refrat GAMBARAN SEVERITAS ASMA PADA

ANAK DENGAN RIWAYAT ATOPI

LAINNYA
Oleh :
Vina Suci Santika S. (1410070100053)
Nadyagustina Zulnesa (1410070100054)
Disci Yelfi Putri (1410070100056)
Jhean Vantika Kenti (1410070100058)
Althof Sona (1410070100144)

Preseptor :
dr. Gustin S, Sp.A (K)

FAKULTAS KEDOKTERAN UNIVERSITAS BAITURRAHMAH

KEPANITERAAN KLINIK SENIOR ILMU KESEHATAN ANAK
RSUD M.NATSIR SOLOK
2019
PENDAHULUAN
PENDAHULUAN
asma dapat muncul karena reaksi terhadap faktor
pencetus yang mengakibatkan penyempitan dan
penyebab yang mengakibatkan inflamasi saluran
pernafasan atau reaksi hipersensitivitas
PENDAHULUAN
Asma didefinisikan sebagai suatu kondisi ketika terjadi
gangguan pada sistem pernapasan yang menyebabkan
penderita mengalami mengi (wheezing).

Batuk
sesak di dada terutama ketika malam hari atau dini hari
 • Infographic Style Pendahuluan

Prevalensi asma pada anak sangat

bervariasi di antara negara-negara di
dunia, berkisar antara 1-18%. Menurut
para ahli, prevalensi asma akan terus
meningkat. Sekitar 100 - 150 juta
penduduk dunia terserang asma
dengan penambahan 180.000 setiap
tahunnya The International Study of Asthma and
berdasarkan Riset Kesehatan Dasar (Riskesdas) tahun
Allergies in Childhood (ISAAC) pernah
2007, prevalensi asma untuk seluruh kelompok usia
melakukan
sebesar 3,5% dengan penelitian mengenai
prevalensi penderitaprevalensi
asma pada
penyakit
anak usia atopi sebesar
1 - 4 tahun di Bandung, di dapatkan
2,4% dan usia 5 - 14bahwa
tahun
penderita
sebesar 2,0%. rinitis alergik 41,5%, dermatitis atopik
7,5%, dan asma 12,4%.
Pendahuluan
ATOPI merupakan suatu kecenderungan
seseorang dan atau keluarga untuk membentuk
immunoglobulin E sebagai respon terhadap
alergen. Manifestasi yang dapat muncul pada
penderita atopi diantaranya asma, dermatitis atopik
atau rinitis alergik.
 Pendahuluan
Biasanya penyakit atopi bermanifestasi awal sebagai dermatitis atopi . Sepertiga dari penderita
dermatitis atopik pada anak-anak akan berkembang menjadi rinitis alergik dan sepertiga lagi
akan berlanjut menjadi asma.

rinitis alergik dermatitis asma

41,5%, atopik 7,5%, 12,4%.

The International Study of Asthma and Allergies in Childhood (ISAAC)

pernah melakukan penelitian mengenai prevalensi penyakit atopi di
Bandung, di dapatkan bahwa penderita rinitis alergik 41,5%, dermatitis
atopik 7,5%, dan asma 12,4%.
risiko penderita asma lebih tinggi pada anak laki-laki dibanding
perempuan.

2 1
 >> >>>

Beberapa penyakit penyerta seperti penyakit atopi lain dapat berkontribusi

memperburuk kontrol asma dan mempersulit manajemen diagnostik dan terapeutik
pasien asma. Sensitisasi alergen atau gejala alergi dapat memprediksi onset dan
tingkat keparahan asma

10% Selain itu, secara luas dijelaskan bahwa risiko pengembangan penyakit pada
pasien dengan dermatitis atopi sangat erat terkait dengan ekspresi klinis sensitisasi
IgE.
20%

Karena
70% rhinitis alergi adalah faktor risiko utama terjadinya hiper-reaktivitas
bronkial dan asma, rhinitis alergi dapat mendahului timbulnya asma dalam perjalan
penyakit atopi.
 Meskipun banyak yang mengatakan sensitisasi atopik adalah suatu
faktor risiko penting terutama untuk penyakit asma pada anak, peran
\alergi atau atopi pada anak-anak yang terkena asma masih dalam
perdebatan. Dan belum pernah dilakukan penelitian mengenai
keparahan asma dengan riwayat atopi lain di RSUD M Natsir Solok.
Maka peneliti tetarik untuk melakukan penelitian mengenai hal ini.
Tujuan dan ManfaatPenulisan
Tujuan
01 • Untuk memenuhi salah satu tugas kepaniteraan klinik
senior pada Departemen Ilmu Kesehatan Anak RSUD
M. Natsir.
• Untuk bahan pengayaan agar lebih memahami materi
Gambaran Severitas Asma pada Anak dengan
Riwayat Atopi Lainnya.

02 Manfaat Penulisan
• Menambah wawasan mengenai Gambaran Severitas Asma
pada Anak dengan Riwayat Gejala Atopi
• Sebagai proses pembelajaran bagi dokter muda yang
menjalankan kepaniteraan klinik senior pada Departemen
Ilmu Kesehatan Anak RSUD M.Natsir Solok
 Epidemiologi

Prevelansi tertinggi yaitu pada pria yaitu pada

95-100%. umur 16-19 tahun

Prevelansi tertinggi yaitu pada wanita umur 14-17 tahun

83-85%
 ETIOLOGI
FAKTOR INTRINSIK FAKTOR EKSTRINSIK

Stress
Genetik Makanan

Suhu/kelembaban/iklim

Kosmetik
Hormonal
Diet

Obat-obatan

Faktor iatrogenik
TINJAUAN PUSTAKA
DEFINISI
Psoriasis adalah suatu penyakit inflamasi
kronis, diperantarai oleh sistem imun, yang
melibatkan terutama kulit dan persendian.
Psoriasis juga didefinisikan sebagai penyakit
peradangan kulit kronik dengan dasar genetik
yang kuat dengan karakteristik perubahan
pertumbuhan dan diferensial sel epidermis
disertai manifestasi vaskuler, juga diduga
adanya pengaruh sistem saraf.
 EPIDEMIOLOGI

Dewasa di Amerika Serikat 0,96% sampai

dengan 8% ditemukan di Norwegia

Psoriasis terus mengalami peningkatan jumlah

kunjungan ke layanan kesehatan di banyak daerah
di Indonesia. Remisi dialami oleh 17-55% kasus,
dengan beragam tenggang waktu.1–3
Di Indonesia pencatatan pernah dilakukan
oleh sepuluh RS besar dengan angka
prevalensi pada tahun 1996, 1997, dan
1998 berturut-turut 0,62%; 0,59%; dan
0,92%.
Etiopatogenesis
 ETIOLOGI

Faktor mekanik intrauteri Defek Plasma Sel Primer

Content Title
Here

Enterovirus (Infeksi
TORCH) Gangguan perkembangan
fetus

Herediter (mutasi gen)

 Perbandingan kejadian CTEV menurut jenis kelamin

2 1
KLASIFIKASI
Soft foot
Dapat disebut juga sebagai postural foot dan
dikoreksi dengan standard casting atau
fisioterapi.

Soft > Stiff foot

Terdapat pada 33% kasus. Biasanya lebih dari 50%
kasus dapat dikoreksi, namun bila lebih dari 7 atau
8 tidak didapatkan koreksi maka tindakan operatif
harus dilakukan.

Stiff > Soft foot

Stiff foot Terdapat pada 61% kasus. Kurang dari 50% kasus
merupakan kategori paling parah, terkoreksi dan setelah casting dan fisioterapi, kategori ini
sering kali bilateral dan memerlukan akan dilakukan tindakan operatif.
tindakan koreksi secara operatif.
 GAMBARAN KLINIS
Ditemukan
kelainan sejak
baru lahir
Kadang terdapat lengkungan
yang besar (Cavus) dan talus
menonjol keluar pada
permukaan dorsolateral kaki.
Tumit biasanya kecil, tinggi
dan terlihat kurus
pergelangan kaki (ankle)
dalam posisi equinus,
telapak kaki inversi dan
forefoot dalam keadaan
adduksi dan supinasi
Kedua kakinya berputar
dan terpelintik ke dalam
sehingga alas kakinya
menghadap ke
posteromedial
 DIAGNOSIS

ANAMNESA

PEMERIKSAAN FISIK

PEMERIKSAAN PENUNJANG
ANAMNESA

Content Here

Content Here
Pemeriksaan Fisik
Pemeriksaan Penunjang
 Gambaran Radiologis

Fleksi plantar anterior kalkaneus sedemikian rupa sehingga sudut antara sumbu panjang
tibia dan sumbu panjang kalkaneus (sudut tibiocalcaneal) lebih dari 90 °
Talus diasumsikan tetap fix terhadap tibia. Kalkaneus dianggap yang
berputar menjadi ke arah garis tengah (varus). Pada tampilan lateral,
sudut antara sumbu panjang sumbu panjang kalkaneus (sudut
talocalcaneal) adalah kurang dari 25°, dan 2 tulang hampir sejajar.
Sudut talocalcaneal kurang dari 15°, dan 2 tulang tampak tumpang tindih lebih dari
biasanya. Selain itu, sumbu longitudinal yang melalui pertengahan talus (midtalar line)
lewat lateral terhadap pangkal metatarsal pertama, karena bagian forefoot terdeviasi ke
medial
Letak varus dan supinasi kaki depan meningkatkan konvergensi pangkal –pangkal
metatarsal, dibandingkan dengan konvergensi pada kaki normal. Pada foto lateral,
tampak gambaran seperti tangga (ladder-like configuration) dari tulang metatarsal.
USG
Diagnosis Banding

Postural clubfoot

Disebabkan oleh posisi fetus dalam uterus. Kaki

dapat dikoreksi secara manual oleh pemeriksa.
Mempunyai respon yang baik dan cepat terhadap
serial casting dan jarang akan kambuh kembali.
 Penatalaksanaan

Tata laksana CTEV EDUKASI

sebaiknya dimulai pada
beberapa hari awal GIPS PEMBEDAHAN
kehidupan sang bayi.
Tujuannya adalah
mendapatkan kaki yang
estetik, fungsional, bebas CAST TAPPING
nyeri dan plantigrade
Metode Ponsetti

Tekhnik Pemasangan Cast

 Metode French

Tekhnik Pemasangan Taping

 Kesimpulan

Clubfoot merupakan deformitas kaki kongenital yang ditandai dengan

equinus kaki belakang dan adduksi kaki tengah dan kaki depan dengan varus
melalui kompleks sendi subtalar. Clubfoot lebih sering menyerang anak laki-
laki dibandingkan anak perempuan. Pemeriksaan penunjang pada clubfoot
seperti USG, X-ray dan CT-Scan. Penatalaksanaan clubfoot berupa
pemasangan Gips, pemasangan Cast, pemasangan Taping, pembedahan dan
edukasi.
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