| ARTIKEL ASLI |
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| XERODERMA PIGMENTOSUM: PENDEKATAN DIAGNOSIS BERDASARKAN GAMBARAN KLINIS |
| Suswardana, Arief Budiyanto, Sunardi Radiono |
| Bagian/SMF IK Kulit dan Kelamin FK Universitas Gadjah Mada/RSUP Dr. Sardjito - Jl. Kesehatan 1, Skip, Yogyakarta |
| ABSTRAK |
<!-- /* Font Definitions */ @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:0; mso-generic-font-family:roman; mso-font-pitch:variable; mso-font-signature:-1610611985 1107304683 0 0 159 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman","serif"; mso-fareast-font-family:"Times New Roman";} .MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; font-size:10.0pt; mso-ansi-font-size:10.0pt; mso-bidi-font-size:10.0pt; mso-ascii-font-family:Calibri; mso-fareast-font-family:Calibri; mso-hansi-font-family:Calibri;} @page Section1 {size:612.0pt 792.0pt; margin:72.0pt 72.0pt 72.0pt 72.0pt; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> Xeroderma pigmentosum (XP) merupakan genodermatosis akibat defek pada gen penyandi protein yang terlibat dalam proses DNA-repair. Kelainan ini jarang dijumpai dan diturunkan secara resesif autosomal. Organ yang sering mengalami kelainan adalah kulit, mata dan sistem saraf. Diagnosis dan fotoproteksi adekuat sejak dini akan mencegah makin beratnya kelainan kulit dan mata pasien. Makalah berikut melaporkan satu kasus XP pada seorang anak wanita yang mengalami keterlambatan diagnosis sehingga dijumpai kelainan kulit, mata dan neurologis yang parah yang timbul pada usia dini, abnormalitas perkembangan fungsi motorik, abnormalitas kemampuan bicara, mikrosefali, gizi kurang, shunted dan failure to thrive dan adanya pertumbuhan keganasan. Pembahasan ditekankan pada pemahaman tanda dan gejala awal XP untuk diagnosis dini serta langkah pendekatan diagnosis genotip berdasarkan gambaran klinis pasien untuk penentuan tipe komplementasi, sehingga diagnosis dapat ditegakkan sedini mungkin dengan penatalaksanaan yang adekuat.Pasien ini mendapat tatalaksana multidisipliner yang terdiri dari bagian kulit, anak, gizi, THT, mata, patologi anatomi, rehabilitasi medik dan konseling genetik. Keterlambatan diagnosis mengakibatkan prognosis pasien menjadi lebih buruk. (MDVI 2007; 34/2 : 69-74)
Kata kunci: xeroderma pigmentosum, diagnosis dini, tipe komplementasi |
| ABSTRACT |
<!-- /* Font Definitions */ @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:0; mso-generic-font-family:roman; mso-font-pitch:variable; mso-font-signature:-1610611985 1107304683 0 0 159 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman","serif"; mso-fareast-font-family:"Times New Roman";} .MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; font-size:10.0pt; mso-ansi-font-size:10.0pt; mso-bidi-font-size:10.0pt; mso-ascii-font-family:Calibri; mso-fareast-font-family:Calibri; mso-hansi-font-family:Calibri;} @page Section1 {size:612.0pt 792.0pt; margin:72.0pt 72.0pt 72.0pt 72.0pt; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> Xeroderma pigmentosum is a rare autosomal recessive genodermatoses caused by a defect on DNA repair genes. The clinical manifestation is characterized by involvement of skin, eyes and neurologic system. Early diagnosis and adequate photoprotection may protect the patient from progressive skin and eyes involvement. This paper report a late diagnosis of XP on a little girl that cause an early onset of severe skin and eyes involvement, abnormality of motoric functional development, disability to speech, microcephaly, bad nutrition, shunted and failure to thrive and malignant development. The discussion is focused on understanding the signs and symptoms of xeroderma pigmentosum, including each complementation type, to provide an early diagnosis and adequate management. These patient had multidiciplinair managements from Department of Dermatology, Pediatric, Nutrition, ENT, Ophthalmology, Patology Anatomy, Medical Rehabitilation and Genetic Conselling. A late diagnosis may caused a worse prognosis for the patient. (MDVI 2007; 34/2 : 69-74)
Keywords: xeroderma pigmentosum, early diagnosis, complementation type |