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Background Thalassemia patients are generally immunocompromised, making them susceptible to infection. A study at the Thalassemia Center at Dr. Cipto Mangunkusumo Hospital, Jakarta, showed that all thalassemia patients experienced zinc deficiency. Decreased cellular immune response has been associated with zinc deficiency, and splenectomy exacerbates the risk of infection. Objective To evaluate for improvement of cellular immune response in splenectomized thalassemia major patients after zinc supplementation. Methods This randomized, double-blind, controlled trial was conducted on splenectomized thalassemia major patients over a 12-week period. The inclusion criteria were splenectomized thalassemia major patients aged > 12 to 18 years with negative HIV test results. Patients receiving corticosteroids were excluded. Fifty-six subjects were randomly divided into two groups, the zinc group and the placebo group. Before and after the 12 -week treatment, we evaluated subjects' serum zinc, T lymphocyte count, CD4+ T lymphocyte count, CD8+ T lymphocyte count, and CD4+/CD8+ ratio and were analyzed with unpaired T-test, Mann Whitney test, and Wilcoxon Signed Rank test. Results After zinc supplementation, serum zinc serum levels in 18/28 subjects in the zinc group became normalized. None of the cellular immune response parameters were significantly different between the two groups after zinc supplementation (P > 0.05). This finding might have been due to the subjects' compliance which was lower in the zinc group (75.82%) than in the placebo group (83.19%). Conclusion Cellular immune response in splenectomized thalassemia major patients is not significantly changed after 12 weeks of zinc supplementation. [ABSTRACT FROM AUTHOR]

NPSLE diagnosis is still challenging because of many SLE-related and non-SLE-related processes that can be presented in patient. The report of NPSLE in Indonesia is still limited. This study aim to describe the clinical features, nutrition status, and laboratory characteristics of Neuropsychiatric Systemic Lupus Erythematosus (NPSLE) and compared to non NPSLE case in Indonesian children. The study is a retrospective cohort study. Data were collected from the complete medical record of Juvenile Systemic lupus Erythematosus (jSLE) patients 2016 - 2020 at the Allergy Immunology Outpatient clinic at Dr. Soetomo General Academic Hospital. We include all patients with ages ranging from age 0-18 years old with a diagnosis of Systemic lupus Erythematosus (SLE). The diagnosis fo SLE based on American College of Rheumatology (ACR) criteria 1997 and Neuropsychiatric (NP) manifestations were classified using the standardized nomenclature and case definitions for the 19 NP manifestations linked to SLE developed in 1999 by the ACR ad hoc Committee. Disease activity SLE was defined according to the American Mexican-Systemic Lupus Erythematosus Disease Activity Index (Mex-SLEDAI) criteria. Statistical analysis conducted in this study was descriptive analysis, paired T-test (NPSLE vs. non-NPSLE as the dependent variable), Fischer exact test, and Pearson Chi-square test using SPSS ver. 21. A total of 90 patients with juvenile SLE were enrolled, but only 71 patients were eligible as participants with complete medical records obtained. Mex-SLEDAI score was significantly higher on NPSLE compared to non-NPSLE (p=0.001). There are no significant differences of body height, body weight, and body mass index between each group (p>0.05). The incidence of NPSLE was 29.57%, with clinical main symptoms were delirium (33.33%), seizures (33.33%), and psychosis (14.29%). 33.33% MRI/CT-scan findings noted brain abnormalities with the most prevalent were ischemic (14.29%), hypodense lesion, brain atrophy, multiple lymphadenopathy, and transverse myelitis (4.76%). The higher disease activity in NP SLE indicates the needs to close observation, the higher patient adherence to medication, and more comprehensive management to achieve therapeutic success. [ABSTRACT FROM AUTHOR]