Pola Penyakit Infeksi pada Thalassemia

Mururul Aisyi, Alan R Tumbelaka

Sari


Pasien thalassemia rentan terhadap infeksi akibat faktor penyakitnya maupun akibat
pengobatan. Kelebihan besi yang terjadi akibat transfusi berulang mempengaruhi sistim
imun, menekan aksi kemotaksis fagositosis, mikrobiosidal leukosit mononuklear dan
polimorfonuklear. Penularan infeksi melalui transfusi seperti virus hepatitis, HIV dan
CMV merupakan komplikasi transfusi yang ditakuti. Infeksi virus hepatitis yang
ditularkan melalui transfusi antara lain hepatitis A, Hepatitis B, hepatitis C dan hepatitis
D. hepatitis C mungkin merupakan penyebab utama sirosis hepatitis pada pasien
thalassemia yang mendapat transfusi. Infeksi bakteri S. pneumoniae merupakan penyebab
terbanyak bakteremia terutama pada pasien thalassemia yang menjalani operasi
splenektomi. Osteomielitis yang terjadi akibat infeksi tulang yang mengalami infark
biasanya disebabkan oleh spesies Salmonella. Vaksin polisakarida pneumokokus
direkomendasikan pada anak 2 tahun atau lebih dan ulangan diberikan setelah 3-5 tahun
pada pasien thalassemia di bawah umur 10 tahun. Infeksi parasit malaria pada thalassemia
sangat rendah; terdapat bukti yang terbatas bahwa perubahan respons imun pada pasien
dengan varian gen globin mungkin berperan penting pada resistensi terhadap malaria.
Mengingat banyaknya penyakit atau komplikasi yang timbul pada pasien thalassemia
maka perlu dilakukan pemantauan seumur hidup.


Kata Kunci


thalassemia; bakteri; sistim imun

Teks Lengkap:

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DOI: http://dx.doi.org/10.14238/sp5.1.2003.27-33

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