Page 114 - Abstract Book KONIKA 18

Allergy Immunology

P-AI-023
A Case of Systemic Lupus Eritematosus Related on Hepatitis A and
Secondary Amenorrhea in A 15-year-5-month-old Girl

Rosalia Sri Wahyuni N, Bahrul Fikri
Department of Child Health, Faculty of Medicine, Universitas Hasanuddin, Dr. Wahidin Sudirohusodo Hospital,
Makassar,South h Sulawesi, Indonesia

Abstract
Background Systemic lupus erythematosus (SLE) is an autoimmune rheumatic disease characterized by
widespread inflammation, which affects every organ or system in the body. Clinical manifestations of SLE
was depend on the organ involved, which can involve many organs in the human body with a complex clinical
course and variety. In some studies, disease activity in SLE patients deemed to affect the health status of
the SLE that will affect the prognosis of each SLE patients. Objective To report a-15 year 5 month old-girl
suffered from systemic lupus eritematosus with hepatitis A and secondary amenorrhea. Case A-15 year 5
months old-girl was admitted to the hospital because of fever and joint pain in the last 3 months, Reddish to
black rash on her hair and hair loss , also nail damage since 2 months ago. There was history no menstruation
since 3 months ago, history treated to psychiatry because of speech disorder in the last 2 months. She looked
pale in this week without spontaneous bleeding. Body temperature 36,50C, body weigh 41 kg. She looked
anemic. No cyanotic, icteric,swelling, or dyspnea. Malar rash not found. Purpura on her hair, alopecia. She
had paronikia. Hemoglobim level 7,8 g/dl, haematocrit 26,4 %, leukocyte 2700/mm3, platelets 288.000/
mm3 .Albumin 3,3 g/dl, ureum 12 mg.dl, creatinin 0,38 mg/dl. SGOT 46 U/L, SGPT 131 U/L. Coombs tes
was negative. Antinuclear antibody (ANA) profile +++, anti double stranded DNA (ds-DNA) 360,3 IU/ml.
MSCT Thoraks was normal.She was treated by using lupus protocol from allergy immunology working
group and got improvement. Conclusion As lesson learned, SLE is a multisystem autoimmune disease that
attacks almost all organs and tissues including the liver and reproductive organs, so early detection and
regular treatment are determinants of the prognosis of SLE.
Keywords: SLE; hepatitis A; Amenorrhea sekunder; case report

P-AI-024
Coronavirus Disease 2019 in Children with Primary Immunodeficiency:
A Case Series

Dara Ninggar Santoso, Dina Muktiarti, Rizqi Amalia, Nia Kurniati, Nastiti Kaswandani
Department of Child Health, Faculty of Medicine Universitas Indonesia,/Dr. Cipto Mangunkusumo General Hospital,
Jakarta, Indonesia

Abstract
Background Primary immunodeficiency (PID) has been linked as a potential predisposition to COVID-19
due to its major defect in at least one component of humoral or cellular immunity. However, the number
of reported COVID-19 cases with underlying PID is scarce. Objective To report two confirmed cases of
COVID-19 in children with underlying PID from our center.Cases Patient 1, a 4-year-old boy with x-linked
severe combined immunodeficiency (SCID). He was diagnosed at the age of 4-months-old and had undergone
bone marrow transplantation surgery two months later. He was confirmed COVID-19, presenting with fever
and mild cough. He was well nourished and fully alert, with vital signs were within normal range and no
signs of respiratory distress. He tested positive with Ct value of 32.66. He showed complete recovery and
tested negative after 5 days of treatment. Patient 2, a 13-year-old boy with Wiskott-Aldrich syndrome and on
low dose oral steroid and irregular intravenous immunoglobulin therapy. He had fever and tested positive for
COVID-19, with Ct value of 29.6. He was obese, with normal vital signs and no signs of respiratory distress.
He was tested negative approximately two weeks after the initial test. Both patients were hospitalized and
part of family clusters. Both patients were treated with oral favirapir for 5 days, vitamin D, vintamin C and
zinc. Conclusion Patients with PID are at risk of developing COVID-19. The diagnosis of COVID-19 should
be considered in presence of fever and mild signs of respiratory symptoms in this population.
Keywords: COVID-19; primary immunodeficiency; X-linked severe combined immunodeficiency;
Wiskott-Aldrich syndrome
66 KONIKA XVIII Abstract Book