Widiasteti Widiasteti
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Eosinofilik Esofagitis Yusri Dianne Jurnalis; Yorva Sayoeti; Widiasteti Widiasteti
Jurnal Kesehatan Andalas Vol 2, No 3 (2013)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v2i3.168

Abstract

AbstrakEosinofilik esofagitis merupakan gangguan dimana terjadi infiltrasi eosinofil pada mukosa superfisial esophagus yang berhubungan dengan alergi makanan dan kondisi atopi seperti asma, dermatitis atopi, rhinitis alergika dan sering bersamaan dengan Gastroesophageal Reflux Disease (GERD). Diperkirakan insiden tahunan 43 per 10.000 pada anak. Gejala klinis mirip dengan GERD yaitu muntah, regurgitasi, nausea, nyeri dada atau epigastrium, disfagia dan hematemesis. Sekitar 50% pasien memiliki gejala alergi dan lebih 50% pasien memiliki orang tua dengan riwayat alergi. Diagnosis dapat ditegakkan berdasarkan pemeriksaan endoskopi dan histologis. Gambaran endoskopi yang ditemukan antara lain feline esophagus, corrugated esophagus, ringed esophagus, atau concentric mucosal rings, eksudat putih, vesikel atau papul dan hilangnya pola vaskular menunjukkan area fokus infiltrasi eosinofil. Diagnosis secara histologis sangat penting dimana kriteria eosinofilik esofagitis adalah jika ditemukan eosinofil >20/HPF (High Power Field). Terapi yang diberikan adalah terapi diet, farmakologis seperti kortikosteroid sistemik atau topikal, penghambat reseptor leukotrin dan anti IL-5.Kata kunci: eosinofilik esofagitis, alergi makanan, atopiAbstractEosinophilic esophagitis is a disorder which there is eosinophil infiltration on superficial esophageal mucosa. It’s correlated with food allergy and atopy condition such as asthma, atopy dermatitis, rhinitis allergic and often in conjunction with Gastroesophageal Reflux Disease ( GERD). The incidence approximately 43/10.000 in children. The symptoms are similar with GERD, which one vomit, regurgitation, nausea, chest or epigastrium pain, dysphagia and hematemesis. About 50% patient has allergic symptoms and more than 50% parent of the patient has allergic history. The diagnose can be made base on endoscopic and histological examination. Endoscopic examination shows feline esophagus, corrugated esophagus or concentric mucosal rings, white exudates, vesikel or papul and diminished of vascular pattern, showing eosinophyl infiltration focus area. Histologic diagnosis is very important where the criteria for eosinophilic esophagitis is found eosinophils > 20 / HPF (High Power Field) within the superficial esophageal mucosa. Therapy eosinophilic esophagitis are diet therapy, pharmacological therapy with systemic or topical corticosteroid, leucotriene receptor antagonist and anti IL-5.Keywords:Eosinophilic esophagitis, food allergy, atopy
DISTROFI MUSKULAR DUCHENNE Iskandar Syarif; Widiasteti Widiasteti
Majalah Kedokteran Andalas Vol 33, No 2: Agustus 2009
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (500.202 KB) | DOI: 10.22338/mka.v33.i2.p%p.2009

Abstract

AbstrakAnak laki-laki umur 10 tahun 9 bulan dirawat di bangsal anak RSUP Dr. M. Djamil Padang dengan keluhan sukar berdiri sejak 2 tahun yang lalu. Riwayat penyakit sekarang adalah pasien sering kram otot betis dan jika mau berdiri, berjongkok terlebih dahulu, kedua tangan bertumpu pada kedua lutut (manuver Gowers) sejak usia 3 tahun. Pasien sering jatuh ketika berjalan sejak usia 5 tahun dan dada mulai tampak membusung ke depan. Sejak usia 8 tahun harus di bantu untuk berdiri dan berjalan dengan posisi kaki berjinjit. Riwayat keluarga dengan kelainan otot tidak ada. Pemeriksaan fisik ditemukan lordosis, pseudohipertropi m.gastrocnemeus, kekuatan otot ekstremitas inferior berkurang dari normal. pemeriksaan kadar creatine kinase meningkat yaitu 1860 U/L (normal : 24- 170 U/L). elektromiogram menyokong untuk miopati dengan gambaran gelombang positif, fibrilasi, amplitudo rendah dan pontensial polifasik. Biopsi otot tidak dilakukan karena keluarga menolak. Pada pasien ini diberikan prednison 0,75 mg/kg BB/hari, suplemen kalsium dan vitamin D.Kata kunci : distrofi muskular duchenne, manuver Gowers, creatine kinaseAbstractA 10 years and 9 months old boy was hospitalized in Pediatric Department of Dr.M. Djamil Hospital Padang with chief complaint need help for standing since 2 years ago. The Symptons were he had recurrent cramps and needing to turn onto his front and rise to standing from the floor using a broad-based stance with the support of his hand on his thigh (Gowers maneuver) since seven years ago. He often fall when he walked and appearance lordotic posture since five years old. Since eight years old he needed for standing and walking with his toes. The patient was born with vaccum extraction, with body birth weight 2900 grams, full term. No family history of muscle disease. Physical examination founded lordosis, pseudohypertrophy of the calves, weakness of muscles of inferior extremities with sensory was normal. Level of creatine kinase was 1860U/L (normal: 24-170 U/L). Electromyography showed myopathic with characterized fibrillations, positive waves, low amplitudepolyphasic potentials. Muscle biopsy could not be done because his parents not agree. The therapy for this patient was prednisone 0,75 mg/kgbb/day, supplement orally calcium and vitamin D.Key words : Duchenne Muscular Dystrophy, Gowers maneuver, muscle diseaseLAPORAN KASUS