Why does acknowledging rheumatic diseases is important? Rheumatic diseases have been reported not only lowering the patient’s life quality, but also increasing the mortality and morbidity rates. In this edition, we provided articles about the rare rheumatic diseases, such as systemic sclerosis and osteomalacia induced renal tubular acidosis (RTA) type 1. Besides there were some articles about the appearances and pregnancy prognosis in patients with Systemic Lupus Erythematosus (SLE) and an article covered joint involvement pattern in rheumatoid arthritis patients in Bandung, West Java, Indonesia.
Scleroderma also known as Systemic Sclerosis (SSc) is chronic autoimmune disease involving connective tissue. It is caused by the excessive collagen deposition in skin and internal organs. However, it is reported as the third most common disease found Hasan Sadikin Hospital Rheumatology Clinic, and also in the fourth most common diseases in Cipto Mangunkusumo National General Hospital. The evaluation of this disease was conducted using Modified Rodnan Skin Score (MRSS) which is well correlated with the gold standard assessment, skin biopsy. Unfortunately, MRSS examination should be performed by the trained physicians who have high skill and experiences. Research done by Vincent, et al, entitled “Correlation between serum procollagen type 1 N-terminal level with modified rodnan skin score in systemic sclerosis patients”. They revealed that serum procollagen type 1 N-terminal Propeptide (P1NP) may be as a potential biomarker and also be an alternative examination of MRSS examination in evaluation skin fibrosis in SSc patients.1 Whether it can be applied to wider clinical settings, a larger study about it is still need to be performed.
The deeper study about Systemic Lupus Erythematosus (SLE) had been done in Hasan Sadikin Hospital, Bandung, West Java. After the studies about mucocutaneus manifestation, organ system involvements, and memory performance in SLE patients which have been published in the last edition of Indonesian Journal of Rheumatology, Hasan Sadikin Hospital submitted study about musculosceletal manifestations,2 neuropsychiatric manifestations,3 anemia,4 prognosis of pregnancies in SLE patients.5 With higher understanding, physicians may have higher proficiency in managing SLE patients. Whether patients have musculosceletal complains due to higher disease activity of SLE or due to other causes2; whether neuro or psychiatic manifestation related to SLE or the change of environment3; whether the anemia due to chronic SLE disease, iron deficiency, or autoimmune hemolytic anemia due to high SLE disease activity.4 Prognosis of pregnancy may be vary among SLE patients. Although most babies (64.2%) could be delivered normally; spontaneous abortion,intrauterine growth retardation, intrauterine fetal death, premature deliveries, and other obstetric complication still higher among SLE patients rather than non-SLE population.5 Secondary prevention such as prepare the mothers before their pregnancy, include controlling disease activity and detecting any risk factors, might result in lower morbidity and mortality.Moreover, we also had an article about the pattern of joint involvement in patients with rheumatoid arthritis, which had written by Pratama MK, et al.6 The last, there was a case report article about osteomalacia in RTA patients reported by Sihombing SS, et al. RTA is a risk factor for osteomalacia, especially proximal RTA or RTA type 2 which is known have association with Fanconi syndrome and bone involvement. In this edition, Sihombing SS, et al, reported Osteomalacia was induced by distal RTA or RTA type 1 in 22-years-old asian woman. This patient suffered prolonged hypokalemia for 4 years before diagnosed as RTA and 5 years after the first onset, patient developed osteomalacia. Learning this case, physicians might have the higher vigilance in making diagnosis of prolonged hypokalemia patients, so that osteomalacia can be prevented.We never get bored to invite all readers to contribute as the author in our Indonesian Journal of Rheumatology. The next edition will be more special, because we have been registered our journal for the accreditation. Every article will get a cum value. So, do not hesitate to collect your manuscript to our editorial office via email: pb.reumato@gmail.com. We accept all type of manuscripts, include original article, case-report, evidence based case report, review article, meta-analysis, etc.1. Vincent, Dewi S, Wachjudi RG. Correlation Between Serum Procollagen Type 1 N-Terminal Propeptide Level With Modified Rodnan Skin Score In Systemic Sclerosis Patients.2. Sutrisno RN, Rahmadi AR, Novita N, Hamijoyo L. Most Frequent Musculoskeletal Manifestation of Systemic Lupus Erythematosus Patients in Dr. Hasan Sadikin General Hospital Bandung3. Putra SD, Ardisasmita MN, Hamijoyo L. Neuropsychiatric Manifestation Screening among Systemic Lupus Erythematosus Patients in Hasan Sadikin General Hospital Bandung4. Modjaningrat IF, Oehadian A, Ghozali M, Hamijoyo L. Overview of Anemia among Systemic Lupus Erythematosus Patients in Reproductive Age based on Reticulocyte Hemoglobin Equivalent (RET-He) Level and Reticulocyte Count5. Yue EK, Rita C, Hamijoyo L. Outcome of Pregnancy in Patients with Systemic Lupus Erythematosus6. Pratama MK, Atik N, Hamijoyo L. The Pattern of Joints Involvement in Patients with Rheumatoid Arthritis in Rheumatology Clinic Dr. Hasan Sadikin General Hospital Bandung7. Sihombing SS, Ariane A, Wibowo RMSAK, Setyohadi B. Case Report : Osteomalacia Induced by Renal Tubular Acidosis Type 1