Mohamad Yanuar Anggara
Department of Child Health, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin General Hospital

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Laporan Kasus: Penyakit Kawasaki Atipikal Setiabudiawan, Budi; Ghrahani, Reni; Sapartini, Gartika; Anggara, Mohamad Yanuar; Garna, Herry
Majalah Kedokteran Bandung Vol 43, No 3 (2011)
Publisher : Fakultas Kedokteran, Universitas Padjadjaran

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Abstract

Penyakit Kawasaki merupakan penyebab utama kelainan jantung dapatan yang sering ditemukan pada anak. Di Indonesia, penyakit ini masih sangat jarang didiagnosis karena dianggap masih jarang dan belum diketahui secara luas. Dua laporan kasus berikut merupakan laporan kasus anak perempuan dan laki-laki, masing-masing berusia 17 bulan dan 3 tahun. Keduanya datang dengan demam yang persisten lebih dari 5 hari dan hanya memenuhi 3 kriteria klasik penyakit Kawasaki, yakni mata merah dan disertai dengan perubahan mukosa bibir serta ekstremitas. Penderita kemudian didiagnosis sebagai penyakit Kawasaki atipikal. Pada pemeriksaan laboratorium didapatkan peningkatan C-reactive protein dan laju endap darah disertai gambaran ekokardiografi yang normal. Kedua anak diberikan imunoglobulin intravena (IGIV) dengan dosis 2 gram/kgBB dosis tunggal dan aspirin dosis 80 mg/kgBB/hari. Penderita mengalami perbaikan setelah 1 hari mendapat terapi kombinasi tersebut. Disimpulkan bahwa pengobatan dengan kombinasi IGIV dan aspirin memberikan respons yang baik pada penyakit Kawasaki atipikal. [MKB. 2011;43(3):146–52].Kata kunci: Aspirin, imunoglobulin intravena, penyakit Kawasaki atipikal Case Reports: Atypical Kawasaki DiseaseKawasaki disease is the most common cause of acquired heart disease in children. In Indonesia the disease is rare to diagnosed, because of difficulty in diagnosis and not widely known. These were 2 case reports about a girl and a boy age 17 months and 3 years, who came with persistent fever more than 5 days and only fulfilled 3 criteria of Kawasaki disease, which are red eyes, changes in lips, mucose of oral and extremities. They were diagnosed as atypical Kawasaki disease. Laboratory examinations showed an increased of C-reactive protein and erythrocyte sedimentation rate with normal echocardiography. The patients were improved after treated with 2 grams per bodyweight of intravenous immunoglobulin (IVIG) and 80 mg per bodyweight of aspirin. The patients were better after one day combination therapy. In conclusion that atypical Kawasaki disease has good response to combination of IVIG and aspirin. [MKB. 2011;43(3):146–52].Key words: Aspirin, atypical Kawasaki disease, intravenous immunoglobulin
Nephropathy and Encephalopathy in an Indonesian Patient with Dengue Viral Infection Rachmadi, Dedi; Anggara, Mohamad Yanuar
International Journal of Integrated Health Sciences VOL 1, NO 1, July (2013)
Publisher : International Journal of Integrated Health Sciences

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Abstract

Objective: To describe unusual manifestation of dengue virus infection that has been increasing in number and elucidate the indirect effect of dengue infection on the central nervous system which may explain the occurence of dengue encephalopathy. Methods: A case report of 6-year-old boy who was admitted with a history of fever for three days, accompanied with decreased consciousness, hypertension, and edema is presented. Laboratory examination showed hemoconcentration, thrombocytopenia, with positive anti dengue Immunoglobulin G (IgG) and IgM, microscopic glomerular hematuria, and proteinuria as well as normal creatinine serum level. He was treated with supportive treatment. Results: After six days, the consciousness was improved and blood pressure was normal.  Proteinuia was alleviated by Day 11 and completely negative on Day 19.  Microscopic glomerular hematuria was negative after 6 months.Conclusions: Recognition of unusual dengue manifestations is important in early diagnosis and effective treatment of the disease.Keywords: Dengue virus infection, encephalopathy, nephropathy DOI: 10.15850/ijihs.v1n1.108
Nephropathy and Encephalopathy in an Indonesian Patient with Dengue Viral Infection Rachmadi, Dedi; Anggara, Mohamad Yanuar
International Journal of Integrated Health Sciences Vol 1, No 1 (2013)
Publisher : International Journal of Integrated Health Sciences

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Abstract

Objective: To describe unusual manifestation of dengue virus infection that has been increasing in number and elucidate the indirect effect of dengue infection on the central nervous system which may explain the occurence of dengue encephalopathy. Methods: A case report of 6-year-old boy who was admitted with a history of fever for three days, accompanied with decreased consciousness, hypertension, and edema is presented. Laboratory examination showed hemoconcentration, thrombocytopenia, with positive anti dengue Immunoglobulin G (IgG) and IgM, microscopic glomerular hematuria, and proteinuria as well as normal creatinine serum level. He was treated with supportive treatment. Results: After six days, the consciousness was improved and blood pressure was normal.  Proteinuia was alleviated by Day 11 and completely negative on Day 19.  Microscopic glomerular hematuria was negative after 6 months.Conclusions: Recognition of unusual dengue manifestations is important in early diagnosis and effective treatment of the disease.Keywords: Dengue virus infection, encephalopathy, nephropathy DOI: 10.15850/ijihs.v1n1.108