patogenesis riniti alergi
DESCRIPTION
dadTRANSCRIPT
![Page 1: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/1.jpg)
Patogenesis Rinitis Alergi
ReferatIchsan Juliansyah Juanda
PembimbingProf. Dr. Teti HS Madiadipoera, dr. SpTHT-KL(K) FAAAAI
DEPTARTEMEN TELINGA HIDUNG TENGGOROK BEDAH KEPALA DAN LEHER
FAKULTAS KEDOKTERAN UNIVERSITAS PADJADJARANRSUP DR. HASAN SADIKIN
BANDUNG2015 1
![Page 2: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/2.jpg)
Pendahuluan
• Rinitis alergi (RA) adalah suatu gangguan fungsi hidung yang terjadi setelah pajanan alergen melalui inflamasi mukosa hidung dengan diperantai IgE.
• (Bersin-bersin, hidung tersumbat, beringus dan gatal) sembuh spontan dengan atau tanpa pengobatan
2Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Introduction in. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 Allergy. 2008
![Page 3: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/3.jpg)
Epidemiology• Survei Nasional 2006 54.6 % di USA
menunjukan hasil positif pada 1 alergen• Angka kejadian rinitis alergi pada poli klinik rhino
alergi di RSHS dari Januari – Desember 201280%
(1037 pasien)• Data epidemiologi mendukung hubungan antara
saluran nafas atas dan saluran nafas bawah: Asma (+) pada 20-50% pasien RA
RA (+) pada 80% pasien Asma
Prof.Supriyatin, in JIFESS 2012.A KleinJan et al Clinical & experimental allergy 2009, 40; 494-504
3
![Page 4: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/4.jpg)
Klasifikasi Rinitis Alergi(ARIA-WHO 2008)
4
![Page 5: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/5.jpg)
Patogenesis Rinitis Alergi James N. Baraniuk
5
![Page 6: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/6.jpg)
Pathophysiology Of Rhinitis
7Pathophysiology of Allergic and Nonallergic Rhinitis, Betul Sin and Alkis Togias
![Page 7: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/7.jpg)
Pathophysiology Of Rhinitis
8Pathophysiology of Allergic and Nonallergic Rhinitis, Betul Sin and Alkis Togias
![Page 8: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/8.jpg)
IgE Immediate Hypersensitivity(Gel and Coombs Type 1)
9
Mast Cell-derived mediators (vasoactive amines, lipid mediators, cytokines)
Cytokine-mediated inflammation (eosinophilis, neutrophils)
Abbas, AK, Lichtman AH, Pillai S. Immediate Hypersensitivity. In: Basic Imunology Function and Disorders of The Immune System, Fourth edition, p 208, Philadelphia, Saunder Elsivier, 2014
![Page 9: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/9.jpg)
10
Immediate Hypersensitivity
Abbas, AK, Lichtman AH, Pillai S. Immediate Hypersensitivity. In: Basic Imunology Function and Disorders of The Immune System, Fourth edition, p 210, Philadelphia, Saunder Elsivier, 2014
![Page 10: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/10.jpg)
11
Immediate Hypersensitivity
Abbas, AK, Lichtman AH, Pillai S. Immediate Hypersensitivity. In: Basic Imunology Function and Disorders of The Immune System, Fourth edition, p 210, Philadelphia, Saunder Elsivier, 2014
![Page 11: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/11.jpg)
12
Abbas, AK, Lichtman AH, Pillai S. Immediate Hypersensitivity. In: Basic Imunology Function and Disorders of The Immune System, Fourth edition, p 211, Philadelphia, Saunder Elsivier, 2014
![Page 12: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/12.jpg)
Produksi dan Aksi Mediator Mast Sel
13
Abbas, AK, Lichtman AH, Pillai S. Immediate Hypersensitivity. In: Basic Imunology Function and Disorders of The Immune System, Fourth edition, p 212, Philadelphia, Saunder Elsivier, 2014
• Vasoactive amines• Protease• Prostaglandin• Leukotriens• Cytokines e.g TNF
![Page 13: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/13.jpg)
Respon Cepat dan Lambat
14
Abbas, AK, Lichtman AH, Pillai S. Immediate Hypersensitivity. In: Cellular And Molecular Immunology, International Edition, Sixth edition, Saunder Elsivier, 2014
![Page 14: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/14.jpg)
Proses Inflamasi Neurogenik Yang Menyebabkan Hidung Gatal Dan Bersin
15Oliver Pfaar. Pathophysiology of Itching and Sneezing in Allergic Rhinitis. Swiss Med 2009;139 35-40
![Page 15: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/15.jpg)
The Hygiene Hypothesis
16
![Page 16: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/16.jpg)
17
![Page 17: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/17.jpg)
Mekanisme Hidung Tersumbat
18
![Page 18: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/18.jpg)
Penatalaksanaan Rinitis Alergi
Hindari AlergenBila memungkinkan
FarmakoterapiKeamananEfektifitas
Mudah didapatkan
ImmunotherapyEfektivitas
Oleh SpesialisMenekan awal penyebab
penyakit
Edukasi PasienDiwajibkan
Bousquet et al. J Allergy Clin Immunol. 2001;108 (5 suppl):S147. 19
Manajemen
![Page 19: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/19.jpg)
20
![Page 20: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/20.jpg)
Terima Kasih
21
![Page 21: Patogenesis Riniti Alergi](https://reader035.vdocuments.site/reader035/viewer/2022081417/5695d15d1a28ab9b02964073/html5/thumbnails/21.jpg)
Intradermal Dilution Test• The upper outer, hairless surface of the arm is wiped with alcohol and
dried• Mark horizontally from 6 to 1 with 2 cm spaces• After controls are placed, and response indicating the patient’s
appropriate state • Specific antigen testing begins for #6 dilution of all of the different
antigens• Inject 0,02 mL of antigen to produce 4 mm skin wheal• Observe for 10-20 minutes• If initial test at #6 is negative, another #5 dilution is placed and so on
until the dilutions are shown to be negative or positive response (horizontal testing)
31Krouse, J. Managing the Allergic Patient, Saunders, 2009