Page 109 - Abstract Book KONIKA 18

Allergy Immunology

P-AI-013
Clinical Manifestation in Pediatrics with Systemic Lupus Eritematous (SLE) at
RSUP. Dr. M Djamil Padang

Mutiara Annisa Amadea, Rusdi, Riri Dwipinta Sari, Tiara Ella Sari
Department of Child Health, Faculty of Medicine Universitas Andalas/Dr. M. Djamil Hospital,
Padang, West Sumatera, Indonesia

Abstract
Background Systemic Lupus Erythematosus (SLE) is chronic autoimmune disease with various etiology and
clinical manifestations, as well as its complications and clinical outcomes. The presenting manifestations
of this disease are diverse and affecting many organs. Based on The American College of Rheumatology
(ACR) and its modification, a patient is classified as having SLE if four or more of the criteria are present.
Patient may have arthritis(60-88%) which commonly happen before diagnosed established. It may followed
by other organ failure, mostly renal involvement and continue to multiple organ involvement. Objective
To describe the variability of manifestations of SLE in Dr. M. Djamil Padang at the time of diagnosis.
Methods This retrospective study has conducted based on medical record. There are 27 samples diagnosed
with SLE who fulfilled ACR criteria at Dr. M. Djamil Hospital, Padang since January 2017 until December
2019. Results Twenty seven samples were included which 70,3% were females. Mean age at diagnosis is
13.33±2.59 years, with a mean duration of disease is 3.74±4 months. The most common symptom was Renal
abnormality (40,7%) and neuropsychiatric abnormality (25,9%) and initial manifestations prior the diagnose
was arthritis (70,3%). Conclusion SLE is rare but the most common autoimmune disease. It most common
affecting children aged 11 to 15 years old. The most common encountered clinical manifestations which come
to hospital was Renal abnormality and neuropsychiatric abnormality but the initial symptom is different.
Keywords: systemic lupus erythematosus; clinical manifestation; American College of Rheumatology

P-AI-014
Salmonella Osteomyelitis in A Patient with Systemic Lupus Erythematosus:
A Rare Case Report
Edy Novery, Rizqi Amalia, Dina Muktiarti, Nia Kurniati
Department of Child Health, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital,
Jakarta, Indonesia
Abstract
Background Salmonella osteomyelitis is an uncommon pathological condition. It counts for 0.8% of
Salmonella infection and only 0.45% of all types of osteomyelitis. It usually occur in immunodeficiency
condition, such as patients on immunosuppression drugs, HIV infection, and autoimmune diseases. Objective
To report the first case of Salmonella osteomyelitis in a patient with SLE in Cipto Mangunkusumo Hospital.
Case A girl, 13 years old, who has been diagnosed with lupus for one year, complained about pain in the
left limb, swelling, inability to move and walk properly for 1 month. There was no trauma according to the
patient and parents. Clinical examination revealed swelling of the left limb, stiffness, pain, and restriction
of passive movement. There was no outlet of discharge. Radiographs revealed lytic lesions in diaphysis
distal left femur and diaphysis proximal left tibia. Initial diagnosis was abscess. Surgery for curettage
and debridement was performed. A culture later showed Salmonella infection. The final diagnosis was
Salmonella osteomyelitis. She was treated to a 6-week intravenous antibiotic (ampicillin sulbactam for 1
week, cefotaxime sulbactam for 5 weeks). Physiotherapy was started during antibiotic treatment and continue
afterward. Once the symptoms relieved, patient was able to walk properly. Conclusion Osteomyelitis should
be considered in patients with joints and bone pain, especially in immunodeficiency conditions and long-
term immunosuppression treatment. Salmonella infection is a rare caused for osteomyelitis, culture should
be sought in every cases to confirm the diagnosis.
Keywords: osteomyelitis; salmonella; SLE

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