Peran Plasmafaresis pada Terapi Pasien Sepsis dengan Myasthenia Gravis
ABSTRACT

Background: Plasmapheresis is potential to remove harmful or toxic mediator from the circulation. Plasmapheresis have been showed significantly improve outcome in autoimmune disease. The theurapetic efficacy and safety of plasmapheresis in the treatment of the patient in the severe sepsis and septic shock have been studied.

Case: A 18 years old female was diagnosed after respiratory failure due to myasthenia gravis and severe sepsis due to pneumonia. She was referred from other hospital after the failure of anticholinesterase drugs to treat the symptomp of myasthenia gravis. Chest x-ray showed infiltrates at paracardial and basal right lung. Therapy had been given during the ICU stay are antibiotic, supportive drugs, and plasmapheresis was performed for 4 times. After appropiate antibiotic had given and plasmapheresis had been performed, the patient showed improvement of the musclestrength. PatienT successfully weaned from ventilator at day-9, and return to the ward at day-10.

Summary: Plasmapheresis plays important role in the treatment of myasthenia gravis with sepsis. Plasmapheresis is utilized to remove a variety of offending plasma pathogens, such as antibodies, abnormal immunoglobulins and circulating immune complexes

Keywords : Myasthenia gravis, plasmapharesis, intensive care
ABSTRAK

 Pendahuluan : Plasmapheresis berpotensi untuk menghilangkan mediator berbahaya atau beracun dari sirkulasi . Plasmapheresis telah menunjukkan peningkatan keluaran yang bermakna pada penyakit autoimun . Kemanjuran theurapetic dan keamanan plasmapheresis dalam pengobatan pasien di sepsis berat dan syok septik telah dipelajari .

Kasus : Seorang perempuan berusia 18 tahun didiagnosis dengan gagal nafas karena myasthenia gravis dan sepsis berat akibat pneumonia . Dia dirujuk dari rumah sakit lain setelah kegagalan obat antikolinesterase untuk mengobati gejala dari myasthenia gravis. x foto thorax menunjukkan infiltrat di paru-paru kanan paracardial dan basal . Terapi yang diberikan selama di ICU adalah antibiotik , obat-obatan suportif, dan plasmapheresis dilakukan selama 4 kali . Setelah antibiotik yang sesuai diberikan dan plasmapheresis selesai, pasien menunjukkan perbaikan kekuatan otot. Pasien berhasil disapih dari ventilator pada hari ke - 9 , dan kembali ke bangsal di hari - 10 .

Ringkasan : Plasmapheresis memainkan peran penting dalam pengobatan myasthenia gravis dengan sepsis . Plasmapheresis digunakan untuk menghapus berbagai factor pemicu dalam plasma , seperti antibodi , imunoglobulin abnormal dan kompleks imun dalam sirkulasi

Kata kunci : Myasthenia gravis, plasmapharesis, terapi intensif
Artikel Sekarang
Dipublikasi pada 01 November 2013
Penulis :
» Ahmad Imron
» Dita Aditianingsih
» Yohanes W George
Kategori : Laporan Kasus
Berkas Artikel (PDF)
Dari Jurnal
Volume V Nomor 3, November 2013 Cover JAI
Daftar Isi | Berkas Full (PDF)

 

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