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.
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
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.
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