LUARAN ANAK DENGAN CONGENITAL RUBELLA SYNDROME

WINDA YANUARNI MEYE, Prof. Dr.dr. E.S Herini Sp.A(K).; Prof. dr. Sri Suparyati Soenarto, Ph.D, Sp.A(K)

2019 | Tesis-Spesialis | ILMU KESEHATAN ANAK

Congenital rubella syndrome (CRS) merupakan gabungan kelainan kongenital yang muncul pada anak sebagai akibat infeksi virus rubela yang terjadi pada ibu selama masa kehamilan. CRS klasik menunjukkan adanya trias berupa kelainan jantung, katarak kongenital, dan tuli sensorineural. Perkiraan insidensi (estimated incidence) dari CRS secara klinis adalah 0.25:1000 kelahiran hidup. Tidak ada terapi khusus untuk mengatasi infeksi virus rubella ini, akan tetapi dibutuhkan tatalaksana holistik untuk mengatasi kelainan dan morbiditas dalam CRS. Telah dilakukan pendampingan selama 24 bulan terhadap seorang anak dengan laboratory confirmed CRS yang memiliki manifestasi klasik berupa patent ductus arteriosus (PDA), katarak kongenital unilateral, dan profound sensory neural hearing loss. Berbagai upaya terapi telah dilakukan pada pasien antara lain berupa penutupan PDA, operasi katarak, pemantauan dan intervensi terhadap pertumbuhan dan perkembangan. Dalam periode pengamatan kami, pasien juga menunjukkan adanya gejala autism spectrum disorder. Belum didapatkan adanya manifestasi awitan lambat seperti diabetes mellitus dan gangguan hormon tiroid. Dalam publikasi ini akan dijelaskan tentang tatalaksana holistik termasuk upaya preventif disertai dengan tinjauan pustaka mengenai CRS pada anak.

Congenital rubella syndrome (CRS) is combination of some congenital anomalies that arise in children as a result of rubella virus infection that occurs during pregnancy. Classical CRS shows trias in form of heart abnormalities, congenital cataracts, and sensorineural deafness. The estimated incidence of clinical CRS is 0.25: 1000 live births. There is no specific therapy to treat this rubella virus infection, however, holistic management are needed to treat any abnormality and morbidity in CRS. We had conducted 24 months observation of a child with laboratory confirmed CRS who had classic manifestations of patent ductus arteriosus (PDA), unilateral congenital cataracts, and profound sensory neural hearing loss. Various therapeutic efforts have been carried out to the patient, including non invansive PDA closure, cataract surgery, monitoring and interventions on growth and development. In our observation period, patients also showed symptoms of autism spectrum disorder. There were no late onset manifestations such as diabetes mellitus and thyroid hormone disorders observed during observation. In this publication, we would like to explain about holistic management, including preventive management and literature review in children with CRS.

Kata Kunci : congenital rubella syndrome, tatalaksana, holistik, anak, congenital rubella syndrome, management, holistic, child