 25- hydroxyvitamin D which appears in circulation. 25-hydroxyvitamin D (circulating form) The kidneys and other tissues convert it to an active form of 1,25- dihydroxyvitamin D 1,25-dihydroxyvitamin D (active form)
- 11. Latitude and chronic disease risk Vitamin D deficiency and latitude of 37° or more increased risk for many chronic diseases. Vitamin D synthesis and serum vitamin D levels negatively correlated with latitude positively correlated with sunlight
- 12. Apa ruginya jika kurang Vitamin D? Coronary artery disease Hypertension Diabetes Type I and Type 2 Osteoarthritis Depression Epilepsy Polycystic Ovaries Musculoskeletal Pain Autoimmune Disease Multiple Sclerosis Cancers Falls in the Elderly Pregnancy and Lactation
- 13. Pain Study with 150 pts with persistent, nonspecific musculoskeletal pain at Mayo clinic 93% had Vit D deficiency Plotnikoff, Quigley. Mayo Clin Proc. 2003;78(12):1463. Children w/ limb pain improved in 3 months Low Back Pain 83% of 299 LBP pts had Vit D def 5000-10,000iu/day Decrease in pain medication in nearly 100% after 3 months Al Faraj, Al Mutairi. Spine 2003;28(2):177.
- 14. Vitamin D role in autoimmunity
- 15. Rekomendasi terapi defisiensi/ insufisiensi vitamin D Kadar 25(OH)D serum (ng/mL) Dosis suplemen vitamin D 20-30 1.000-2.000 IU/hari 12-20 2.000 IU/hari <12 (asimtomatik) 4.000-5.000 IU/hari <12 (simtomatik) 30.000 IU/ minggu Dikutip dari : Khan QJ dkk42
- 16. Penyakit autoimun dapat mengenai berbagai organ tubuh Pemphigus Multiple Sclerosis Lupus Rheumatic Fever Autoimmune Hepatitis Ulcerative Colitis Goodpasture’s Syndrome Diabetes Autoimmune Uveitis Autoimmune hemolytic Anemia Addison’s Disease Rheumatoid Arthritis Autoimmune Oophoritis
- 19. Gejala dan Tanda Awal RA Radang Bengkak Kaku Nyeri Hangat Cepat lelah
- 20. Nodules (Arthritis Foundation, 2012; Day et al., 2010; American College of Rheumatology, 2009)
- 21. RA dapat mengenai seluruh sistem RA dapat menyebabkan 1. Synovitis 2. Serositis 3. Nodules 4. Vasculitis 5. Autoantibodies
- 24. Spondyloarthritis Juvenile SpA Reactive arthritis Arthritis associated with IBD PsA (Psoriatic Arthritis) Undifferentiated SpA (uSpA) Ankylosing spondylitis (AS)
- 25. Penyakit Purba Kala Amenhotep II (1439-1413 BC)1 Ramses the Great (1298-1232 BC)1
- 26. Ankylosing Spondylitis “Bamboo Spine” • Radang kronis tulang belakang dan sendi sakroiliak • Tulang belakang menyatu
- 27. Enthesitis Peripheral arthritis Dactylitis Gejala dan Tanda Lain AS 50% pasien AS dengan entesitis 58 % pasien kemungkinan erosi tulang lebih tinggi pada pasien dengan daktilitis
- 28. Gejala dan Tanda Lain AS Gejala awal Ankilosing Spondilitis : • Nafsu makan turun • Lemas • Demam ringan • Penurunan berat badan • Cepat lelah Cepat lelah adalah keluhan AS paling sering
- 29. AS: Extra-articular Manifestations (EAM) EAM Prevalence in AS Patients (%) Anterior uveitis 30-50 IBD 5-10 Subclinical inflammation of the gut 25-49 Cardiac abnormalities Conduction disturbances Aortic insufficiency 1-33 1-10 Psoriasis 10-20 Renal abnormalities 10-35 Lung abnormalities Airways disease Interstitial abnormalities Emphysema 40-88 82 47-65 9-35 Bone abnormalities Osteoporosis Osteopenia 11-18 39-59 Elewaut D & Matucci MC. Rheumatology 2009;48:1029-1035 Terminal ileitis Anterior uveitis Cardiac abnormalities
- 32. Penyakit Sistemik Autoimun Lain Sjogren’s Syndrome
- 33. Mata Kering Keratokonjungtivitis sicca Lidah Kering Pemeriksaan MRI
- 35. Sklerosis Sistemik “ Wajah topeng “ “ Mulut ikan “ Sclerodactyly
- 36. SYSTEMIC SCLEROSIS CREST VARIANT CALCINOSIS RAYNAUD’S ESOPHOGEAL DYSFUNCTION SCLERODACTALY TELANGECTASIA
- 37. Paru tak lentur
- 39. LUPUS Penyakit 1000 wajah Mrs Wolf Kupu-kupu
- 40. Siapa yang mengalami LUPUS
- 41. Faktor pemicu Infeksi Bakteri EBV HZV CMV Noninfeksi Alergen Makanan Logam berat Stres Hormon Ultra violet Vaksinasi Hair Dyes
- 42. Organ yang dikenai ? Sistem otot dan tulang Kulit dan rambut Mata Ginjal Jantung Pembuluh darah Susunan saraf Paru-paru Komponen darah Hati
- 44. Bercak diskoid Kulit & mukosa Vaskulitis Rambut rontok Bercak malar
- 45. Fotosensitif Sariawan berulang Kulit & mukosa
- 48. Pembekuan Darah Pada Sindroma Antifosfolipid
- 49. Sindroma Antifosfolipid (APS) Sumbatan (trombosis) arteri, vena dan kapiler Gangguan kehamilan keguguran berturut-turut ≥3 x kematian janin dalam kandungan ≥1 x lahir prematur preeklamsia gangguan plasenta ≥1x
- 50. Sindroma Antifosfolipid (APS) Manifestasi : Trombosit menurun Anemia hemolitik Livedo reticularis Gangguan otak Penyakit katup jantung Hipertensi Hipertensi pulmonal Ulkus kaki
- 51. Anak Mahal