DAFTAR ISI

DAFTAR ISI............................................................................................... ii
DAFTAR TABEL...................................................................................... iv
DAFTAR GAMBAR.................................................................................. v
DAFTAR SINGKATAN............................................................................ vi
BAB I PENDAHULUAN............................................................................ 1
BAB II SINDROM LELAH KRONIK..................................................... 4
2.1. Definisi................................................................................................ 4
2.2. Epidemiologi........................................................................................ 4
2.3. Etiologi................................................................................................ 5
2.3.1. Teori Genetik....................................................................................... 5
2.3.2. Teori Infeksi..................................................................................... 5
2.3.3. Disfungsi Sistem Imun...................................................................... 7
2.3.4. Disfungsi Sistem Endokrin Metabolik.............................................. 7
2.3.5. Gangguan Neuro Psikiatri.................................................................. 7
2.3.6. Teori Biopsikososial Model................................................................. 8
2.4. Patofisiologi.............................................................................................. 9
2.4.1. Immuno-Inflamatory Pathways............................................................... 9
2.4.2. Oxidative & Nitrosative (O&NS) Pathways...................................... 11
BAB III DIAGNOSIS DAN TATALAKSANA SINDROM LELAH
KRONIK.................................................................................................... 13
3.1. Diagnosis............................................................................................. 13
3.1.1. Kriteria Holmes................................................................................. 13
3.1.2. Kriteria Oxford................................................................................. 14
3.1.3. Kriteria Fukuda................................................................................. 15
3.1.4. Kriteria Kanada................................................................................ 19
3.1.5. Kriteria Instite of Medicine (IOM)......................................................... 20
3.2. Tatalaksana.......................................................................................... 21
3.2.1. Tatalaksana Non Farmakologi................................................................ 22
3.2.1.1. Cognitive Behavior Therapy (CBT)................................................... 22
3.2.1.2. Grade Exercise Therapy (GET)..................................................... 23

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3.2.1. Tatalaksana Farmakologi................................................................... 24
BAB IV PENUTUP......................................................................................... 26
4.1. Kesimpulan................................................................................................ 26
4.2. Saran.......................................................................................................... 26
DAFTAR PUSTAKA

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 DAFTAR TABEL

Tabel 3.1 Kriteria Holmes.................................................................................. 14

Tabel 3.2 Kriteria Oxford ................................................................................. 15

Tabel 3.3 Kriteria Fukuda.................................................................................. 16

Tabel 3.4 Kriteria Eksklusi CFS berdasarkan Kriteria Fukuda............ ........ 17

Tabel 3.5 Kriteria Kanada..................................................................... ................ 20

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 DAFTAR GAMBAR

Gambar 2.1. Hubungan antara Infeksi, Sistem Imun, dan Psikososial yang
Menyebabkan Lelah Kronik.........................................................6

Gambar 2.2. Biopsikososial Model pada Sindrom Lelah Kronik..................... 9

Gambar 2.3. Efek Patogen pada Sistem Imun yang Mengaktifkan Kaskade
Immuno-Inflamatory................................................................... 10

Gambar 2.4. Immuno-Inflamatory Pathways yang Menyebabkan Gejala

Sindrom Lelah Kronik................................................................. 12

Gambar 3.1. Alur Diagnosis Sindrom Lelah Kronik......................................... 18

Gambar 3.2. Alur Diagnosis ME/CFS Menurut IOM........................................ 21

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 DAFTAR SINGKATAN

ATP : Adenosin Triphosphat

BMI : Body Mass Index
CBT : Cognitive Behavior Therapy
CDC : Disease Control and Prevention
CFS : Chronic Fatique Syndrome
CMV : CytomegaloVirus
EBV : Epstein-Barr Virus
FDA :Food and Drug Admistration
GET : Graded Exercise Therapy
HLA : Human leucosite Antigen
HPA : Hipotalamus Hipofisis Adrenal
IOM : Institute of Medicine
ICD : International Classification of Disease
IBS : Irritable Bowel Syndrome
ME :Myalgic Encepphalomyelitis
OSA : Obstruktif Sleep Apnea
O&NS : Oxydative and Nitrosative Pathway
PIFS : Post-Infectius Fatigue Syndrom
PICs : Pro Inflamatory Cytokines
ROS : Reactive Oxngen Spesies
RNS : Reactive Nitrogen Spesies
SEID : Systemic Exertion Intolerance Disease
SNP : Single-Nucleotide Polimorphism
TGF : Tumor Growh Factor
TNF : Tumor Necrosis Factor
VAS : Visual Analog Scale
XMRV: Xenotropic Murine Leukemia Virus-Related Virus

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