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Gambaran Klinis Steven Johnson Syndrome dan Toxic Epidermal Necrolysis pada Pasien Anak Annisa Fitriana; Anang Endaryanto; Afif Nurul Hidayati
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 30 No. 2 (2018): AGUSTUS
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (488.227 KB) | DOI: 10.20473/bikk.V30.2.2018.102-110

Abstract

Latar Belakang: Steven Johnson Syndrome (SJS) dan Toxic Epidermal Necrolysis (TEN) merupakan suatu penyakit yang tergolong langka namun dapat mengancam nyawa. Ketidakjelasan etiologi, serta komplikasi yang mungkin timbul pada pasien anak dapat berdampak buruk terhadap prognosis penyakit. Tujuan: Menjelaskan gambaran klinis SJS, SJS – TEN overlap dan TEN pada pasien usia 0 – 18 tahun. Metode: Penelitian deskriptif retrospektif dengan menggunakan total sampling data rekam medis pasien anak usia 0 – 18 tahun di Instalasi Rawat Inap RSUD Dr. Soetomo Surabaya periode 2013 – 2016. Hasil: Terdapat 19 data rekam medis pasien yang memenuhi kriteria inklusi dengan rincian, 16 pasien dengan SJS, 1 pasien dengan SJS – TEN overlap, dan 2 pasien dengan TEN. Kesimpulan: Dugaan etiologi terbanyak adalah reaksi alergi yang diinduksi oleh obat jenis acetaminophen (24%), manifestasi klinis terbanyak adalah makula (100%), baik eritematosa dan hiperpigmentasi, penyakit penyerta terbanyak adalah malnutrisi (31%) dan konjungtivis (31%), komplikasi terbanyak adalah konjungtivitis (67%). Lama perawatan terbanyak adalah selama 1 hingga 7 hari (53%) dengan rata – rata lama perawatan selama 11,6 hari, konsultasi ke dokter lain terbanyak yaitu ke dokter spesialis mata (80%), dan tatalaksana terapi terbanyak adalah melakukan penghentian obat penginduksi timbulnya penyakit.
Tinjauan Ulang Hipotesis Higiene Anang Endaryanto
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 30 No. 3 (2018): DESEMBER
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (646.148 KB) | DOI: 10.20473/bikk.V30.3.2018.264-274

Abstract

Latar Belakang: Hipotesis higiene mendalilkan bahwa infeksi memberikan perlindungan terhadap alergi. Hubungan terbalik antara infeksi dan alergi belum banyak dikonfirmasi secara langsung oleh studi epidemiologi. Belum ada review yang konsisten tentang hal ini. Tujuan: Tulisan ini memberikan informasi dan analisis mengenai berbagai hasil penelitian yang relevan dalam rangka memberi gambaran tentang peran Hipotesis higiene pada alergi. Telaah Kepustakaan: Ditemukan kesesuaian hipotesis higiene dengan fakta klinis dan epidemiologis masa kini; serta relevansi konsep keseimbangan respons imun Th1/Th2 dalam hubungan antara infeksi dengan penyakit alergi saat ini setelah adanya temuan baru tentang respons imun Treg, Th17, Th9, serta Th22. Simpulan: Hipotesis Higiene menjadi salah satu cara untuk menjelaskan perubahan global terbaru dalam prevalensi alergi, teori mengenai imunopatogenesis lebih lanjut yang konsisten dengan bukti epidemiologi masih diperlukan.
Pengaruh Dermatitis Atopik, Urtikaria dan Gangguan Saluran Cerna sebagai Komorbiditas dalam Perbaikan Klinis dan Kepuasan Orang Tua Pasien pada Anak Alergi dengan Gejala Saluran Nafas Tingkat Moderate-Persistent yang Mendapatkan Imunoterapi Alergen Debu Rumah Anang Endaryanto
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 31 No. 2 (2019): AGUSTUS
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V31.2.2019.112-122

Abstract

Latar Belakang: Rendahnya efektivitas imunoterapi dan kepuasan orang tua perlu dieksplorasi untuk menurunkan angka dropout imunoterapi yang masih tinggi. Tujuan: mengevaluasi pengaruh keberadaan gejala alergi di luar saluran nafas pada efektivitas imunoterapi dalam meredakan gejala alergi dan kepuasan para orang tua. Metode: Penelitian dilaksanakan mulai 1 Januari 2008 sampai 31 Desember 2018 dengan disain kohort retropektif pada anak alergi debu rumah dengan gejala saluran nafas moderate-persistent yang diberikan imunoterapi alergen debu rumah subkutan. Setelah fase rumatan imunoterapi selesai, tingkat gangguan kualitas hidup dan frekuensi gejala, jumlah hari/minggu bebas gejala alergi, dan tingkat kepuasan orang tua dievaluasi dalam 30 hari. Hasil: Sejumlah 100 % dari total subjek penelitian (2,171 pasien) sensitif pada alergen debu rumah dengan gejala saluran nafas. Sebesar 79,7 % pasien membaik menjadi mild-intermittent. Rerata jumlah hari bebas gejala pada 30 hari paska fase rumatan imunoterapi adalah 25,1 + 8,31 hari. Tingkat kepuasan yang tinggi dinyatakan oleh 72,9 % orangtua pasien. Adanya komorbiditas dermatitis atopik, urtikaria, dan gejala alergi saluran cerna tidak berpengaruh terhadap skor perbaikan gejala alergi saluran nafas. Keberadaan dermatitis atopik, urtikaria, dan gangguan saluran cerna berkorelasi dengan penurunan jumlah hari bebas gejala. Simpulan: Keberadaan dermatitis atopik, urtikaria, dan gangguan saluran cerna sebagai komorbiditas tidak menurunkan efektivitas imunoterapi alergen debu rumah dalam meredakan gejala alergi saluran nafas, tetapi menurunkan jumlah hari/minggu bebas dari gejala alergi dan tingkat kepuasan orang tua pasien.
Inverse association between positive tuberculin tests and positive allergy skin tests in children Nur Rochmah; Dyahris Kuntartiwi; Anang Endaryanto; Aryanto Harsono
Paediatrica Indonesiana Vol 49 No 1 (2009): January 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (96.142 KB) | DOI: 10.14238/pi49.1.2009.7-10

Abstract

Background  The  association between  Mycobacterium  tuberculosisinfection  and  atopy remains controversial. Reaction to tuberculosisinfection  is  mediated  by  Th-1  immune responses whereas allergicreactions are mediated  by  Th- 2 immune response. In patients withatopic syndrome who also suffer from tuberculosis infection,  theTh-2  response will be suppressed  and  allergy manifestations willdecrease. Therefore, it  is  important to determine the appropriateallergy test and to predict outcome after completing tuberculosistreatment.Objective  To  evaluate the influence  of  a positive tuberculin teston  skin test results in diagnosing atopic disease.Methods  A cross sectional study was  conducted  in  the  pediatricallergy  outpatient  clinic, Soetomo Hospital, Surabaya, Indonesiabetween 2004  and  2007. Eighty-five patients were enrolled inthis study.  The  tuberculin test was performed  on  all patientswith allergy.  The  allergy test was carried  out  by  performing a skinscratch test.Results  There  was a weak inverse correlation between positivetuberculin tests and positive allergy skin tests in children (housedust  mite, food  and  pet  allergies).  The  correlation between apositive  tuberculin  test  and  house  dust  mite allergy test wasr:  -0.364  (P=O.OOl;  a=O.Ol).  The  correlation  between  thetuberculin  test  and  food allergies was  r:  -0.420  (P=O.OOl;a=O.Ol).  The  correlation between the tuberculin test  and  petallergies was  r:  -0.344  (P=  0.001;  a=O.Ol).Conclusions  A positive tuberculin test  is  weakly correlated withpositive allergy skin test results, suggesting  that  it  is  appropriate  todo allergy skin testing even in children with a positive tuberculintest.
Role of sublingual immunotherapy and probiotics in clinical improvements of childhood asthma Mira lrmawati; Anang Endaryanto; Arijanto Harsono
Paediatrica Indonesiana Vol 48 No 5 (2008): September 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (137.735 KB) | DOI: 10.14238/pi48.5.2008.261-8

Abstract

Background Sublingual immunotherapy (SLIT) is an effectivesecondary prevention to improve natural course of asthma. Itsefficacy is limited to allergic asthma caused by inhalant allergen.Recent studies showed that probiotic as immunomodulatordecreases inflammatory process induced by food allergy. No suf-ficient clinical evidence reported about the efficacy of combinationsublingual immunotherapy and probiotics or probiotics only inclinical improvement of childhood asthma.Objective To investigate the role of SLIT and probiotic on clinicalparameters of childhood asthma (FEVl reversibility, medicationscore, and symptom score).Methods A randomized single blind clinical trial was conductedon 6-17 year-old asthmatic children sensitive to food and aero-allergens. Subjects were allocated to Group A receiving SLIT,Group B receiving probiotics and SLIT, Group C receiving probiot-ics only. All parameters were evaluated in week 0 untill4.Results FEVl reversibility improved in all groups. Medicationscore and symptom score was also decreased in all groups. Themost marked decrease of FEVl reversibility and symptom scorewere found in probiotics group. Statistical analysis revealedthat the difference of each parameter between groups were notsignificant.Conclusion Combination of SLIT and probiotics and probiot-ics are only similarly effective to improve clinical symptoms aschildhood asthma. Hence, information about probiotics as im-munomodulator was proved to be an excellent alternative therapyfor childhood asthma has been obtained.
Changes in bacterial profiles after periodontal treatment associated with respiratory quality of asthmatic children Wiyarni Pambudi; Imelda Fabiola; Retno Indrawati; Haryono Utomo; Anang Endaryanto; Ariyanto Harsono
Paediatrica Indonesiana Vol 48 No 6 (2008): November 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (221.622 KB) | DOI: 10.14238/pi48.6.2008.327-37

Abstract

Background Despite the reduction phenomenon of asthmaexacerbation after dental plaque control, no scientific report hasbeen found to describe the link between bacterial profiles andrespiratory quality in children with asthma.Objective To investigate association between bacterial profiles changesand improvement in respiratory quality after periodontal treatment.Methods Asthmatic children with FEV1 reversibility ~ 12% anddental plaque index ~ 2 who qualified for inclusion criteria wererandomized into two groups. The treatment group was referred fordental plaque removal by oral biology dentist and guided to performan individual oral health care for seven days. The control groupwas observed without intervention. Each subject was assessed forrespiratory quality and bacterial profiles taken from plaque culturebefore and after one week run-in period. Paired t-test and correlationwere used for statistical anayses. The study protocol was approved bythe Medical Research Ethics Committee of Dr. Soetomo Hospital.Results Dental plaque control was performed in 18 of 36 childrenwith mild asthma. At follow-up, plaque analysis among thesubjects receiving dental treatment showed a significant reduction(P<0.01) in number of microbial colony and gram negative bacilli,corresponding by a fall in asthma score, FEV1 reversibility, andblood eosinophil (P<O.Ol). The improvement of respiratoryquality variables were moderately associated (r>0.4; P<0.05) withbacterial profiles changes after periodontal treatment.Conclusions A reduced rate of gram negative bacilli colonizationin dental plaque after periodontal treatment is related toimprovement of respiratory quality of asthmatic children.
Transfer of dietary allergen in human milk Aryono Harsono; Anang Endaryanto
Paediatrica Indonesiana Vol 39 No 7-8 (1999): July - August 1999
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1116.312 KB) | DOI: 10.14238/pi39.7-8.1999.181-92

Abstract

The presence of dietary allergens in breast milk have been studied eitherin animal model or human milk. Transfer of these allergens to the infants have been proven qualitatively and quantitatively. Maternal dietary allergen transfer can also be detected by the presence of antibody response in the infants. The relationship of maternal dietary allergens and sensitisation to the infants can be observed in prolonged breastfed infants. The benefit of maternal dietary avoidance may be found either early from the beginning of pregnancy or in the lactation period. Factors predicting the onset of atopic disease are the nature of dietary protein in breast milk, lgA in breast milk, family history of atopy, allergen exposure, cord blood IgE and contributory factors. Evaluation of infants with sensitivity to dietary allergen in breast milk mainly is DBPCFC. Preventive measure is still avoidance of maternal dietary  allergen. The mainstay of treatment is avoidance of the offending foods obtained from food challenge.
lmmunomodulatory Effects of Human Milk upon Immune Functions in Infants Ariyanto Harsono; Anang Endaryanto; Muhammad Faizi
Paediatrica Indonesiana Vol 39 No 9-10 (1999): September - October 1999
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (6778.48 KB) | DOI: 10.14238/pi39.9-10.1999.243-50

Abstract

Human milk is capable to modulate the immune system in infants in several ways. lmmunorestoration is mostly dominated by immunoglobulins content of human milks especially secretory lgA, although lgG antibody also plays important role. Nucleotide content of human milk is among substances widely investigated all over the world, capable to potentiate immune response in infants by increasing NK cell activity and production of lL-2. lmmunopotentiation also the result of cell content activity of human milk, interferon, and complement. Special feature of anti-inflammatory property  of human milk is its capability to prevent of allergic disease in infants. This because ofprotein in breast milk is species specific, instead the role of secretotry lgA in  preventing absorption of foreign macromolecules. Other substances also play an important role in the antiinflammatory properties of human milk and interestingly the paucity of initiators and mediators in human milk.
Clinical manifestation of drug allergy in children Ariyanto Harsono; Anang Endaryanto
Paediatrica Indonesiana Vol 39 No 11-12 (1999): November - December 1999
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1922.183 KB) | DOI: 10.14238/pi39.11-12.1999.325-9

Abstract

In the period of January-December 18 cases of Drug Allergy were recognized, 4 cases from the allergy clinic, 8 cases were referred from outpatient clinic, 6 cases were referred from inpatient ward. The clinical manifestation varied from urticaria 5 cases (30%), Steven Johnson Syndrome 2 cases ( 12%), maculopapular rash 2 cases (12%), Drug fever 2 cases (12%), Fixed drug eruption 1 case (6%), exanthem 1 case (6%), Quinke's edema 5 cases (30%) consisted of 2 cases Quinke's edema only, 2 cases with urticaria, 1 case with drug fever. The underlying disease of these cases were upper respiratory tract infection 5 cases, chronic cough 2 cases, Asthma 5 cases, diarrhea 1 case cerebral abscess 1 case, Dengue Haemorrhagic Fever 1 case and Epilepsi 1 case. The mainstay of treatment was discontinuation of the offending drug. Drug substitution were given to patients nescessitated continuation of drugs, antihistamines were given to patients with urticaria and Quinke's edema. Two cases with Steven Johnson syndrome received supportive treatment and hydrocortisone intravenously.
Correlation of Epidermal Fibroblast Growth Factor and Clinical Improvement of Asthma in Children after Zinc Supplementation Retno Asih Setyoningrum; Anang Endaryanto; I Dewa Gede Ugrasena
Jurnal Respirasi Vol. 6 No. 3 (2020): September 2020
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (178.86 KB) | DOI: 10.20473/jr.v6-I.3.2020.61-66

Abstract

Background: Background The presence of remodeling process on the pathogenesis of asthma that involves some growth factors such as epidermal growth factor (EGF) and fibroblast growth factor (FGF) causes the chronicity of the disease. The role of zinc on the pathogenesis of asthma is being widely investigated. This study aimed to analyze the correlation between EGF and FGF2 and clinical improvement of asthma after  zinc supplementation.Methods: A quasi-experimental study was conducted in Outpatient Clinic Dr. Soetomo Hospital. The samples were persistent asthma patients from 6-15 years old who received controller therapy. The samples were divided into 2 groups, those who received zinc supplementation as the intervention group, and who received pacebo as the control. EGF and FGF2 plasma level of both groups were measured, and clinical improvement was evaluated with Childhood Asthma Control Test (C-ACT).Results: There were 11 patients who received zinc supplementation and 12 patients in the control group. There was a significant difference (p = 0.000) on the increase of EGF level in the intervention group (55.59 ± 6.48) than the control (5.35 ± 5.55). There was a significant difference (p = 0.000) on the increase of the FGF2 level in the intervention group (6.37 ± 1.41) than the control (0.72 ± 0.48). The increase of EGF (r = 0.592; p = 0.003) and FGF2 (r = 0.607; p = 0.002) would be followed by the increase of C-ACT scores.Conclusion: Zinc supplementation increase EGF and FGF2 levels. This improvement is correlated with clinical improvement of patients.
Co-Authors Afif Nurul Hidayati Ahmad Suryawan Aida Fahira Rachma Albarok, Muhammad Abdir Rahman Alpha Fardah Athiyyah Andy Darma Anggraeni, Sylvia Anindya Paramita Anisa Ayu Maharani Annisa Fitriana Ariani Setiawati Arijanto Harsono Arini Setiawati Ariyanto Harsono Ariyanto Harsono Ariyanto Harsono Ariyanto Harsono, Ariyanto Aryanto Harsono Aryono Harsono Azwin Lubis Azwin Mengindra Putera Badriul Hegar Bagus Bagus Bagus Haryo Kusumaputra, Bagus Haryo Bella Ayu Paramitha Budi Prasetyo Budi Setiabudiawan Budi Utomo Budiono Budiono Choirunisa, Latifatu Cita Rosita Sigit Prakoeswa Damayanti Damayanti Damayanti Deasy Fetarayani desy wulandari Dewanto, Naomi Esthernita Fauzia Dina Muktiarti, Dina Dinda Anes Tunjungsari Dominicus Husada DYAH FAUZIAH, DYAH Dyahris Kuntartiwi Ergia Latifolia Evy Ervianti Far-Far, Imanuel Fatima Safira Alatas, Fatima Safira Ferry Sandra Flora Ramona Sigit Prakoeswa Florentina Sustini Garindra Wicaksono Gatot Soegiarto Hardyanto Soebono Hari Basuki Notobroto Haryono Utomo Hasna, Iffa Halimah Hidajat, Boerhan I Dewa Gede Ugrasena I Gusti Ayu Agung Elis Indira I Gusti Made Reza Gunadi Ranuh I Gusti Nyoman Darmaputra Ida Bagus Ramajaya Sutawan, Ida Bagus Ramajaya Ike Wahyu Triastuti Imelda Fabiola INGRID SURYANTI SURONO Johannes Hudyono Ketut Dewi Kumara Wati Linda Astari, Linda Linda Dewanti M. Yulianto Listiawan Marcos, Imella Maya Weka Santi Melva Louisa Menul Ayu Umborowati Menul Ayu Umborowati Menul Ayu Umborowati, Menul Ayu Mira Irmawati Mira lrmawati Muhammad Faizi Muhammad Faizi Muhammad Faizi, Muhammad Muhammad Faris, Muhammad Natalia Erica Jahja Natalia Erica Jahja, Natalia Erica Ningsih, Rusdian Nur Rochmah Nur Rochmah, Nur Nyoman Suryawati Pambudi, Wiyarni Pudji Lestari Retno Asih Setyoningrum Retno Asih, Retno Retno Asti Werdhani Retno Indrawati Roestamadji Reza Ranuh S.Pd. M Kes I Ketut Sudiana . Santi Martini SITI NURUL HIDAYATI Sitisalma Amirah Dzakiyyah Soetjipto SOETJIPTO . Subijanto MS Sudarmo, Subijanto Marto Sumadiono Sumadiono Thinni Nurul Rochmah Umi Fahmida Widodo, Naufallutfi Widyantari, Septiana Wisnu Barlianto Wisnu Triadi Nugroho Wiweka Merbawani Yetti Hernaningsih Yohanes Aditya Adhi Satria Yudhi Kurniawan Yuni Hisbiyah Yuri Widia, Yuri Yusra, Yusra Zahrah Hikmah, Zahrah Zakiudin Munasir