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Abstrak :
Latar belakang: Penyakit alergi didasari reaksi hipersensitivitas yang diinisiasi mekanisme imunologi spesifik diperantarai oleh IgE. Warga kota Denpasar memiliki karakteristik spesifik, yaitu tingkat memelihara hewan berbulu anjing dan konsumsi daging babi yang tinggi. Data sensitisasi alergen pada anak di kota Denpasar belum ada. Penelitian sensitisasi alergen dapat memberikan gambaran sensitisasi spesifik untuk anak di kota Denpasar sehingga upaya pencegahan penyakit alergi dapat dilakukan dengan lebih efektif. Tujuan: Mengetahui sensitisasi alergen pada anak dengan penyakit alergi dermatitis atopi, asma, rinitis alergi yang dibuktikan melalui uji tusuk kulit di RSUP Sanglah Denpasar. Metode: Penelitian potong lintang di Poliklinik Rawat Jalan Alergi Imunologi Bagian/SMF Ilmu Kesehatan Anak, RSUP Sanglah, Denpasar, periode Januari 2017-Maret 2017. Anak usia 3-18 tahun dengan dermatitis atopi, asma, rinitis alergi dan orang tua setuju mengikuti penelitian akan diinklusi. Sensitisasi alergen dibuktikan melalui uji tusuk kulit terhadap alergen spesifik inhalan dan/atau ingestan, hasil positif bila diameter urtika 3 mm. Data dinyatakan sebagai proporsi, dilakukan pengelompokan berdasarkan jenis penyakit alergi dan umur. Hasil: Proporsi anak dengan penyakit alergi, yaitu dermatitis atopi 30,5, asma 57,9, dan rinitis alergi 56,8. Proporsi berdasarkan multimorbiditas penyakit adalah dermatitis atopi dengan asma 8,5, dermatitis atopi dengan rinitis alergi 4,2, asma dengan rinitis alergi 24,2, dermatitis atopi dengan asma dan rinitis alergi 4,2, dermatitis atopi 13,7, asma 21, rinitis alergi 24,2. Sensitisasi pada kelompok dermatitis atopi usia 3-6 tahun tersering terhadap alergen ingestan, usia sekolah baik pada dermatitis atopi, asma, maupun rinitis alergi sensitisasi terutama terhadap alergen inhalan D. farinae, D. pteronyssinus, kecoa. Simpulan: Proporsi penyakit alergi tertinggi pada anak di kota Denpasar adalah asma dengan rinitis alergi. Sensitisasi terutama terhadap alergen inhalan pada anak usia sekolah. ...... Background: Allergic disease in children is based on hypersensitivity reactions initiated by specific immunologic mechanism mediated by IgE. Residents of Denpasar city have their own characteristics in terms of the level of having furry animals dogs and the level of consumption of pork is high. While allergen sensitization data for the children of Denpasar is still not available. Allergen sensitization research in Denpasar will give a picture of the sensitization type specifically for children in Denpasar in order for having more effective prevention programs. Objectives: To study the sensitization of allergens in children with atopic dermatitis, asthma, and allergic rhinitis that proven through skin prick test at Sanglah Hospital Denpasar. Methods: A cross sectional study was done in the Outpatient Immunology Allergy Polyclinic, Sanglah Hospital, Denpasar in the period of January to March 2017. Children 3 18 years who are diagnosed with atopic dermatitis, asthma, and allergic rhinitis, and the parents signed a letter of approval, will be included. Allergen sensitization proven by skin prick test against specific allergens inhalants and or ingestants, and it classified positive results when indicating wheal diameter ge 3 mm. The data is calculated as a proportion number and is grouped based on the type of allergy and age. Results: The proportion of children with allergy was atopic dermatitis 30.5, asthma 57.9, and allergic rhinitis 56.8. While the proportion based on the multimorbidity of the disease is atopic dermatitis with asthma 8.5, atopy dermatitis with allergic rhinitis 4.2, asthma with allergic rhinitis 24.2, atopy dermatitis with asthma and allergic rhinitis 4.2, atopic dermatitis 13, 7, asthma 21, and allergic rhinitis 24.2. Sensitization in the atopy dermatitis at age 3 6 years group frequently to ingestant allergen, but at school age in both atopic dermatitis, asthma, and allergic rhinitis sensitization especially to inhalants allergen D. farinae, D. pteronyssinus, and cockroaches. Conclusions: Children in Denpasar showed the highest proportion of allergies for asthma and allergic rhinitis, with the majority of allergen are inhaled at school age.

Abstrak :
Latar belakang: Tungau debu rumah TDR merupakan alergen hirup yang penting pada asma alergik. Namun, penelitian diagnostik molekuler menggunakan Imunoglobulin E IgE spesifik akibat sensitisasi alergen TDR dihubungkan dengan derajat keparahan asma alergik belum pernah dilakukan di Indonesia. Tujuan: Mengetahui perbedaan kadar IgE spesifik serum kuantitatif akibat sensitisasi alergen Dermatophagoides D. pteronyssinus, D. farinae dan Blomia B. tropicalis pada asma alergik intermiten dan persisten. Metode: Desain penelitian potong lintang pada pasien asma alergik dewasa yang diundang untuk pemeriksaan IgE spesifik serum dan merupakan bagian dari penelitian payung di Divisi Alergi dan Imunologi Klinik, RS Cipto Mangunkusumo. Derajat keparahan asma ditentukan berdasarkan kriteria Global Initiative on Asthma GINA 2015 dan dikelompokkan menjadi intermiten dan persisten. Pemeriksaan IgE spesifik serum kuantitatif menggunakan metode multiple allergosorbent test Polycheck Allergy, Biocheck GmbH, Munster, Germany . Alergen TDR yang diperiksa adalah D. pteronyssinus, D. farinae, dan B. tropicalis. Perbedaan antara dua kelompok dianalisis dengan uji Mann-Whitney. Hasil: Sebanyak 87 subyek dilibatkan dalam penelitian ini; 69 79,3 subyek adalah perempuan. Rerata usia pasien adalah 40,2 tahun. Enam puluh tiga 72,4 pasien menderita asma dan rinitis alergik. Sebanyak 58 66,7 pasien asma persisten. Gambaran sensitisasi alergen TDR adalah 62,1 D. farinae; 51,7 D. pteronyssinus dan 48,3 B.tropicalis. Median kadar IgE spesifik secara bermakna lebih tinggi pada asma persisten dibandingkan asma intermiten untuk alergen D. farinae 1,30 vs. 0,0 kU/L; p=0,024 dan B. tropicalis 0,57 vs. 0,0 kU/L; p=0,015 . Kadar IgE spesifik D. pteronyssinus lebih tinggi pada asma persisten dibandingkan intermiten 0,67 vs. 0,00 kU/L; p=0,066. Kesimpulan:Gambaran sensitisasi alergen secara berurutan didapatkan D. farinae 62,1, D. pteronyssinus 51,7 dan B. tropicalis 48,3 . Kadar IgE spesifik akibat sensitisasi D. farinae dan B. tropicalis lebih tinggi secara bermakna pada pasien asma persisten dibandingkan asma intermiten. Kadar IgE spesifik akibat sensitisasi D. pteronyssinus lebih tinggi pada pasien asma persisten dibandingkan asma intermiten, tetapi secara statistik tidak bermakna.

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Introduction House dust mites HDM are an important inhalant allergen in allergic asthma. However, molecular diagnostic study using specific IgE level induced by HDM allergens associated with asthma severity has not been done in Indonesia. Objective To investigate the difference of serum quantitative specific IgE levels induced by Dermatophagoides D. pteronyssinus, D. farinae and Blomia B. tropicalis sensitization in intermittent and persistent allergic asthma. Method This was a cross sectional study on adult allergic asthma patients who were invited for serum specific IgE testing. This study was a part of a larger research within the Division of Allergy and Immunology, Cipto Mangunkusumo Hospital. Asthma severity was defined based on Global Initiative on Asthma GINA 2015 criteria and were grouped as intermittent or persistent. Quantitative specific IgE testing was done on blood serum using a multiple allergosorbent test Polycheck Allergy, Biocheck GmbH, Munster, Germany . The HDM allergens tested were D. pteronyssinus, D. farinae, and Blomia tropicalis. Difference between two groups were analyze using Mann Whitney test. Results A total of 87 subjects were enrolled in this study 69 79.3 were women. Mean patients rsquo age was 40, 2 years. Sixty three 72.4 patients had asthma and allergic rhinitis. Fifty eight 66.7 patients were classified as persistent asthma. The prevalence of sensitization was 62.1 D. farinae, 51.7 D. pteronyssinus, and 48.3 Blomia tropicalis. The median of specific IgE levels is significantly higher in persistent asthma compares to intermittent asthma induced by D. farinae median 1.30 vs. 0.0 kU L p 0.024 and B. tropicalis median 0.57 vs. 0.0 kU L p 0.015 sensitization. Level of Specific IgE D. pteronyssinus is also to be higher in persistent asthma than the level measured in intermittent asthma 0.67 vs. 0.00 kU L p 0.066. Conclusion Sensitization of HDM allergens is shown to be highest for D. farinae 62.1 , followed by D. pteronyssinus 51, 7 and Blomia tropicalis 48, 3 . Specific IgE level induced by D. farinae and Blomia tropicalis sensitization are significantly higher in patients with persistent compares to intermittent asthma, whereas specific IgE level induced by D. pteronyssinus sensitization to be higher in persistent asthma although not statistically significant.