presentasi referat buerger disease
TRANSCRIPT
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BUERGER’S DISEASEDisusun oleh:
Diah Andini
Hein Intan
Nordiansyah
Sandra Rini
Tri Agustina Dewi
Tryvanie R Putra
Yusi Farida
Perseptor:
dr H Yus!aidi" Sp#
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HISTORY
Jerman 1879, Von Winiwarter : “ A strange
of endarteritis and endophlebitis with gang
of the feet ”
Brooklyn New York 1908, Leo Buerger : “ Pres
spontaneous gangrene“
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DEFINISI
Thromboangiitis Obliterans T!O"
#enyakit okl$si %emb$l$h &arah arteri &an 'ena
ber$k$ran ke(il &an se&ang ekstremitas bagian &is
'asokonstriksi ata$ obstr$ksi sebagian oleh in)lamasi
bek$an meng$rangi aliran &arah ke *aringan+
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ETIOLOGI
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Ti&ak&iketah$i
se(ara %asti.okok
/enetik
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PATOFISIOLOGI
↑ im$nitas sel$ler kolagen ti%e &an
↑ ser$m titer anti en&othelial antibo&y sel
$tasi gen %rothrombin 20210 &an a&anya antibo&
anti(ar&ioli%in
↑ %arameter hemorheologi(al se%erti hematokrit,rigi&itas sel &arah merah &an 'iskositas &arah
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PATOFISIOLOGI
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DIAGNOSIS
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DIAGNOSIS
!N!N344
#33.54!!N 645• !llen test
#33.54!!N #3NNJ!N/• aboratori$m
•
4/ &o%%ler• !ngiogra)i
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MANIFESTASI KLINIS
Jari tangan ata$ kaki tam%ak %$(at, kemerahan ata$ kebir$an
terasa &ingin saat &isent$h
Nyeri yang tiba tiba %a&a tangan &an kaki, terasa se%erti terb
Nyeri %a&a tangan &an kaki sering ter*a&i saat istirahat
bertambah ketika tangan &an kaki ter%a%ar &ingin ata$ selama
ter*a&i stres emosional Nyeri %a&a %aha, t$ngkai ata$ kaki ketika ber*alan kla$&ikasi"
#er$bahan %a&a k$lit ata$ $lk$s ke(il yang nyeri %a&a *ari tang
ata$ kaki
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ALLEN TEST
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USG DOPPLER
nt$k mengetah$i ke(e%atan aliran &arah &alam
%emb$l$h &arah
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ANGIOGRAFI
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KRITERIA KLINIS (ELLEN ET AL) $sia k$rang &ari - tah$n
riwayat ata$ se&ang mengg$nakan tembaka$
iskemia ekstremitas &istal
eksl$si a$toimm$ne &isease &an &iabetes
eksl$si s$mber emboli %roksimal
hasil angiogra%hy yang konsisten
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DIAGNOSIS (SKORING)
Kriteria +1 +2
sia onset 0;-0 tah$n < =5la$&ikasio
intermiten kaki!&a riwayat !&a saat
%emeriksaan
3kstremitasatas
!simtomatik 4imtomatik
Trombo)lebitiss$%er)isial
migrans
!&a riwayat !&a saat%emeriksaan
6enomenarayna$&
!&a riwayat !&a saat%emeriksaan
!ngiogra)i,bio%si
5has $nt$ksalah sat$
5has $nt$kke&$anya
Kriteria 1
sia onset -;0 tah$n
Jenis kelamin,kebiasaanmerokok
>anita
okasi 1 ekstremita
?ilangnya%$lsasi
Bra(hial
!rtriosklerosis,@, ?T &an
hi%erli%i&emia
Ter&iagnosis 10 th kem$&i
0;1 &iagnosis Buerger’s disease tersingkirkan -; %robabilitas se&ang
2; tersangka, %robabilitas ren&ah A %robabilitas tinggi, &iagnosis &a%at &i%astikan
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DIAGNOSIS BANDING !theros(lerosis
#eri%heral arterial o((l$si'e &isease
.ayna$& &isease
4ystemi( l$%$s erythemato$s
@iabetes melit$s
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TERAPI
Berhenti merokok
?in&ari s$h$ &ingin
5om%res hangat
!ntibiotik
!s%irin &an obat 'aso&ilator
@ebri&ement konser'ati) 4$rgi(al sym%athe(tomy
!m%$tasi
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AMPUTATION
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AMPUTATION
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PROGNOSIS
Berhenti merokok menghentikan %rogresi'itas
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T e r a % i t e r b a i k
!UIT SMOKING"""
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REFERENSI !CiCi , et al+ Thromboangiitis obliterans and endothelial function+ 3$ro%ea
Jo$rnal o) Dlini(al n'estigation+ 2010E-0:18+ @argon #T, an&ry /J+ B$ergerGs &isease+ !nn Has( 4$rg+
anCer #, To%ol 3J+ PanVascular edicine: !ntegrated "linical anagement+
Jerman: 4%ringerE 2002+
Olin J>+ #ther peripheral arterial diseases+ n: /ol&man , 4(ha)er !, e&s+
/ol&manGs De(il e&i(ine+ #hila&el%hia, #!: 3lse'ier 4a$n&ersE 2011+
Olin J>, 4hih !+ Thromboangiitis obliterans $Buerger%s disease&+ D$rr O%in.he$matol+ 200 JanE181":18;2-+
#iaCCa /, Dreagar !+ Thromboangiitis obliterans+ Dir($lation !?!+ 2010+
1211":188;1+
htt%s:IIwww+nlm+nih+go'Ime&line%l$sIen(yIarti(leI000172+htm
https://www.nlm.nih.gov/medlineplus/ency/article/000172.htmhttps://www.nlm.nih.gov/medlineplus/ency/article/000172.htmhttps://www.nlm.nih.gov/medlineplus/ency/article/000172.htm
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SOME PEOPLE #UST $AN’T !UIT"
(E%EN IF IT $OSTS AN ARM & A LEG")
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TERIMA K