Vol. 38 No. 2 Maret 2021
TERAPI PREDNISON MEMBERIKAN LUARAN KLINIS YANG BAIK PADA MIOSITIS POST VAKSINASI
Ivan Santosa,* Yudy Goysal,* Andi Kurnia Bintang,* Cahyono Kaelan*
PREDNISONE THERAPY RESULTED IN GOOD CLINICAL OUTCOME IN POST VACCINATION MYOSITIS
ABSTRACT
A six-year-old girl was consulted from the Pediatrics department to the Neurology outpatient clinic at Wahidin Sudirohusodo Hospital in Makassar with an initial diagnosis of neuropathy. She complained of weakness on both legs suffered a month before treatment, she had difficulty reaching a standing position from sitting or squatting. She walked quite normally when standing, there was no disturbance in gait, but she had difficulty on climbing stairs, and had myalgia in the leg area. There was a history of intramuscular injection of diphtheria tetanus (Td) vaccine in the right upper arm. She got the vaccine according to the vaccination program. On physical examination, vital signs were within normal limits, there was slight paraparesis, decreased patellar reflex and no pathological reflexes. Sensory and autonomic physical examination were normal. There was Gower’s sign noted. Laboratory investigations findings: SGOT 134, SGPT 49, LDH 1584, CK 1922.80. Biopsy finding shows inflammatory changes consistent with myositis. Prednisone therapy provides significant clinical improvement.
Keywords: Myositis, prednisone, vaccination
ABSTRAK
Anak perempuan usia 6 tahun dikonsul dari departemen Pediatri ke Poliklinik Neurologi RS Wahidin Sudirohusodo Makassardengan diagnosis neuropati. Anak mengeluhkan lemah pada kedua tungkai yang dialami 1 bulan sebelum berobat, sulit menggapai posisi berdiri dari duduk atau jongkok. Pada saat posisi berdiri, anak dapat berjalan cukup normal, tidak ada gangguan gaya berjalan, tetapi kesulitan untuk menaiki anak tangga, nyeri pada kedua tungkai. Riwayat penyuntikan vaksin difteri tetanus (Td) di lengan kanan atas secara intramuskular. Program vaksinasi sejak bayi sampai sekarang lengkap. Pemeriksaan fisik anak, tanda vital dalam batas normal, terdapat slight paraparesis, refleks patellamenurun, refleks patologis tidak ada. Pemeriksaan saraf sensorik dan otonom normal, terdapat tanda Gower. Hasil laboratorium SGOT 134, SGPT 49, LDH 1584, Creatine Kinase (CK)1922,80. Hasil pemeriksaan biopsi otot dilaporkan suatu miositis. Pemberian terapi prednison memberikan perbaikan klinis yang cukup signifikan.
Kata kunci: miositis, prednison, vaksinasi
----------------------------------------------------------*Departemen Neurologi, Fakultas Kedokteran Universitas Hasanuddin, Makassar, Indonesia.
Korespondensi: santosa_ivan87@yahoo.com
