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DIAGNOSIS DAN PENDEKATAN TERAPI PASIEN PERITONITIS Putu Enrico Pramana Okaniawan; Ida Ayu Setyawati Sri Krisna Dewi
Ganesha Medicina Vol. 2 No. 2 (2022)
Publisher : Universitas Pendidikan Ganesha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23887/gm.v2i2.52053

Abstract

Abstrak Peritonitis merupakan inflamasi pada peritonium yang terdiri atas membran serosa yang melapisi rongga abdomen dan organ viseral di dalamnya dan merupakan suatu kegawatdaruratan yang dapat disertai dengan sepsis. Etiologi peritonitis bervariasi menurut lokasi geografis dan faktor lingkungan lokal dengan predisposisi genetik. Peritonitis berdasarkan luas infeksinya dibagi menjadi peritonitis lokalisata dan peritonitis generalisata. Sedangkan peritonitis berdasarkan penyebabnya dapat dibagi menjadi peritonitis primer, sekunder, dan tersier. Penyebaran agen infeksi secara hematogen menjadi mekanisme perkembangan peritonitis primer dan difasilitasi oleh gangguan pertahanan imun dari host. Pada pemeriksaan pencitraan, USG dan CT scan abdomen memainkan peran penting dalam diagnosis dan strategi terapeutik. Fokus utama manajemen adalah identifikasi dan pengobatan yang ditargetkan dari agen penyebab melalui antibiotik dan/atau intervensi bedah Abstract Peritonitis was an inflammation of the peritoneum which consists of a serous membrane that lines the abdominal cavity and the visceral organs in it and is an emergency that could be accompanied by sepsis. The etiology of peritonitis varies according to geographic location and local environmental factors with a genetic predisposition. Peritonitis based on the extent of infection was divided into localized peritonitis and generalized peritonitis. While peritonitis based on the cause could be divided into primary, secondary, and tertiary peritonitis. Hematogenous spread of infectious agents was the mechanism for the development of primary peritonitis and was facilitated by impaired host immune defense. In imaging studies, ultrasound and CT scan of the abdomen play an important role in the diagnosis and therapeutic strategy. The main focus of management was the identification and targeted treatment of the causative agent through antibiotics and/or surgical intervention.
Management of Severe Warm Autoimmune Hemolytic Anemia in Chronic Systemic Lupus Erythematosus Putu Enrico Pramana Okaniawan; Ajib Zaim Alamsyah; Dwiputra Yogi Pramarta
Journal of Social Research Vol. 5 No. 7 (2026): Journal of Social Research
Publisher : International Journal Labs

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55324/josr.v5i7.3202

Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with multi-organ involvement, often complicated by hematologic disorders such as warm autoimmune hemolytic anemia (AIHA). AIHA in SLE patients can lead to severe anemia, jaundice, organ dysfunction, and increased mortality, yet data on its management, particularly in severe cases, remain limited. This study aimed to describe the diagnosis, management, and clinical outcomes of severe warm AIHA in a patient with chronic SLE. A qualitative case report methodology was employed, collecting data through anamnesis, physical examination, laboratory testing, imaging studies, and treatment documentation. The patient, a 28-year-old female with chronic SLE, presented with severe normochromic-normocytic anemia, jaundice, splenomegaly, and discoid lesions. Management included methylprednisolone pulse therapy, hydroxychloroquine, packed red cell transfusions, supportive care, and vitamin D supplementation. Clinical monitoring demonstrated progressive improvement in hemoglobin levels, reduction in autoimmune activity, and resolution of systemic symptoms over five days of hospitalization. The study concludes that integrated medical and supportive therapies are effective for stabilizing severe warm AIHA in chronic SLE, emphasizing the need for individualized care and close monitoring. Future research should focus on larger cohorts to validate treatment protocols, explore adjunctive therapies, and identify predictive markers for severe hemolysis to enhance early diagnosis and improve long-term patient outcomes.