Gambaran Klinis Steven Johnson Syndrome dan Toxic Epidermal Necrolysis pada Pasien Anak

Annisa Fitriana, Anang Endaryanto, Afif Nurul Hidayati

= http://dx.doi.org/10.20473/bikkk.V30.2.2018.102-110
Abstract views = 2037 times | views = 9971 times

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.

Keywords


Steven Johnson Syndrome; Toxic Epidermal Necrolysis; Steven Jonson Syndrome pada anak; gambaran klinis;

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References


Marcdante KJ, Kliegman RM, Jenson HB, Behrman RE, Nelson Ilmu Kesehatan Anak Esensial.6th ed. Singapore: Elsevier; 2014.

Rzany B, Mockenhaupt M, Baur S, Schroder W, Stocker U, Mueller J, et al. Epidemiology of erythema exsudativum multiforme majus, Stevens-Johnson syndrome, and toxic epidermal necrolysis in Germany (1990–1992): Structure and results of a population-based registry. Journal of Clinical Epidemiology 1996; 49(7): 769-73.

Del Pozzo-Magana BR, Lazo-Langner A, Carleton B, Castro-Pastrana LI, Rieder MJ. A systematic review of treatment of drug-induced stevensjohnson syndrome and toxic epidermal necrolysis in children. Journal of population therapeutics and clinical pharmacology 2011 March 21; 18(1): 121-33.

Weinand C, Xu W, Perbix W, Lefering R, Maegele M, Rathert M, et al. 27 years of a single burn centre experience with Stevens–Johnson syndrome and toxic epidermal necrolysis: Analysis of mortality risk for causative agents. Burns 2013 November; 39(7): 1449-55.

Finkelstein Y, Gordon SS, Acuna P, George M, Pope E, Ito S, et al. Recurrence and outcomes of Stevens-Johnson syndrome and toxic epidermal necrolysis in children. Pediatrics 2011 October; 128(4): 723-28.

Sharma VK, Sethuraman G, Minz A. Stevens Johnson syndrome, toxic epidermal necrolysis and SJS-TEN overlap: A retrospective study of causative drugs and clinical outcome. Indian J Dermatol Venereol Leprol 2008; 74: 238-40.

Harr T, French LE. Toxic epidermal necrolysis and Stevens-Johnson syndrome. Orphanet Journal of Rare Disease 2010; 5(39): 1-11.

Cekic S, Canitez Y, Sapan N. Evaluation of the patients diagnosed with Stevens Johnson syndrome and toxic epidermal necrolysis: a single center experience. Turkish Archives of Pediatrics 2016 April 4; 51: 152-8.

Hsu DY, Brieva J, Silverberg NB, Paller AS, Silverberg JI. Pediatric Stevens-Johnson syndrome and toxic epidermal necrolysis in the United States. Journal of American Academy of Dermatology 2017 May; 76(5): 811-17.

Ibrahim MK, Zambruni M, Melby CL, Melby PC. Impact of childhood malnutrition on host defense and infection. Clinical Microbiology Review 2017 October; 30(4): 919-71.

Wu J, Lee YY, Su SC, Wu TS, Kao KC, Huang CC, et al. Stevens–Johnson syndrome and toxic epidermal necrolysis in patients with malignancies. Britis Journal of Dermatology 2015 November; 173(5): 1224-31.

Morales ME, Purdue GF, Verity SM, Arnoldo BD, Blomquist PH. Ophthalmic manifestations of Stevens-Johnson syndrome and toxic epidermal necrolysis and relation to SCORTEN. American Journal of Ophtalmology 2010 October; 150(4): 505-10.

Kohanim S, Paliora S, Saeed HN, Akpek EK, Amescua G, Basu S, et al. Acute and chronic ophthalmic involvement in Stevens-Johnson syndrome/toxic epidermal necrolysis - a comprehensive review and guide to therapy. II. Ophthalmic Disease. Ocular Surface 2016 April; 14(2): 168-88.

Ramayanti S. Manifestasi oral dan penatalaksanaan pada penderita sindrom Stevens-Johnson. Majalah Kedokteran Andalas 2011; 35(2): 91-6

Roongpisuthipong W, Prompongsa S, Klangjareonchai T. Retrospective analysis of corticosteroid treatment in Stevens-Johnson syndrome and/or toxic epidermal necrolysis over a period of 10 years in Vajira Hospital, Navamindradhiraj University, Bangkok. Dermatology Research and Practice 2014 June 15; 2014: 1-5.

Lehloenya R. Management of Stevens-Johnson syndrome and toxic epidermal necrolysis. Current Allergy & Clinical Immunology 2007 August; 20(3): 124-8.


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