SPONDILOARTROPATI

SERONEGATIF
Oleh : Ardhicandra Pratama Putra Rantung
Spondiloartropati
Seronegatif
01 Definisi
02 Epidemiologi
03 Etiologi
04 Patofisiologi
05 Manifestasi Klinis
06 Diagnosis
07 Penatalaksanaan
.
DEFINISI

Spondiloartropati seronegatif (SpA) merupakan

kelompok penyakit autoimun yang ditandai dengan
peradangan sendi serta pemeriksaan faktor
rheumatoid negative. Termasuk kedalam
Subkelompok Spondiloartropati adalah

Ankilosa Spondylitis (AS)

Spondiloartropati yang
Artritis Reaktif
Tidak Dikelompokkan

Artritis Psoriatik

Artritis Enteropati
 EPIDEMIOLOGI
Menurut Subkelompok Spondiloartropati

1. Ankilosing Spondilitis : populasi usia > 20 tahun berkisar dari 68 per

100.000 penduduk di Belanda dan 197 per 100.000 penduduk di
Amerika Serikat

2. Artritis reaktif : diperkirakan mempunyai insiden sebesar 10-30 kasus per

100.000 penduduk (seperti hasil suatu studi di Skandinavia)

3. Artritis psoriasis diantara penderita psoriasis diperkirakan antara 7-25%.

dibandingkan dengan populasi umum yang hanya sekitar 2-3%.3

4. Artritis Enteropati di

Sumber : IRA
 Menurut Subkelompok Spondiloartropati
ETIOLOGI
1. Ankylosing spondylitis (AS) merupakan salah satu subkelompok SpA yang
masih belum diketahui penyebabnya. Beberapa studi menyebutkan
bahwa gen HLA-B27 dan lingkungan memberikan pengaruh terhadap
terjadinya AS.
2. Artritis reaktif : ditandai dengan adanya infeksi sebelum muncul gejala
artritis. Infeksi dapat terjadi pada saluran pencernaan, kemih, dan genital
dengan spektrum kuman Chlamydia trachomatis, Yersinia enterocolitica,
Yersinia pseudotuberculosis, Campylobacter jejuni, Shigella flexneri, dan
Salmonella enteric.
3. Artritis psoriasis ditandai dengan inflamasi muskuloskeletal, serta ada
riwayat psoriasis. Artritis psoriatik banyak terjadi pada dewasa usia 40-50
tahun.
4. Artritis enteropati merupakan penyakit subkelompok SpA yang timbul
bersamaan dengan inflammatory bowel disease (IBD).

Sumber : IRA
 IMUNOPATOLOGI
Faktor Genetik. Peran HLA-B27 Peran dari microba Inflamasidanexpre
usus sicytokine

Pembentukan
- Expresi TNF
Tulang Baru Pensinyalan IL-23
Peran HLA-B27 dalam pathogenesis
ankylosing spondylitis Peran dari microba usus
Inflamasi dan expresi cytokine
Expresi TNF
MANIFESTASI KLINIS
Manifestasi klinis utama SpA menurut ASAS 2009 adalah
nyeri pinggang inflamasi >3 bulan, dan/atau predominan
di ekstremitas bawah.

EKSTRA-
SKELETAL
SKELETAL

.
Diagnosis
ANKYLOSING SPONDYLITIS (AS)

ARTRITIS REAKTIF
.

ARTRITIS PSORIATIK

ARTRITIS ENTEROPATI

SPONDILOARTROPATI YANG TIDAK DIKELOMPOKAN

Diagnosis Umum
Spondiloartropati
Kriteria Diagnosis Spondiloartropati ASAS
(Assessment of SpondyloArtritis international society)
2010

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Kriteria Diagnosis Spondiloartropati ASAS
(Assessment of SpondyloArtritis international society)
2010

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 Kriteria

AMOR
Untuk Spondiloartropati
(1990)
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 Kriteria

AMOR
Kriteria ESSG untuk
Spondiloartropati (1991)
Untuk Spondiloartropati
 Kriteria

AMOR
Kriteria nyeri pinggang inflamasi
(inflammatory back pain/IBP)
Untuk Spondiloartropati
Kriteria Diagnosis Spondiloartropati ASAS
(Assessment of SpondyloArtritis international society)
2010

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Diagnosis dan Tata Laksana Ankilosing Spondilitis
(AS)

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Diagnosis dan Tata Laksana Ankilosing Spondilitis
(AS)

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Rekomendasi tatalaksana AS menurut
ASAS/EULAR 2010
Pemeriksaan untuk menilai keterbatasangerak tulang belakang pada
AS (ankilosing Spondilitis)
 Kriteria

AMOR
Kriteria radiologis dan MRI sacroiliitis
pada Ankilosing Spondilitis (AS)
Untuk Spondiloartropati
Diagnosis dan Tata Laksana Artritis Reaktif
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Diagnosis dan Tata Laksana Artritis Reaktif
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Diagnosis dan Tata Laksana Artritis Psoriatik
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Diagnosis dan Tata Laksana Artritis Psoriatik
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Rekomendasi tatalaksana artritis psoriatic dari Group for Research and
Assessment of Psoriatik and Psoriatik Arthritis(GRAPPA) 2009
Diagnosis dan Tata Laksana Artritis Enteropati
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Diagnosis dan Tata Laksana Spondiloartropati yang Tidak
Dikelompokkan

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PERBANDINGAN BEBERAPA
SUBKELPMPOK YANG
TERMASUK
SPONDILOARTROPATI
Jenis dan dosis obat yang digunakan pada terapi Spondiloartropati
TERIMAKASIH