Prof. DR.dr. Ariyanto Harsono SpA(K); DR.dr.

Anang Endaryanto SpA(K)

ALERGI DEBU RUMAH Difinisi Penyakit alergi yang disebabkan paparan dengan debu rumah pada penderita atopi yang sensitif terhadap debu rumah Patofisiologi Alergen dalam debu rumah: serpih kulit manusia, serpih insekta, bulu hewan, sisa makanan, kapuk, tungau:-dermatophagoides pteronyssinus, -dermatophagoides farinei. Alergen berupa:-glikoprotein -BM: 24.000 D -dalam feses tungau Pada pemurnian alergen: gliko-protein dari feses tungau: -Der p1 -Der f1 Diagnosis: 1. Anamnesa: bersin, batuk setelah menyapu, perang bantal, geblok kasur, bongkar buku/pakaian tua 2. Fisik: wheezing, pernafasan cepat, retraksi 3. Gejala alergi yang lain: rinitis alergika, urtikaria, dermatitis atopika 4. Riwayat keluarga atopi 5. Foto dada: hyper aeration 6. Lab: eosinofil pada dahak, Spiral Curshmann, kristal Charcot Leiden, Creola Body, eosinofilia darah tepi, IgE spesifik meningkat. Penatalaksanaan 1. House dust control (Kendali debu rumah), terutama kamar tidur 2. Menurunkan populasi tungau dengan Acarosan 3. Imunoterapi: dengan menyuntikkan ekstrak debu rumah subkutan seminggu sekali 4. mulai dosis kecil sampai dosis rumatan sampai 2-3 tahun 3 minggu sekali (Tabel 1). Tabel 1. Jadwal Imunoterapi Konsentrasi ekstrak Dosis Frekuensi debu rumah 0,1cc; 0,15cc; 0,22cc; 0,32cc; Selang 1 minggu sekali 0,05mg/ml 0,48cc, 0,72cc; 1cc 0,1cc; 0,15cc; 0,22cc; 0,32cc; Selang 1 minggu sekali 0.5mg/ml 0,48cc, 0,72cc; 1cc 0,1cc Selang 3 minggu sekali 5mg/ml slama 2-3 tahun Keberhasilan imunoterapi dapat dilihat dari: 1.Peningkatan blocking antibody (IgG4) 2.Penurunan IgE 3.Penurunan reaksi lambat pada pemeriksaan Bronchial Provocation Test 1

Prof. DR.dr. Ariyanto Harsono SpA(K); DR.dr. Anang Endaryanto SpA(K)

1. . DAFTAR PUSTAKA
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Varney VA, Gaga M, Frew AJ, Aber VR, Kay AB, Durham SR. Usefulness of immunotherapy in patients with severe summer hay fever uncontrolled by anti-allergic drugs. Br Med J 1991; 302:265-9. Durham SR, Walker SM, Varga EM, Jacobson MR, O'Brien F, Nobel W, et al. Long-term clinical efficacy of grass pollen immunotherapy. N Engl J Med 1999; 341:468-75. Varney VA, Edwards J, Tabbah K, Brewster H, Mavroleon G, Frew AJ. Clinical efficacy of specific immunotherapy to cat dander: A double blind placebo controlled trial. Clin Exp Allergy 1997;27:860-7. Bousquet J, Lockey RF, Malling HJ. WHO position paper. Allergen immunotherapy: Therapeutic vaccines for allergic disease. Allergy 1998;53(S44):1-42. Abramson M, Puy R, Weiner J. Immunotherapy in asthma: An updated systematic review. Allergy 1999;54:1022-41. Creticos PS, Reed CE, Norman PS, Khoury J, Adkinson NF, Buncher CR, et al. Ragweed immunotherapy in adult asthma. N Engl J Med 1996;334:501-6. Bousquet L, Demoly P, Michel FB. 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Prof. DR.dr. Ariyanto Harsono SpA(K); DR.dr. Anang Endaryanto SpA(K)

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