SINDROM STEVENS-JOHNSON DENGAN HIPOALBUMINEMIA BERAT AKIBAT ASAM MEFENAMAT: CASE REPORT

Abstract

 ABSTRAK 

Sindrom Stevens-Johnson (SSJ) merupakan kondisi kegawatdaruratan kulit dengan karakteristik terdapat nekrolisis pada lapisan epidermis dan mukosa. Salah satu penyebab SSJ adalah pemberian obat anti-inflamasi non-steroid (OAINS) seperti asam mefenamat. Kondisi SSJ dengan hipoalbuminemia berat dapat mempengaruhi durasi perawatan dan prognosis pasien. Pada laporan kasus ini mendeskripsikan kasus SSJ dengan hipoalbuminemia berat akibat asam mefenamat pada seorang perempuan 42 tahun dengan keluhan demam dan ruam kemerahan disertai kulit melepuh pada area wajah,leher,perut dan mukosa mulut setelah 3 hari konsumsi asam mefenamat. Pasien diberikan terapi resusitasi cairan, antibiotik dan kortikosteroid sistemik dan menunjukan perbaikan klinis. Namun, kondisi hipoalbuminemia menyebabkan durasi perawatan lebih panjang. Identifikasi tanda dan gejala awal serta perhatian khusus terhadap pemberian OAINS pada pasien berisiko alergi merupakan kunci untuk meminimalisir risiko SSJ. 

ABSTRACT 

Stevens-Johnson Syndrome (SJS) is an emergency skin condition characterized by necrolysis of the epidermis and mucosal layers. One of the causes of SJS is administration of non-steroidal anti-inflammatory drugs (NSAIDs) such as mefenamic acid. The condition of SJS with severe hypoalbuminemia can affect the duration of treatment and the patient's prognosis. This case report describes a case of SJS with severe hypoalbuminemia due to mefenamic acid in a 42-year-old woman with complaints of fever and rash accompanied by blisters on the face, neck, stomach and oral mucosa after 3 days of consuming mefenamic acid. The patient was given with fluid resuscitation, antibiotics and systemic corticosteroids therapy and clinical improvement was achieved. However, the condition of hypoalbuminemia led to a longer duration of treatment. Identification of early signs and symptoms as well as special attention to the administration of NSAIDs in patients at risk of allergy is the key to minimizing the risk of SJS.