COLLOID AND METHYLPREDNISOLONE THERAPY AS ALTERNATIVE MANAGEMENT OF DHF

Date
2012
Author
Nasronudin, Nasronudin; Institute of Tropical Disease. Airlangga University. Surabaya, Indonesia, Tropical Infection Diviston, Department of Internal Medicine Dr Soetomo Hospital-Faculty of Medicine Airlangga University, Surabaya, lndonesia
P, Widiyanti; Institute of Tropical Disease. Airlangga University. Surabaya, Indonesia, Tropical Infection Diviston, Department of Internal Medicine Dr Soetomo Hospital-Faculty of Medicine Airlangga University, Surabaya, lndonesia
MV, Arfijanto; Institute of Tropical Disease. Airlangga University. Surabaya, Indonesia, Tropical Infection Diviston, Department of Internal Medicine Dr Soetomo Hospital-Faculty of Medicine Airlangga University, Surabaya, lndonesia
M, Rusli; Institute of Tropical Disease. Airlangga University. Surabaya, Indonesia, Tropical Infection Diviston, Department of Internal Medicine Dr Soetomo Hospital-Faculty of Medicine Airlangga University, Surabaya, lndonesia
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Abstract
There are three phase in progresivity of dengue infection which are afferent phase, efferent phase and efector phase. In dengue infection, it has been found endothelial cells leak age, the pro inflammatory cytokine level alteration and other mediator followed by the plasma migration and it has the potency to become dengue shock. The mam clinical manifestationare fever and bleeding. The aim of this research is to prove the influence of colloid and methylpredmsolone theraphy to inhabit the endothelial cells leakage through the alteration of IL-1b. TNF-a and PLA-2 level. This research has been involved 36 dengue patients in Tropical Infection Division, Departement of lntemal Medicine Medical Faculty Airlangga University -Dr. Soetomo Hospital Surabaya and 36 control group. We did the examination of cytokine level (IL-1b. TNF-a PLA-2) on blood sample with ELISA method. The dose methylprednisolone 125 mg twice a day and colloid (MW 40 kDa) 500 cc perday for 3 days has been given to the patient whose fulfilled the inclusion critena. We found temperature change to normal level after intervention. In conclusion, colloid and methylprednisolone therapy is effective to accelerade the temperature, IL -1b, TNF-a, and PLA-2 level declination, accelerate the endothelial cells sealing and plasma migration in dengue infective patient. Key words: DHF, Colloid, Methylprednisolone, proinflammatory cytokine
URI
http://ejournal.litbang.depkes.go.id/index.php/hsr/article/view/2261
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