ANAFILAKSIS

Iva Yuana DK

PENDAHULUAN
Definisi : Reaksi sistemik yg bersifat akut dan
mengancam jiwa akibat pelepasan mediatormediator dari sel mast dan basofil yg terjadi
secara mendadak.
Pengenalan secara dini thd tanda dan gejala
penting utk penatalaksanaan yg cepat dan
efektif.
Epinefrin : merupakan terapi pilihan, pemberian
lebih dini memberikan prognosis lebih baik

PENYEBAB

Makanan
Obat
Gigitan serangga
Vaksinasi
Lateks
Exercise dan imunoterapi (jarang)
Idiopatik

Prevalensi anafilaksis yg mengancam jiwa :

10 (5-15) per 100.000 orang

Penyebab Anafilaksis

PATOGENESIS
Dua mekanisme yg terjadi pada
anafilaksis :
1. cross-linking reseptor imunoglobulin E
(IgE) dg afinitas tinggi pada permukaan
sel mast dan basofil setelah berikatan
dg IgE.
2. aktivasi mast sel secara langsung
(non-IgE mediated), contoh opiate,
media radiokontras, vankomisin.

Kriteria Klinis Diagnosis Anafilaksis

Memenuhi SATU dari tiga kriteria di bawah ini :
1. Acute onset of an illness (minutes to several hours) involving the skin,
mucosal tissue, or both (eg generalized hives, pruritus or flushing,
swollen lips-tongue-uvula)
AND AT LEAST ONE OF THE FOLLOWING :
a. respiratory compromise
b. reduced blood pressure (BP) or associated symptoms of end-organ
dysfunction
2. Two or more of the following that occur rapidly after exposure to a likely
allergen for that patient (minutes to several hours) :
a. involvement of the skin-mucosal tissue
b. respiratory compromised
c. reduced BP or associated symptoms
d. persistent gastrointestinal symptoms
3. Reduced BP after exposure to known allergen for that patient (minutes
to several hours) :
a. infants and children : low systolic BP (age speific) or greater than
30% decrease in systolic BP
b. adults : systolic BP of less than 90 mmHg or greater than 30%
decrease from that persons baseline
Low systemic blood perssure for children is defined as less than 70 mmHg
from 1 month to 1 year, less than (70 mmHg + [2xage]) from 1 to 10

TATALAKSANA
First line : Epinefrin
pengenceran 1 : 1000
Dosis 0.01 mg/kg, maksimal 0.3 mg
Diberikan scr intramuskuler tiap 5 menit bila
diperlukan
Second line :
Diphenhydramine 1-2 mg/kg setiap 6 jam
Ranitidin 1-2 mg/kg setiap 12 jam
-agonis dapat diberikan bila terdapat
bronkospasme atau wheezing

Tatalaksana Jangka Panjang

Identifikasi agen penyebab bila
memungkinkan
Penghindaran pencetus
Imunoterapi

TERIMA KASIH