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19 Maret 2009

Re: [Dokter Umum] Apakah Lameson Tab 16 Mg cocok untuk therapi ITP -urgent please

Terima kasih Dr Peter, atas informasinya. Apakah ada effek samping dari obat ini ? atas penjelasannya saya ucapkan terima kasih


Ibu Saraswati


-- In dokter_umum@yahoogroups.com, Peter K <physiqal@...> wrote:
>
> Dear Ibu Saraswati,
>
> Saya turut prihatin atas anak ibu yang menderita ITP (Idiopathic
> Thrombocytopenic Purpura), suatu keadaan penurunan kadar trombosit yang
> disertai gejala perdarahan (ringan-berat), misalnya bintik2 merah di kulit
> atau mimisan, yang sebabnya tidak diketahui (biasanya autoimun = imun tubuh
> sendiri menghancurkan trombosit dalam tubuh sendiri), biasa terjadi beberapa
> minggu setelah infeksi virus (flu?), atau obat-obatan, atau penyakit
> autoimun lain yg tidak terdeteksi, atau bisa juga timbul 'begitu' saja.
>
> Lameson adalah sejenis steroid, yang disini berfungsi untuk menekan sistem
> immun pada anak, sehingga mengurangi reaksi autoimun tersebut, dan
> diharapkan pengrusakan trobosit oleh tubuh bisa ditekan, sehingga produksi
> trombosit oleh tubuh bisa mengejar penghancuran oleh sistem imun.
>
> Jadi saran saya, terus kontrol ke dokter anaknya, dan hindarkan anak dari
> aktivitas yg beresiko menimbulkan trauma (misal lari-larian) apabila kadar
> trobosit masih relatif rendah ( <75.000).
> Jangan menghentikan penggunaan Lameson secara mendadak, harus sesuai saran
> dokter karena nanti dosis akan diturunkan secara bertahap (tapering off).
>
> ITP *biasanya* akan sembuh sendiri dalam waktu maximum 6 bulan.
>
> Berikut informasi lebih lengkap mengenai itp
>
> ITP stands for Immune (also referred to as idiopathic) Thrombocytopenic (a decreased platelet number) Purpura (purplish areas of skin and mucous membranes).
>
> You may also hear the term "Idiopathic" Thrombocytopenic Purpura which means the cause of the low platelets is unknown.
>
> ITP occurs when a person makes antiplatelet antibodies which attach to his/her own platelets. The antibodies cause the immune system to destroy the platelets. This results in a decrease in the platelet count.
>
> Platelets are the blood cells that help form clots to stop bleeding.
>
> A blood test is done to count the number of platelets you /your child has.
>
> A normal platelet count is higher than 150,000/mm3.
>
> Hematologists generally agree that platelet counts:
>
> higher than 100,000/mm3 are always safe,
>
> higher than 30,000/mm3 are nearly always safe, and
>
> lower than 10,000/mm3 may be associated with an increased risk of bleeding.
>
>
> The cause of ITP is not known.
>
> ITP has been associated with:
>
> recent viral infection,
>
> some medications,
>
> immune disorders (including Lupus), and
>
> infections.
>
> There is nothing you did to cause ITP.
>
> ITP is not contagious.
>
> There is no cure for ITP. Fortunately, most childhood cases resolve on their own.
>
>
> The main reason to treat ITP is to keep you/your child's platelet count in a safe range so that the risk of bleeding is minimized.
>
> Platelet counts lower than 10,000 may increase the risk of bleeding.
>
> Therapy temporarily raises the platelet count to minimize the bleeding risk.
>
>
> The treatment for ITP may include:
>
> observation (monitoring platelet counts),
>
> stopping medications that are thought to cause ITP, and
>
> treating infections.
>
> Other treatments such as steroids, Winrho, IVIG, and/or 6-mercaptopurine infusions may be considered. These medications help to trick the body's response so that it does not destroy the platelets.
>
> In some instances a splenectomy (removal of the spleen) may be recommended.
>
> Platelet counts may go up and down for many months.
>
> Childhood ITP usually resolves itself within 6 months.
>
> Some patients do not resolve within this period of time and continue with Chronic ITP.
>
> Some patients may also require several courses of treatment before the ITP resolves at a later time.
>
> http://www.itpkids.org/content/about_itp.html
>
> Demikian sedikit masukan dari saya, semoga bermanfaat.
>
> Salam,
> Peter, dr.
>
>


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