Gambaran Klinis Ketoasidosis Diabetikum Anak
DOI:
https://doi.org/10.21776/ub.jkb.2012.027.02.10Abstract
Penelitian ini dilakukan untuk menggambarkan profil klinis ketoasidosis diabetikum pada anak. Data dikumpulkan dari rekam medik gambaran klinis pasien ketoasidosis diabetikum yang didapatkan di Bagian Anak Rumah Sakit dr . Saiful Anwar Malang pada tahun 2005-2009. Pada masa penelitian ini didapatkan 19 pasien dengan usia 1-14 tahun dengan proporsi 58% perempuan, 53% berusia antara 5-10 tahun dan 63% mengalami gizi kurang. Pada 53% pasien memberikan gambaran konsentrasi bikarbonat pada darah sebesar  5-9,9 mmol/L. osmolaritas darah >295-400 mOsm/l ditemukan pada 84% pasien dan 53% pasien mempunyai level potasium 3,5-5 mmol/L dan 42% pasien mempunyai kadar leukosit 10.000-<20.000/ul.  Keluhan  yang  paling  banyak  ditemukan  pada  pasien  adalah  muntah,  nyeri  perut,  penurunan kesadaran, kejang, diare, penurunan berat badan, polyuria, polydipsia, polyphagi dan demam. Keluhan terbanyak adalah polyuria yang didapatkan pada 16% kasus. Sebagian besar (67%) penderita Ketoasidosis Diabetikum anak mempunyai kadar keton  lebih dari 5 mmol/l dan 61% mengalami ketonuri  (4+) serta 63% pasien mempunyai anion gap 12.0-24.0.
Kata Kunci: Anak, gambaran klinis, ketoasidosis diabetikeum
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References
Piva JP, Czepielewskii M, Garcia PC, and Machado D.Current Perspectives for Treating Children with Diabetic Ketoacidosis. Jornal de Pediatria. 2007;83(5): S119-127.
Kitabchi AE and Nyenwe EA. Hyperglycemic Crises in Patients With Diabetes Melitus: Diabetic Ketoacidosis and Hyperglycemi c Hyperosmolar State. Endocrinology and Metabolism Clinics of North America. 2006; 35(4): 725-751.
Cokram CS. The Epidemiology of Diabetes Mellitus in the Asia-Pasific Region. Hong Kong Medical Journal.2000; 6(1): 43-52.
Charfen MA and Fernandez-Frackelton M. Diabetic Ketoacidosis. Emergency Medicine Clinics of North America. 2005; 23(3): 609-628.
Danne T, Lange K, and Kordonouri O. New Developments in the Treatment of Type 1 Diabetes in Children. Archives of Desease in Childhood. 2007;92(11): 1015-1019.
Dunger DB, Sperling MA, Acerini CL, et al. European Society for Paediatric Endocrinology/Lawson Wilkins Paediatric Endocrine Society Consensus Statement on Diabetic Ketoacidosis in Children and Adolescent. Pediatrics. 2004; 113(2): e133-140.
Kirschbaum B, Sica D, and Anderson FP. Urine Electrolytes and the Urine Anion and Osmolar Gaps. Journal of Laboratory and Clinical Medicine. 1999;133(6): 597-604.
Rosenbloom Al, Silverstain JH, Amemiya S, Zeitler P,and Klingensmith. Type 2 Diabetes in Children and Adolescent. Pediatric Diabetes. 2009; 10(suppl 12):17-32.
Cardwell CR, Stene LC, Joner G, et al. Birth Order and Childhood Type 1 Diabetes Risk: A Pooled Analysis of 31 Observational Studies. Int. J. Epidemiol. 2011;40(2):363-374.
White NH. Diabetic Ketoacidosis in Children. Endocrinology and Metabolism Clinics of North America. 2000; 29(4): 657-682.
Edge JA. UK DKA Guidelines. British Society for Paediatric Endocrinology and Diabetes. 2002; 2: 231-245.
Wolfsdorf J, Glaser N, and Sperling MA. Diabetic Ketoacidosis in Infants, Children, and Adolescents. Diabetes Care. 2006; 29(5): 1150-1159.
Kayashima T, Yamaguchi K, Akiyoshi T, Nanimatsu H, Aragaki S, and Hosokawa T. Leukemoid Reaction Associated with Diabetic Ketoacidosis with Measurement of Plasma Levels of Granulocyte Colony-Stimulating Factor. Internal Medicine Journal. 1993; 32(11): 869-871.
Sperling MA. Diabetes Mellitus. In: Sperling MA (Ed). Pediatric Endocrinology 2nd edition. Philadelphia: Saunders; 2002; p. 325-353.
Knight AH, William DN, Ellis G, and Goldberg DM. Significance of Hyperamylasaemia and Abdominal Pain in Diabetic Ketoacidosis. British Medical Journal. 1971; 3(5872): 128-131.
Craig ME, Jones TW, Silink M, and Ping YJ. Diabetes Care, Glycemic Control and Complications in Children with Type 1 Diabetes from Asia and the Westren Pasific Region. Journal of Diabetes and It's Complication. 2007; 21(5): 280-287.
Umpierrez GE, Murphy MB, and Kitabachi AE. Diabetic Ketoacidosis and Hyperglicemic Hyperosmolar Syndrome. Diabetes Spectrum. 2002; 15(1): 28-36.
Silink M APEG Handbook on Childhood and Adolescent Diabetes the Management of Insulin-Dependent(Type 1) Diabetes Mellitus (IDDM). Paramatta NSW: Australian Paediatric Endocrine Group Australia; 2006.
Rustama DS, Subardja D, Oentario MC, Yati NP, Satriono, dan Harjantien N. Diabetes Mellitus. Di dalam: Jose RLB (Ed). Buku Ajar Endokrinologi Anak. Jakarta: Sagung Seto; 2010; hal. 124-161.
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