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Komplikasi Perforasi Gaster Dan Gagal Ginjal Akut Pada Henoch-Schonlein Purpura Dengan Bula Hemoragik

Komplikasi Perforasi Gaster Dan Gagal Ginjal Akut Pada Henoch-Schonlein Purpura Dengan Bula Hemoragik
Gita Siti Purnama Adiprama, Ayu Nur Ain H, Maya W., Hartati Purbo Dharmadji, Endang Sutedja. Oki Suwarsa, Budi Setiabudiawan
Universitas Padjadjaran, Buku Makalah Lengkap I Pertemuan Ilmiah Tahunan XII PERDOSKI " Skin Tomur, Cosmetic and Aedthetical Approaches " Solo, 21-23 Juni 2012 ISBN : 9799791035810, Penerbit PT. ITA Surakarta Dicetak di Rajawali Offset Surakarta
Bahasa Indonesia, Bahasa Inggris
Universitas Padjadjaran, Buku Makalah Lengkap I Pertemuan Ilmiah Tahunan XII PERDOSKI " Skin Tomur, Cosmetic and Aedthetical Approaches " Solo, 21-23 Juni 2012 ISBN : 9799791035810, Penerbit PT. ITA Surakarta Dicetak di Rajawali Offset Surakarta
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Latar Belakang: Henoch-Schoenlein Purpura (HSP) adalah nontrombocytopenic palpable purpura. disertai nyeuri perut, artitis, atralgia. glomerulonefritis. ataupun leukocytoclastic varculitis. Diagnosis berdasarkan American College of Rheumatology dan EULAR/PRINTO/PRES 2008. Secara klinis vesikobulosa dapat ditemukan 16-60% kasus pasien HSP dewasa, sedangkan anak-anak hanya <2% kasus. Kasus: Dilaporkan satu kasus HSP disertai komplikasi pada seorang anak laki laki usia 11 tahun. Lesi kulit diawali purpura pada kedua daun telinga,. kedua ekstremitas atas dan bawah, pinggang. serta bokong. Selanjutnya, sebagian lesi berkembang menjadi bula hemoragik pada kedua daun telinga. ektremitas bawah kaki. disertai nyeuri sendi dan edema pada kedua kaki. Ditemukan proteinuria+++. Selama perawatan timbul komplikasi. berupa perforasi gaster dan acute kidney injury, Pasien diterapi kombinasi dengan metilprednisolon 30 mg/kgBB dan siklofosfamid 500 mg Intracena dosis denyut per tiga minggu. Mengalami perbaikan pada hari ke 28 perawatan dan kemudian pulang pada hari ke-39 perawatan. Diskusi: HSP merupakan penyakit self-limitting,Namu dapat menimbulkan komplikasi serius sampai dengan kematian. Penegakan diagnostic pada pasien ini berdasarkan ananmesis. Pemeriksaan fisik dan laboratorium. Bula hemoragik menandakan HSP yang disertai nefritis. sehingga diperlukan terapi siklofosfamid dosis denyut. Selama perawatan timbul komplikasi. namun dengan penanganan yang baik. komplikasi dapat teratasi. Background : Henoch-Schoenlein purpura (HSP) is characterized be nontromboolopenic palpable purpura. and alsoaccompanied with abdominal pain. arthritis. arlhralgia. glomerulonephritis. or leukocytoclastic vasculitis. Diagnosis based on the American College of Rheumatology and the EULAR / PRINTO / Pres. 2008. Clinical manifestation vesico-bullous lesions found at 16-60% of HSP cases in adult patients, and, only less than 2% of cases occurs in children. Case report: A case of Henoch-Schoenlein purpura with complication in a 11-year old boy was reported. The patient presented with purpuric lesions in his earlobes. on the upper and lower examines. Lower back. and bullocks. Furthermore, some lesions progress in hemorrhagic bullae were found in both earlobes, lower extremities, Feet, accompanied with athralgia and edematous feet. The presence of high proteinuria was found as well. During treatment, patient had complications of gastric perforation and acute kidney injury, The patient were given combination treatment of 30 mg/kgBW methylpednisolone and pulse dose of 500 mg cyclophosphamide intravenously within three weeks interval. Improvement was shown on the 28th day of treatment. the patient was then discharged from hospital on the 39th day. Discussion: HSP is a self-limiting diseave. but can cause serious complications even death. The diagnosis was established have on history taking. Clinical appearance. and laboratory examinations. Hemorrhagic bullae marked HSP with nephritis. which required pulsed dose of cyclosphamide as treatment. Although he had serious complications during the treatment. the complications were resolved with proper management.

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