Kortikosteroid sebagai Profilaksis Nefritis pada Purpura Henoch-Schonlein

Ratih Dewi Palupi, Zakiudin Munasir

Sari


Purpura Henoch-Schonlein (PHS) merupakan penyakit vaskulitis tersering pada anak. Sebagian besar
kasus PHS bersifat sembuh sendiri (self-limiting). Morbiditas dan mortalitas jangka panjang PHS berkaitan
dengan keterlibatan ginjal. Nefropati persisten terjadi pada 1% dari keseluruhan kasus PHS dan kurang dari
1% mengalami progresifitas menjadi gagal ginjal terminal. Tata laksana PHS terutama bersifat suportif.
Kortikosteroid digunakan pada kasus PHS dengan nyeri perut, edema subkutan, dan nefritis. Penggunaan
kortikosteroid sebagai profilaksis terjadinya gangguan ginjal pada PHS masih merupakan kontroversi.
Pemberian kortikosteroid dini tidak dapat mencegah terjadinya keterlibatan ginjal pada PHS namun dapat
mengurangi beratnya manifestasi gastrointestinal dan mengurangi risiko kelainan ginjal persisten.


Kata Kunci


purpura Henoch-Schonlein; kortikosteroid; profilaksis

Teks Lengkap:

PDF

Referensi


Tizard EJ. Henoch-Schonlein purpura. Arch Dis Child

;80:380-3.

Gonzalez-Gay MA, Llorca J. Controversies on the use of

corticosteroid therapy in children with Henoch-Schonlein

purpura. Semin Arthritis Rheum 2005;35:135-7.

Oxford Centre of Evidence-based Medicine. Oxford

Centre of Evidence-based Medicine Levels of Evidence.

Diunduh dari: http://www.cebm.net/index aspx?o=1025

Trapani S, Micheli A, Grisolia F, Resti M, Chiappini E,

Falcini F, dkk. Henoch Schonlein purpura in childhood:

Epidemiological and clinical analysis of 150 cases over

a 5-year period and review of literature. Semin Arthritis

Rheum 2005;35:143-53.

Rosenblum ND, Winter HS. Steroid effects on the course

of abdominal pain in children with Henoch-Schonlein

purpura. Pediatrics 1987;79:1018-21.

Saulsbury FT. Henoch-Schonlein purpura in children:

Report of 100 patients and review of the literature.

Medicine 1999;78:395-409.

Weiss PF, Feinstein JA, Luan X. Effects of corticosteroid

on Henoch-Schonlein purpura: a systematic review.

Pediatrics 2007;120:1079-87.

Mollica F, Li Volti S, Garozzo R, Russo G. Effectiveness

of early prednisone treatment in preventing the

development of nephropathy in anaphylactoid purpura.

Eur J Pediatr 1992;151:140-4.

Buchanec J, Galanda V, Belakova S, Minarik M,

Zibolen M. Incidence of renal complications in

Schonlein-Henoch purpura syndrome in dependence

of an early administration of steroids. Int Urol Nephrol

;20:409-12.

Kaku Y, Nohara K, Honda S. Renal involvement in

Henoch-Schonlein purpura: A multivariate analysis of

prognostic factors. Kidney Int 1998;53:1755-9.

Saulsbury FT. Corticosteroid therapy does not prevent

nephritis in Henoch-Schonlein purpura. Pediatr Nephrol

;7:69-71.

Huber AM, King J, McLaine P, Klassen T, Pothos M.

A randomized, placebo-controlled trial of prednisone

in early Henoch Schonlein Purpura. BMC Med

;2:7.

Gonzalez-Gay MA, Calvino MC, Vazquez-Lopez ME,

Garcia-Porrua C, Fernandez-Iglesias JL, Dierssen T,

dkk. Implications of upper respiratory tract infections

and drugs in the clinical spectrum of Henoch-

Schonlein purpura in children. Clin Exp Rheumatol

;22:781-4.

De Almeida JL, Campos LM, Paim LB, Leone C, Koch

VH, Silva CA. Renal involvement in Henoch-Schonlein

purpura: a multivariate analysis of initial prognostic

factors. J Pediatr (Rio J) 2007;83:259-66.

Rai A, Nast C, Adler S. Henoch-Schonlein purpura

nephritis. J Am Soc Nephrol 1999;10:2637-44.

Coppo R, Mazzucco G, Cagnoli L, Lupo A, Schena FP.

Long-term prognosis of Henoch-Schonlein nephritis

in adults and children. Nephrol Dial Transplant

;12:2277-83.

Ronkainen J, Nuutinen M, Koskimies O. The

adult kidney 24 years after childhood Henoch-

Schonlein purpura: a retrospective cohort study. Lancet

;360:666-70.

Sano H, Izumida M, Shimizu H, Ogawa Y. Risk factors of

renal involvement and significant proteinuria in Henoch-

Schonlein purpura. Eur J Pediatr 2002;161:196-201.

Lanzkowsky S, Lanzkowsky L, Lanzkowsky P. Henoch-

Schonlein purpura. Pediatr Rev 1992;13:130-7.




DOI: http://dx.doi.org/10.14238/sp11.6.2010.409-14

Refbacks

  • Saat ini tidak ada refbacks.


##submission.copyrightStatement##

##submission.license.cc.by-nc-sa4.footer##

Informasi Editorial:
Badan Penerbit Ikatan Dokter Anak Indonesia
Jl. Salemba I No 5, Jakarta 10430, Indonesia
Phone/Fax: +62-21-3912577
Email: editorial [at] saripediatri.org

Lisensi Creative Commons
Sari Pediatri diterbitkan oleh Badan Penerbit Ikatan Dokter Anak Indonesia
Ciptaan disebarluaskan di bawah Lisensi Creative Commons Atribusi-NonKomersial-BerbagiSerupa 4.0 Internasional.