TB MDR Primer dengan Limfadenitis TB pada Wanita SLE

Ika Yunita Sari, Tutik Kusmiati

= http://dx.doi.org/10.20473/jr.v1-I.3.2015.81-87
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Abstract


Background: Primary resistance is the resistance that occurs in patients who have never received treatment OAT or had ever received  treatment OAT is less than 1 month. The incidence of primary MDR in Central Java in 2006 2.07%. Extrapulmonary TB about 15-20%  of all cases of TB, and TB lymphadenitis is the highest form (35% of all extrapulmonary TB). Patients with decreased immune systems  (SLE) can increase the incidence of TB. Research in Spain get 6x higher TB incidence in patients with SLE. Case: We present the case  of 19 year old woman SLE who received treatment for 11 months whose came with shortness of breath and chronic cough since 2 month  prior to admission. In physical examination we found right and left submandibula lymphonodi enlargement as solid, slightly mobile  nodule with diameter 3 cm. Chest X ray showed lung inflammation which suspicion of specific process and minimal left pleural effusion,  and concluded as pulmonary TB. FNAB confirmed lymphadenitis TB with granulomatous inflammation. One of AFB result is positive  and Gene Xpert is MTB positive with rifampicin resistant that make this patient categorized as primary MDR TB with lymphadenitis  TB. This patient received Pirazinamid 1500 mg, Ethambutol 800 mg, Kanamicin 750 mg, Levofloxacin 750 mg, Ethionamide 500 mg,  Cicloserin 500 mg, and B6 100 mg. Conclusion: MDR TB in general occur in patients with a history of OAT previous TB (MDR TB  secondary). Primary MDR TB with lymphadenitis tb is a rare case, but can occur on the condition that decreases the immune system,  one of SLE. This involves multiple immune disorders caused by the use of long-term immunosuppressive therapy. 


Keywords


Primary resistance, Lymphadenitis TB, SLE

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References


Perhimpunan Dokter Paru Indonesia. Tuberculosis: pedoman diagnosis dan penatalaksanaan di Indonesia. PDPI. 2011. 1-64.

Aditama TY, dkk. Tuberkulosis Pedoman Diagnosis dan Penatalaksanaan di Indonesia, PERPARI, Jakarta, 2006.

Soedarsono. Multi-Drug Resistance (MDR) - TB. Buku Ajar Ilmu Penyakit Paru, Surabaya, 2010, 27-36.

Soedarsono. Genesis of MDR TB : clinically and program aspect. Majalah Kedokteran Respirasi. Vol. 1.2010. 12-18.

Agraz R, Balchin D, Bayona J. Drug Resistant Tuberculosis a survival guide for clinicians. Edisi 2. 2008. 1-143.

Program Pengendalian TB Nasional Indonesia. Draf Pedoman Diagnosa dan pengobatan programatik TB-MDR(MDR) dan TB- XDR(XDR) dalam konteks proyek uji pendahuluan Green Light Committee, Juni 2008.

Powell DA, (2002). Tuberculous Lymphadenitis In: Tuberculosis and nontuberculosis mycobacterial infection 4nd edition. Eds: Schlossberg,WB Saunders Company, Philadelpia. Pp: 186-93.

Prabu VNN, S Agrawal. Systemic lupus erythematosus and tuberculosis: a review of complex interaction of complicated disease. Postgrad Med 2010; 56: 244-250.

Riyanto BS, Wilhan. Management of MDR TB Current and Future dalam Buku Program dan Naskah Lengkap Konferensi Kerja Pertemuan Ilmiah Berkala. PERPARI.Bandung. 2006.

Wallace RJ, Griffith DE. Antimycrobial Agents in Kasper DL, Braunwald E (eds), Harrison’s Principles of Internal Medicine, 16th ed. McGraw-Hill. New York. 2004.

Helmia Hasan. Tuberculosis Paru. Buku Ajar Ilmu Penyakit Paru, Surabaya, 2010, 9-22.

Alsagaff H, Mukty A, 2002. Dasar-dasar ilmu penyakit paru. Edisi kedua Airlangga University Press, Surabaya pp. 73-109.

Hopewell PC (2000). Tuberculosis and other mycobacterium disease. In: Text book of respiratory medicine. Eds: Murray SF, Nadel JA, WB Sunders Company, Philadelphia. Pp: 1043-96.

Arce-Salinas CA, Villaseñor-Ovies P. Infection and systemic lupus erythematosus. In: Almoallim H. ed. Systemic Lupus Erythematosus. Croatia: In Tech; 2012. pp. 407-428.

Tasneem S, Islam N, Ali R. Crossreactivity of SLE autoantibodies with 70 kDa heat shock proteins of Mycobacterium tuberculosis. Microbiol Immunol 2001; 45: 841-846.

Chodisetti SB, Rai PK, Gowthaman U, Pahari S, Agrewala JN. Potential T cell epitops of Mycobacterium tuberculosis that can instigate molecular mimicry against host: implication in autoimmune pathogenesis. BMC Immunol 2012; 13: 13.

Mohd A, Goh EML, Chow SK, Looi LM, Yeap SS. Tuberculosis or systemic lupus erythematosus. A diagnostic and therapeutic dilemma. Southeast Asian J Trop Med Public Health 2003; 34: 361-364.


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