Scribd Logo
Upload

Welcome to Scribd!

  • 79 views

    Pucat Dan Anemia Pada Anak

    Uploaded by

    Herry Wara
    This document discusses different types of anemia, including hemolytic anemia, aplastic anemia, deficiency anemia, anemia due to blood loss, and anemia due to malignancy. It provides guidance on distinguishing between aplastic anemia and anemia due to malignancy based on blood tests and physical exam findings. The document also presents a schematic for categorizing different types of anemia based on red blood cell size and hemoglobin content. Finally, it discusses thalassemia and hemoglobinopathies, including epidemiology, genetics, clinical manifestations, diagnosis, and prevention strategies.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd

    Pucat Dan Anemia Pada Anak

    Uploaded by

    Herry Wara
    79 views21 pages
    This document discusses different types of anemia, including hemolytic anemia, aplastic anemia, deficiency anemia, anemia due to blood loss, and anemia due to malignancy. It provides guidance on distinguishing between aplastic anemia and anemia due to malignancy based on blood tests and physical exam findings. The document also presents a schematic for categorizing different types of anemia based on red blood cell size and hemoglobin content. Finally, it discusses thalassemia and hemoglobinopathies, including epidemiology, genetics, clinical manifestations, diagnosis, and prevention strategies.

    Original Title

    pucat dan Anemia pada Anak.ppt

    Copyright

    © © All Rights Reserved

    Available Formats

    PPT, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document discusses different types of anemia, including hemolytic anemia, aplastic anemia, deficiency anemia, anemia due to blood loss, and anemia due to malignancy. It provides guidance on distinguishing between aplastic anemia and anemia due to malignancy based on blood tests and physical exam findings. The document also presents a schematic for categorizing different types of anemia based on red blood cell size and hemoglobin content. Finally, it discusses thalassemia and hemoglobinopathies, including epidemiology, genetics, clinical manifestations, diagnosis, and prevention strategies.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    79 views21 pages

    Pucat Dan Anemia Pada Anak

    Uploaded by

    Herry Wara
    This document discusses different types of anemia, including hemolytic anemia, aplastic anemia, deficiency anemia, anemia due to blood loss, and anemia due to malignancy. It provides guidance on distinguishing between aplastic anemia and anemia due to malignancy based on blood tests and physical exam findings. The document also presents a schematic for categorizing different types of anemia based on red blood cell size and hemoglobin content. Finally, it discusses thalassemia and hemoglobinopathies, including epidemiology, genetics, clinical manifestations, diagnosis, and prevention strategies.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 21

    Yudhi Kurniawan

    Departemen Ilmu Kesehatan Anak RSUD Propinsi


    NTB/Fakultas Kedokteran Universitas Mataram
    Jenis Anemia
     Anemia hemolitik
     Anemia aplastik
     Anemia defisiensi
     Anemia akibat perdarahan
     Anemia akibat keganasan
    Bagaimana Membedakannya
    Secara Sederhana?
    • Anemia aplastik vs Anemia akibat keganasan
    Hasil pemeriksaan darah pansitopenia, namun
    pada pemeriksaan fisis, anemia aplastik tidak
    dijumpai organomegali sedangkan anemia
    karena keganasan dijumpai organomegali
    • Anemia akibat perdarahan
    Ada bukti perdarahan yang terjadi
    • Jika hanya dijumpai anemia saja,
    gunakan skema
    Skema
    Anemia Anemia Anemia makrositik
    hipokromik- normokromik-
    mikrositik normositik

    1 2 3
    Contoh: Contoh: A. Megaloblastik,
    - Anemia pasca contoh:
    - Anemia perdarahan akut - Anemia defisiensi
    defisiensi Fe - Anemia aplastik Folat,
    - Thalasemia - Anemia hemolitik - Anemia defisiensi
    - Anemia akibat - Anemia akibat vitamin B12
    penyakit kronik B. Nonmegaloblastik
    Penyakit Kronik - Anemia pada GGK contoh:
    - Anemia - Anemia pada - Anemia pd peny.
    sideroblastik mielofibrosis Hati kronis
    - dll - Anemia pd
    hipotiroid, dll

    MCV <80 fl; MCV 80 -95 fl MCV > 95 fl


    MCH <27 pg MCH 27-34 pg
    Thalassemia and hemoglobinopathy

     The most frequent genetic disorder in the world including in Indonesia

     Autosomal recessive

     Clinical: Severe hemolytic anemia, lifelong regular blood transfusion


    Epidemiology

     In the world (WHO 2001):


     7% of world population 
    thalassemia carrier
     300-400 thousand thalassemic
    children born each year

    Weatherall , 2001
    Gene frequencies of thalassemia-β and HbE
    in Indonesia

    Lanni, 2008
    Thalassemia Patients in Indonesia

    Frequency of carriers in Indonesia


    (Eijkman Institute, 2016)
    • β-thalassemia : 3-10%
    • α-thalassemia : 2.6-11%
    • Hb E : 1.5-36%

    Each year 2.500 children born


    with thalassemia major

    (Wahidiyat I, Wahidiyat PA, 2005)


    Thalassemia Patients in Indonesia
    At the end of Oct 2016, total thalassemia patients in Indonesia: 9.121 patients

    300 115

    5
    147 16
    149 20
    60
    125
    231 40
    60 200 2200

    579 3300 920


    602 12
    40

    Hematology Oncology Working Group Data - Indonesian Pediatric Society 2016


    Mendel’s Law

    25
    25
    %
    %
    50
    Clinical features...

    Facies Cooley

    Massive
    organomegaly Thalassemia Center-RSCM, 2019
    Skin hyperpigmentation

    Thalassemia Center-RSCM, 2019


    Head appearance Radiologic features
    Hair on end
    appearance

    Facies Cooley

    Frontal
    bossing

    Osteoporosis

    Thalassemia Center-RSCM, 2019


    Laboratorium examinations

    Blood count:
    Normal
     Hb 
     Erytrocyte indices:
    MCV , MCH , MCHC, RDW 
    Trait
    Blood smear: thalassemia

     Microcytic, hypocromic, anisopoikilocytosis,


    target cell (+), normoblast (+) Thalassemia
    major
    False leucocytosis
    normoblast
    Prevention

     WHO recommendation for thalassemia screening :


     Population with high gene frequencies of thalassemia eg: Indonesia
     High risk couples: 25% risk of having thalassemia major child
     Premarital screening (prospective screening)
     High risk family (family with history of thalassemia)  retrospective
    screening
     Screening in medical student of FMUI:
     Frequency of thalassemia carrier: 5.3%
    Screening Program In Indonesia
    Family screening

    Student screening

    Collaboration with
    1. NGOs
    2. DKI Jaya Government: screening all premarital couples

    Prenatal diagnosis  available but useless because the current


    abortion law only allows us to terminate before 6 weeks of gestational
    age

    National screening: on going lobbying


    Result of prevention in several countries
    100

    80

    60

    40

    20

    0
    1972 1974 1976 1978 1980 1982 1984 1986 1988 1990 1992
    Thank You

    You might also like