alergi susu sapi (egon ilman saputra - 1161050261)

8/15/2019 Alergi Susu Sapi (Egon Ilman Saputra - 1161050261)

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ALERGI SUSU SAPIOleh:

Egon Ilman Saputra1161050261

Pembimbing:dr. Keswari A.P, Sp. A


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+

REAKSI HIPERSENSITIVITAS


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+DEFINISI

Reaksiimun l

gis

Akiba!"embe#iansusu

sa"i$makanan

%angmengan&ungsususa"i

Te#'a&isege#a

a!aulamba!

(unasi# )* Si#ega# SP+ Ale#gi Susu Sa"i+ Buku Ajar Alergi Imunologi Anak , -../: -: "+ -012/3


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+DEFINISI

Reaksisim"ang!e#ha&a""# !ein

susu sa"i

Di"e#an!a#ai IgE4hi"e#sensi!i5i!as

!i"e I6

N n2IgE4hi"e#sensi!i5i!as

!i"e IIIa!au IV6

IDAI+ Ale#gi Susu Sa"i+ Pedoman Pelayanan Medis Ikatan Dokter Anak Indonesia , -../: "+72/+


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+EPIDE(IOLOGI

Ale#giSusuSa"i

Insi&ensi -289 &ian!a#akeselu#uhan

ba%i

Insi&ensi"a&a ba%i

%angmen&a"a!ASI eksklusi

.*723*79

P#e5alensi -2;*79* 3*79&i"e#an!a#ai

IgE

Ge'ala&imulai "a&ausia < bulan

"e#!amakehi&u"an

Umumn%aba%i akan

! le#anseki!a# usia

8 !ahun

(unasi# )* Si#ega# SP+ Ale#gi Susu Sa"i+ Buku Ajar Alergi Imunologi Anak , -../: -: "+ -012/3 T#kaman (* Ami#sala#i S* Sabu#i A e! al+ = >?s (ilk P# !ein Alle#g% in In an!s an& Thei# Res" nse ! A5 i&an@e+ Journal of Clinical and Diagnostic Research , -.3- (a% 4Su""l2-6: < 416: "+


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+KLASIFIKASI

IgE mediated

Di"e#an!a#ai IgE

Ge'ala !imbul &alam >ak!u 8. meni! 2 3 'am

U#!ika#ia* angi e&ema* #uam kuli!* &e#ma!i!isa! "ik* mun!ah* n%e#i "e#u!* &ia#e*b# nk s"asme* ana laksis

Ka&a# IgE susu sa"i " si!i

Non IgEmediated

Di"e#an!a#ai IgG &an Ig(

Ge'ala !imbul &alam >ak!u 328 'am

Allergic eosinophilic gastroenteropathy * k lik*en!e# k li!is* "# k! k li!is* anemia* gagal!umbuh

IDAI+ Diagn sis &an Ta!alaksana Ale#gi Susu Sa"i+ Rekomendasi Ikatan Dokter Anak Indonesia , -.3.: "+ 323.+


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+FISIOLOGI

P# ses imun%ang

me#ugikan

Res" n"en@e#naan

• Abs #bsi an!igenmelalui sa>a#"en@e#naan

• (ekanisme n ns"esi k

• (ekanisme s"esi k

Res" n! le# genik

Tle#ansi#al

Gi 5anna V* =a#la =* Al na = e! al+ The immun "a!h genesis @ >?s milk "# !ein alle#g% 4=(PA6+ Italian Journal ofPediatrics , -.3-: 80: 87: "+ 327


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+PATOGENESIS

Res" nimun

menu#un

Penekanan T reactive

speci c!antigen

cells &an T

#eg

Res" ninBamasi!e#ha&a"an!igen

meningka!

Reaksiale#gi susu

sa"i

Gi 5anna V* =a#la =* Al na = e! al+ The immun "a!h genesis @ >?s milk "# !ein alle#g% 4=(PA6+ Italian Journal of

Pediatrics , -.3-: 80: 87: "+ 327


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+PATOGENESIS

Casein

C23

C2-

2@asein

@asein

"hey proteins

C2la@!abulmin

2la@! gl bulin

5ine se#umalbumin5ine

immun gl bulin

Ka#abus S * &u T i! G+ IgE me&ia!e& = >?s (ilk P# !ein Alle#g%+ Current Allergy # Clinical Immunology , -.3- (a#@h:

-7 436: "+ 12;+


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+PATOGENESIS

Di"e#an!a#ai leh sel Th3

In!e#aksi an!a#a lim si! T* sel mas!&an neu# n %ang menga!u# ! !" l s &an m !ili!as in!es!inal

Gi 5anna V* =a#la =* Al na = e! al+ The immun "a!h genesis @ >?s milk "# !ein alle#g% 4=(PA6+ Italian Journal of

Pediatrics , -.3-: 80: 87: "+ 327

N n2IgE mediatedReactions


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+DIAGNOSA

Anamnesis

angka >ak!u !imbuln%a ge'ala

umlah susu %ang&iminum$makanan %angmengan&ung susu sa"i

Pen%aki! a! "i

(unasi# )* Si#ega# SP+ Ale#gi Susu Sa"i+ Buku Ajar Alergi Imunologi Anak , -../: -: "+ -012/3+



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+DIAGNOSA

!rgan "ang #erli$at %ani&estasi 'erat

Salu#an Pen@e#naan Failu#e ! !h#i5e

Anemia &e besi

En!e# "a!h%

Dehiasi

Ke!i&akseimbangan elek!# li!

Penu#unan

Kuli! De#ma!i!is a! "ik %ang be#a!

Sis!em Pe#na"asan E&ema la#ing

Umum Ana laksis


IDAI+ Ale#gi Susu Sa"i+ Pedoman Pelayanan Medis Ikatan Dokter Anak Indonesia , -../: "+72/+G#ee ED* Vee#eman2 au!e#s G* De5#eke# T e! al+ Diagn sis an& (anagemen! = >?s (ilk P# !ein Alle#g% inIn an!s+ Allergic Diseases ! $ighlights in the Clinic% Mechanisms and &reatment , -.3-: "+-;/200+


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+DIAGNOSA

!rgan "ang #erli$at %ani&estasi (ingan Sedang

Sis!em Pe#na"asan Rhini!is k# nik a!au be#ulang

a!uk be#ulang !e#u!amamalam ha#i

K n'ung!i5i!ishee ing

O!i!is me&ia

Umum I#i!abili!as


IDAI+ Ale#gi Susu Sa"i+ Pedoman Pelayanan Medis Ikatan Dokter Anak Indonesia , -../: "+72/+G#ee ED* Vee#eman2 au!e#s G* De5#eke# T e! al+ Diagn sis an& (anagemen! = >?s (ilk P# !ein Alle#g% inIn an!s+ Allergic Diseases ! $ighlights in the Clinic% Mechanisms and &reatment , -.3-: "+-;/200+


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+DIAGNOSA

Peme#iksaanFisik

K n&isi umum• S!a!us gi i* s!a!us hiasi

Kuli!• De#ma!i!is a! "i* u#!ika#ia* angi e&ema

Salu#an na"as• K nka e&ema &an "u@a!* allergic shiners * nasal crease *geographic tongue

Salu#an @e#na• (e!e #ismus* skibala* su#a ani


IDAI+ Ale#gi Susu Sa"i+ Pedoman Pelayanan Medis Ikatan Dokter Anak Indonesia , -../: "+72/+


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+DIAGNOSA

IgE me&ia!e&

Ge'ala klinis

U'i IgE s"esi k 4!usukkuli! a!au RAST6

N n2IgEme&ia!e&

Ri>a%a! ale#gi !e#ha&a""# !ein susu sa"i

Die! eliminasi

U'i "# 5 kasi makanan

En& sk "i &an bi "si



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+Peme#iksaan Penun'ang

Peme#iksaanDa#ah Te"i U'i Tusuk Kuli!

Ka&a# IgE T !al

&an Ka&a# IgES"esi k SusuSa"i

U'i Eliminasi&an P# 5 kasi

(akananPeme#iksaanKa&a# His!amin

Peme#iksaanDa#ah "a&a

Tin'a


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+Peme#iksaan Da#ah Te"i

P si!ibila

hi!ung 'enise sin

"hilJ89a!au

e sin"hil

! !alJ8..$ml



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+U'i Tusuk Kuli!

ila " si!i kemungkinan ale#gi susu sa"i sebesa# 7.9 4"#e&iksi " si!iaku#asin%a 7.96

ila nega!i be#a#!i ale#gi susu sa"i %ang &i"e#an!a#ai leh IgE &a"a!&isingki#kan 4"#e&iksi nega!i aku#asin%a J/79 6

ila salah sa!u u'i kuli! a!au ka&a# IgE ! !al a!au IgE s"esi k " si!i &an&ise#!ai "a&a anamnesis &an "eme#iksaan sik &ugaan ale#gi susu sa"i u'i eliminasi &an "# 5 kasi susu sa"i

ila hasil !es IgE nega!i namun !e#&a"a! &ugaan %ang kua! a&an%a ale#gisusu sa"i !es "# 5 kasi makanan


IDAI+ Diagn sis &an Ta!alaksana Ale#gi Susu Sa"i+ Rekomendasi Ikatan Dokter Anak Indonesia , -.3.: "+ 323.+=a a#elli =* al&i F* en&an&i e! al+ = >?s milk "# !ein alle#g% in @hilen: a "#a@!i@al gui&e+ Italian Journal ofPediatrics , -.3.: 8


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+U'i Eliminasi &an P# 5 kasi(akanan

Eliminasi susu sa"iselama -28 minggu

Ge'ala be#ku#ang a!aumenghilangSusu sa"i &ibe#ikan

be#!aha" 8 ml < ml3- ml sam"ai !e#@a"ai

'umlah susu %ang &iminum!ia" 3. meni! ila se!elah - 'am

!i&ak !imbul ge'alau'i "# 5 kasi

nega!i

Ti&ak ale#gi susu sa"i

Dou'le Blind Place'o Controlled (oodChallenge


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+Peme#iksaan Ka&a# His!amin

Se!elah "# 5 kasi &engan susu sa"i &ilakukan* &iuku#his!amin &engan @a#a memasang in!#agas!#ik tu'e

i "si 'e'unum un!uk men%ingki#kan Co)*s milk protein induced enterocolitis

Peme#iksaan hamba!an mig#asi leuk si! un!ukmembuk!ikan imuni!as selula# !e#liba! "a&a ale#gi sususa"i



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+Peme#iksaan Da#ah "a&a Tin'a

Pa&a kea&aan A &engan &a#ah %ang!i&ak n%a!a

Peme#iksaan @ hromiun!+, la'ellederythrocites "a&a eses

Peme#iksaan #eaksi #!h ! li&in

IDAI+ Diagn sis &an Ta!alaksana Ale#gi Susu Sa"i+ Rekomendasi Ikatan Dokter Anak Indonesia , -.3.: "+ 323.


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+ TATALAKSANA

Un!uk a%i &engan (akanan Pa&a!• (enghin&a#i a&an%a "# !ein susu sa"i &alam (P2

ASIPemakaian Susu Ke&elai• ika susu #mula !e#hi lisa! eks!ensi !i&ak

!e#se&ia• Ken&ala bia%a• a%i be#usia J< bulan

(e&ikamen! sa• Sim! ma!is



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+PROGNOSIS

Remisi 172779"a&a!ahu

n

"e#!amaRemisi


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+DAFTAR PUSTAKA

(unasi# )* Su% k E(D+ Reaksi Hi"e#sensi!i5i!as+ Buku Ajar Alergi Imunologi Anak , -../: -: "+ 337283+


IDAI+ Diagn sis &an Ta!alaksana Ale#gi Susu Sa"i+ Rekomendasi Ikatan Dokter Anak Indonesia , -.3.: "+323.+

IDAI+ Ale#gi Susu Sa"i+ Pedoman Pelayanan Medis Ikatan Dokter Anak Indonesia , -../: "+72/+ T#kaman (* Ami#sala#i S* Sabu#i A e! al+ = >?s (ilk P# !ein Alle#g% in In an!s an& Thei# Res" nse !A5 i&an@e+ Journal of Clinical and Diagnostic Research , -.3- (a% 4Su""l2-6: < 416: "+ ?s (ilk P# !einAlle#g% in In an!s+ Allergic Diseases ! $ighlights in the Clinic% Mechanisms and &reatment , -.3-: "+-;/200+

=a a#elli =* al&i F* en&an&i e! al+ = >?s milk "# !ein alle#g% in @hilen: a "#a@!i@al gui&e+ Italian Journal of Pediatrics , -.3.: 8

alergi susu sapi (egon ilman saputra - 1161050261)

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