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1 ALERGI MAKANAN Batasan Reaksi simpang terhadap makanan sering ditemukan pada anak, terutama pada 3 tahun pertama kehidupan. Reaksi simpang makanan dapat terjadi akibat reaksi imunologis (alergi) atau non imunologis (intoleransi, kontaminan, intoksikasi). Makanan yang menjadi alergen yang banyak dilaporkan di negara maju adalah telur, susu sapi, kacang tanah, gandum, dan soya. Pada anak besar ikan, kerang, dan kacang- kacangan merupakan penyebab alergi seumur hidup. Alergi makanan bermanifestasi dengan menginduksi reaksi hipersensitivitas yang utamanya diperantarai oleh IgE. Anamnesis dan pemeriksaan fisis 1. Anamnesis yang perlu ditanyakan adalah: a.  Jenis makan an yang diduga sebag ai pencetus alergi b.  Jarak waktu anta ra makan makana n pencetus alergi deng an timbulnya ge jala alergi c. Lamanya gejala berlangsung d.  Jumlah maka nan yang d ikonsumsi sehingga timbul reak si alergi e. Frekuensi dan berulangnya kejadian alergi terhadap jenis makanan yang sama f. Tanda dan gejala alergi g. Apakah makanan pencetus mentah atau matang saat dimakan h. Apakah aktivitas menjadi predisposisi penyebab alergi makanan? i. Apakah ada kemungkinan kontaminasi dari makanan lain? 2. Manifestasi klinis dapat terjadi pada: a. Kulit: urtikaria, dermatitis atopi, angioedema, gatal dan bengkak di sekitar mulut b. Saluran napas: asma, rinitis c. Saluran cerna: nyeri perut, mual, muntah, diare, BAB berdarah d. Umum: anafilaksis. 3. Pencatatan makanan harian. Pemeriksaan penunjang 1. Skin prick test, berguna untuk menyingkirkan alergen tertentu karena nilai prediksi negatif cukup tinggi, sedangkan nilai prediksi positif paling tinggi hanya 60%. 2. Kadar IgE spesifik darah mempunyai nilai prediksi positif untuk beberapa alergen tertentu mempunyai nilai prediksi positif yang cukup baik. 3. Baku emas alergi makanan adalah DBPCFC ( double blind placebo control food challenge). Namun karena sulit dilakukan maka dapat dilakukan uji provokasi makanan terbuka. Persiapan uji provokasi makanan terbuka adalah makanan

Ppm Rscm Dept Ika 2015

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http://www.influenzareport.com/ir/cp.htm%20.%20Accessed%2009/05/2006
http://www.influenzareport.com/ir/cp.htm%20.%20Accessed%2009/05/2006
http://www.show.scot.nhs.uk/sehd/pandemicflu/Documents/PFClinicalguidelinesScotJa%202006.pdf
http://www.show.scot.nhs.uk/sehd/pandemicflu/Documents/PFClinicalguidelinesScotJa%202006.pdf
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http://www.ncbi.nlm.nih.gov/pubmed/22513908
http://www.ncbi.nlm.nih.gov/pubmed/?term=Newton%20R%5BAuthor%5D&cauthor=true&cauthor_uid=22513908
http://www.ncbi.nlm.nih.gov/pubmed/?term=Offringa%20M%5BAuthor%5D&cauthor=true&cauthor_uid=22513908
http://www.ncbi.nlm.nih.gov/pubmed/23702315
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http://www.un.org.vn/who/avian/docs%5CWHOHQ200605.pdf
http://www.azdhs.gov/pandemicflu/pdf/supp_5_clinical_guidelines.pdf
http://www.influenzareport.com/ir/cp.htm.
http://www.show.scot.nhs.uk/sehd/pandemicflu/Documents/PFClinicalguidelinesScotJan2006.pdf
http://www.show.scot.nhs.uk/sehd/pandemicflu/Documents/PFClinicalguidelinesScotJan2006.pdf
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