ANTIBODI ANTI DS-DNA SEBAGAI FAKTOR PROGNOSIS MORTALITAS PADA LUPUS ERITEMATOSUS SISTEMIK

dr. Muslikhah Yuni Farkhati, dr. Sunartini Hapsara , Ph.D, Sp AK

2012 | Tesis | S2 Ked.Klinik/MS-PPDS

Latar belakang : Angka kejadian SLE di RSUP Dr Sardjito meningkat dengan mortalitas tinggi. Antibodi anti double stranded-DNA (ds- DNA ) merupakan antibodi patognomonik pada SLE. Tujuan : Mengetahui hubungan antara antibodi anti ds-DNA dengan mortalitas pasien SLE R Metode : Data mengenai usia , jenis kelamin, gambaran klinis saat terdiagnosis dan mortalitas diambil secara retrospektif melalui rekam medis pasien SLE yang berumur kurang dari 18 tahun. Survival dihitung menggunakan metode Kaplan Meier . Analisis log rank dan regresi Cox digunakan untuk mengidentifikasi faktor yang berhubungan dengan mortalitas erata waktu follow up pasien Hasil : Sebanyak 46 pasien diikutkan dalam penelitian, delapan (17,4%) lakilaki dan 38 ( 82,6 %) perempuan dengan rerata usia terdiagnosis adalah 11,9 tahun. Sebanyak 21 subyek ( 45,7 %) meninggal . Survival pada tahun pertama , ke-tiga dan ke-lima sebesar 85%, 60% dan 30 %. dengan antibodi anti ds-DNA sebesar 885,5 hari ( IK 95% 631,9 – 1139,1 ) tampak lebih pendek secara bermakna dibanding pasien dengan antibodi anti ds DNA negatif sebesar 4807,5 ( IK 95% 4025,4 – 5389,0 ) Analisis multivariat menunjukkan antibodi anti ds-DNA merupakan satu – satunya faktor prognostik terhadap mortalitas pasien SLE ( Hazard Ratio 6,7; IK 95% 1,38 – 12,40 ). Antibodi anti ds Simpulan : -DNA merupakan faktor prognosis terhadap mortalitas pasien SLE

Background: The incidence of SLE in Dr Sardjito General Hospital increased with high mortality. Anti double stranded (ds-DNA) antibody is a pathognomonic antibodies in SLE. Objective: To evaluate relationship between anti ds-DNA antibodies and mortalities in SLE patients Methods: The chart of all children under 18 years old with SLE were retrospectively reviewed for the age at diagnosis, sex, clinical features at presentation and mortality . Overall survival rate was calculated using Kaplan Meier’s method. Univariate log rank analysis and multivariate Cox regression analysis were used to identify variables associated with mortality Results: A total of 46 patients were included in the study, eight ( 17,4%) males and 38 ( 82,6 %) females . A mean age of diagnosis was 11,9 years. A total of 21 subjects ( 45,7%) died. Survival in the first, third and fifth year is 85%, 60% and 30% respectively. The mean time of follow-up of anti ds-DNA antibodies patients of 885,5 days ( 95% CI 631,9-1139,1) appears significantly shorter than patients with anti ds-DNA antibodies negative for 4807,5 ( 95% CI 4025,4-5389,0). Multivariate analysis showed anti ds-DNA antibodies is the only prognostic factor for mortality of SLE patients ( Hazard ratio 6,7;95%CI 1,38-12,4 ) Conclusion: Anti ds-DNA antibodies is a significant prognostic factor for mortality of SLE patients

Kata Kunci : antibodi anti ds-DNA, mortalitas, faktor prognosis, systemic lupus erythematosus