Tips Dan Trik Menegakkan Diagnosis Rinitis Alergi
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Transcript of Tips Dan Trik Menegakkan Diagnosis Rinitis Alergi
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7/24/2019 Tips Dan Trik Menegakkan Diagnosis Rinitis Alergi
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TIPS DAN TRIKSRINITIS ALERGI
dr. Lusiana Herawati Y, Sp. T.H.T.K.L
RSUD Raden Mattaher
a!"i
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PENDAHULUAN
#PS !en$e%uar&an '(( )enispen*a&it untu& d+&ter %a*ananpri!er
Sa%ah satun*a ada%ah rinitis a%er$i
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GEALA ALERGI MULTIPLE TARGET -RGAN
/ 0 DI KEPALA LEHER Hidung Tenggorok Mulut Telinga Mata
Ku%it #r+n&us Sa%uran pen1ernaan
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Dia$n+sis
Ana!nesis
Pe!eri&saan 2sis
Pe!eri&saan penun)an$ Pe!eri&saan in 3i3+
Pe!eri&saan in 3itr+
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ANAMNESIS
Riwa*at pen*a&it se1ara u!u!
Pertan*aan %e"ih spesi2& $e)a%a dihidun$,te!pat tin$$a%4&er)a dan pe&er)aan penderita
Ge)a%a rinitis a%er$i *$ per%u ditan*a&an ad% #ersin "ersin 56/ 7 setiap &a%i terpapar a%er$en8
Rin+re
Hidun$ tersu!"at 5!enetap4"er$anti9$anti8,$ata%
dihidun$, ten$$+r+&, %an$it9%an$it4te%in$a Kd$ disertai!ata $ata%, "erair4&e!erahan,
hip+s!ia4an+s!ia, PND4"atu& &r+ni&
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ten$$+r+& terdapat sensasi $%+"us d$serin$ "erdehe!, "atu&
:re&uensi seran$an, "eratn*apen*a&it, %a!a sa&it,inter!itten4persisten
Apa&ah "erpen$aruh thp &ua%itashidup seperti $$ thp pe&er)aanse&+%ah, tidur dan a&ti2tas seharihari
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Mani;estasi pen*a&it a%er$i %ainse"e%u!4"ersa!aan d$n rinitisAs!a "r+n&ia%
Der!atitis at+pi
Urti&aria
A%er$i !a&anan
Riwa*at at+pi di &e%uar$aApa&ah ada an$$+ta &e%uar$a dari
a*ah4i"u *an$ perna !enderita sa%ahsatu pen*a&it ts" diatas
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:a&t+r pe!i1u ti!"u%n*a $e)a%a Rinitis a%er$i
Lin$&un$an diru!ah, te!pa& &er)a, se&+%ah
Apa&ah ada hu"un$an antara h+"i penderita*an$ dapat !e!pr+3+&asi ti!"u%n*a $e)a%a
Penderita rinitis a%er$i dapat "er&e!"an$!en)adi &eadaan hipera&ti2tas hidun$ thp iritan
n+n spesi2& spt asap r+&+&, "au *$ !eran$san$,udara din$in, p+%utan, "au par;u!, "au de+d+ran
Riwa*at pen$+"atan
E;e&ti2tas +"at *an$ di$una&an se"e%u!n*a
Ma1a! pen$+"atan *an$ sdh diteri!a Kepatuhan "er+"at
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Ge)a%a spesi2& pada ana& A%%er$i1 shiner
A%%er$i1 sa%ute
A%%er$i1 1rease :a1ies aden+id
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Pe!eri&saan :isis :+&us pd hidun$, !ata,
ten$$+r+& dan te%in$a Rin+s&+pi anteri+r atau
nas+end+s&+pi
Mu&+sa hipere!i, pu1at, Li3ideRin+re seperti air, ser+us,
!u&us
Ede!a atau hipert+pi &+n&a
P+%ip, sinusitis, de3iasi =
P+steri+r :arin$ cobblestoneappearance
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Tes A%er$i
In3i3+ Test
oS&in Pri1& TestoIntrader!a% Di%uti+n Test5 IDT 8
Sin$%e Di%uti+n
Mu%tip%e Di%uti+noNasa% Pr+3+1ati+n Test
In3itr+ Testo
A%%er$en Spe1i21 I$ EAssa*RAST
RAST M+di21ati+n
oNasa% S!ear
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Watery anterior and sneezing
*es
Nasal obstruction
Symptoms occur at the
same time every year
N+
Post nasaldrip
Colored discharge
and/orfacial pain
Thepatientmay beallergic
Thepatientis likely
to beallergic
Thepatient isunlikely tobe allergic
Suspectchronic
rhinosinusitis
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Symptoms suggestive of
Allergic Rhinitis
skin prick test
(+)
eosinophil on nasal cytology
(+) (-)
non allergicrhinitis
NARES
(-)
Allergic rhinitis
Classify andassess severity
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Allergic rhinitis ARIA-W! classification
IntermittentSymptom:
>< 4 days/ week
>or < 4 weeks
PersistentSymptom
* > 4 days/ week
* and > 4 weeks
M+derate9se3ere> a"n+r!a% s%eep> a"n+r!a% dai%* a1ti3ities> w+r& and s1h++% pr+"%e!s> distur"in$ s*!pt+!s
Mi%d> n+r!a% s%eep> n+r!a% dai%* a1ti3it*,
sp+rt, re1reati+n>n+r!a% w+r& ? s1h++%>n+ distur"in$ s*!pt+!
G%+ria @'
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PENATALAKSANAANRINITIS ALERGI
Tu)uan pen$+"atan !e598 $e), per"ai&an &ua%itashidup, !598 ES +"at, edu&asi, !en$u"ah )a%ann*apen* 4 terapi &ausa%
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Intermittent symptoms
ild"ot in preferred order
-ra% H'"%+1&er
+r intranasa%
and4+r de1+n$estant
!iagnosis o" #llergic rhinitis
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Intermittent symptoms #ersistent symptoms
oderate$se%ere ild
"ot in preferred order-ra%4 intranasa% H'"%+1&er
and4 +r de1+n$estant+r intranasa%
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#ersistent symptoms
$oderate- severe
improved failure
Step-do%n & continue ' (mo Revie% ) D*+ complianceInfection or other causes
Increaseintranasal &S
doses
'hinorrheaadd
ipratropium
(lockade) adddecongestant/ ral
&S
,ailure) referred to specialist
&onsider speci+c
!iagnosis o" #llergic rhinitis
In preferred orderIntranasal CS, ! bloc"er
'e%iew a"ter ,$4 weeks
Updated ARIA re1+!!endati+n5A%%er$* Sup% BC C @B8
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DA:TAR PUSTAKA
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