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

Hallo Ibu,

Steroid memang memiliki banyak efek samping, mulai dari gangguan pencernaan
(maag), penurunan daya tahan tubuh, sampai gangguan hormon (gangguan
pertumbuhan).
Namun terapi yang didapatkan anak ibu termasuk dosis rendah - menengah, dan
penggunaannya pun masih relatif jangka pendek, jadi saya kira efek samping
yang dikhawatirkan belum akan timbul, atau sangat minimal.
Dibandingkan dengan anak penderita asma berat, misalnya, membutuhkan obat
steroid ini untuk jangka waktu lama.

Sama-sama.

Salam,
Peter

2009/3/19 Krisna <sarasw@gmail.com>

>
> 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 <dokter_umum%40yahoogroups.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.
> >
> >
>
>
>