Professional Documents
Culture Documents
Wisnu Barlianto
Divisi Alergi-Imunologi
Lab. Ilmu Kesehatan Anak
FK Universitas Brawijaya/RS dr. Saiful Anwar
Malang
Pokok bahasan
Adverse
Food
Reaction
Immune
Non-Immune
Mediated
Mediated
(food allergy
(primarily food
and celiac
intolerances)
disease)
Adverse
Food
Reaction
Non-Immune
Mediated
(primarily food
intolerances)
Tree nuts
Wheat
Fish
Soy
Bass
Cod
flounder
67.8
70
50 46.6
Hasil SPT positif dalam %
40
30
20
10
0
coklat udang telur susu kepiting tongkol
IgE-Mediated
IgE-receptor
APC
Mast cell
Non-IgE-
Mediated
Histamine
B cell T cell TNF-
IL-5
The immunologic spectrum
IgE-Mediated Non-IgE-Mediated
Clinical manifestation
Dermatitis atopi
Asma bronkhial
Rhinitis alergi
Pendekatan diagnosis alergi makanan
- Anamnesis
- Gejala klinis
- Uji tusuk kulit (Skin Prick Test)
- IgE spesifik alergen
- Eliminasi dan provokasi
- Endoskopi dan biopsi
APA TANDA DAN GEJALA
ALERGI MAKANAN?
Organ system Immediate symptoms Delayed symptoms
Cardiovascular Dizziness
Fainting
Hypotension
Loss of consciousness
Tachycardia
(occasionally
bradycardia
in anaphylaxis
Cutaneous Angioedema Angioedema
Erythema Eczematous rash
Morbilliform eruption Erythema
Pruritus Flushing
Urticaria Morbilliform eruption
Pruritus
Gastrointestinal Colicky abdominal Abdominal pain
(lower) pain Diarrhea
Diarrhea Hematochezia
Nausea Irritability and
Reflux food refusal with
Vomiting weight loss (young
children)
Nausea or vomiting
Reflux
Yawn BP. Am Fam Physician. 2012;86(1):43-50.
Organ system Immediate symptoms Delayed symptoms
Obat tidak
direkomendasikan
Anti histamin
adrenalin
IgE Non-IgE
mediated mediated
Uji Plasma
provokasi tryptase
Interpretation of SPT
The peak reactivity of prick/puncture
tests is 15 to 20 minutes at which time
both wheal and erythema diameters (or
areas) should be recorded in
millimeters and compared with positive
and negative controls
(+) = wheal (with equivalent erythema)
of 3 mm or above
Perbandingan uji kulit dan IgE spesifik
ALLERGENICITY
Formula
Formula pengganti untuk
terhidrolisat pencegahan
sebagian pada anak yang
belum alergi
Makanan yang mungkin mengandung
protein susu sapi
Batter-fried foods Muffins
Biscuits Other baked goods
Bread Packaged soups
Breakfast cereals Pies
Cakes Puddings
Chocolate Rusks
Cookies Sausages
Cream sauces Sherbet
Cream soups Soy cheese
Custard Soup mixes
Fish in batter Sweets
Gravies and gravy mixes Canned soups
Ice cream (and "non-milk" Vegetarian cheese
fat)
Imitation sour cream
Instant mashed potatoes
Margarine Steinman HA. J Allergy Clin Immunol
Muesli
1996:98:241-50
Label yang menunjukan adanya protein susu
sapi
Allergy
Diet
Environment
infection
Microbial exposure
in early life
Allergen
Pollution
Primary Prevention of immunological
prevention sensitisation