BUERGERS DISEASE DENGAN PENYAKIT AUTOIMUN

PADA WANITA
(Laporan Kasus)
Devvi Riasari, Endang Retnowati
Departemen Patologi Klinik
Fakultas Kedokteran Universitas Airlangga / RSUD Dr. Soetomo Surabaya
Abstrak
Pendahuluan
Buergers Disease adalah penyakit pembuluh darah pada bagian tubuh perifer, terutama jari
tangan dan kaki. Buergers Disease disebut juga Thromboangiitis Obliterans yang terjadi bila
pembuluh darah perifer mengalami inflamasi dan membentuk bekuan darah. Pencetus utamanya
adalah merokok lama, nikotin dapat menyebabkan vakonstriksi pembuluh darah. Penyakit
tersebut terutama menyerang laki-laki di bawah usia 40 tahun terbanyak pada ras Asia dan Eropa
Timur. Buergers Disease berkaitan dengan genetik. Buergers Disease dan Raynauds
Phenomenon dengan SLE merupakan penyakit pembuluh darah perifer dengan gambaran klinis
dan pencetus yang mirip.
Kasus
Seorang wanita 39 tahun dengan keluhan jari kaki menghitam sejak lima minggu yang lalu,
tanpa didukung riwayat merokok. Jari kaki mengbengkak dan nyeri pada awalnya, nyeri
bertambah bila terpapar hawa dingin, makin lama menghitam dan meluas. Pemeriksaan fisik
didapatkan nekrosis pada jari kaki kanan dan kiri disertai nyeri tekan. Pemeriksaan darah
lengkap didapatkan trombositopenia dan LED meningkat. Hapusan darah tepi adalah gambaran
eritrosit normokrom normositer dan trombositopenia. Pemeriksaan kimia klinik didapatkan
hipoalbuminemia, proteinuria dan hematuria. Pemeriksaan imunoserologi didapatkan tes ANA
positif kuat, tes Anti dsDNA juga positif kuat. Diagnosis klinis adalah Buergers Disease dan
curiga Systemic Lupus Erythematosus (SLE). Terapi dengan methylprednisolon pulse dose 3 hari
dilanjutkan per oral 3 kali sehari 16 mg.
Simpulan
Gambaran klinis penderita mendukung diagnosis Buergers Disease. Hasil positif kuat terhadap
antibodi ANA dan Anti dsDNA dapat terjadi pada penderita penyakit autoimun karena adanya
autoantibodi sistemik.
Kata kunci : Buergers Disease, Raynauds Phenomenon, ANA test, Anti dsDNA test

BUERGERS DISEASE WITH AUTOIMMUNE DISEASE IN WOMEN

(Case Report)
Devvi Riasari, Endang Retnowati
Department of Clinical Pathology
School of Medicine Faculty, Airlangga University / Dr. Soetomo Hospital, Surabaya
Abstract
Introduction
Buerger's Disease is a blood vessel disease in the peripheral parts of the body, especially the
fingers and toes. Buerger's Disease is also called Thromboangiitis obliterans, and happens when
a peripheral blood vessel becomes inflamed and blood clots form. Primarily this happens in long
time smoking, nicotine can cause vasoconstriction of blood vessels. This disease primarily
affects males under 40 years of age in Asian and Eastern European race. Buerger's Disease is
related to genetics. Buerger's Disease and Raynaud's Phenomenon with SLE are diseases of
peripheral blood vessels with clinical manifestations and similar trigger.
Clinical Case
A 39-year-old women with blackened toes, complained since five weeks ago, without any
smoking history. Swelling of toes and pain in the beginning, the pain increased when exposed to
cold, the blackened toes became widespread. On physical examination necrosis of the right and
left toes with tenderness were found. Complete blood count results were increased ESR and
thrombocytopenia. Peripheral blood smear revealed normochromic normocytic erythrocyte and
thrombocytopenia. Clinical chemistry results were hypoalbuminemia, proteinuria and hematuria.
Examinations of immunoserology were strong positive ANA test and Anti-dsDNA. Clinical
diagnosis was Buerger's Disease and suspected Systemic Lupus Erythematosus. Treatment was
methylprednisolone pulse dose in 3 days followed by 16 mg oral 3 times daily.
Conclusion
Clinical features of patient support the diagnosis of Buerger's Disease. Strong positive results for
ANA and anti-dsDNA antibodies may occur in patients with autoimmune diseases due to
systemic autoantibodies.
Keywords : Buergers Disease, Raynauds Phenomenon, ANA test, Anti dsDNA test.