Seorang Pasien dengan Batu Staghorn Bilateral dan Spondilitis Ankilosis : Laporan Kasus Langka

Authors

  • Sibin Chandra Program Studi Ilmu Bedah Fakultas Kedokteran Universitas Diponegoro, Indonesia
  • Sofyan Rais Addin Devisi Urologi, Fakultas Kedokteran Universitas Diponegoro/ RSUP Dr. Kariadi, Indonesia
  • Ardy Santosa Devisi Urologi, Fakultas Kedokteran Universitas Diponegoro/ RSUP Dr. Kariadi, Indonesia
  • Eriawan Agung Nugroho Devisi Urologi, Fakultas Kedokteran Universitas Diponegoro/ RSUP Dr. Kariadi, Indonesia
  • Mohamad Adi Soedarso Devisi Urologi, Fakultas Kedokteran Universitas Diponegoro/ RSUP Dr. Kariadi, Indonesia
  • Dimas Sindhu Wibisono Devisi Urologi, Fakultas Kedokteran Universitas Diponegoro/ RSUP Dr. Kariadi, Indonesia
  • Nanda Daniswara Devisi Urologi, Fakultas Kedokteran Universitas Diponegoro/ RSUP Dr. Kariadi, Indonesia

DOI:

https://doi.org/10.36408/mhjcm.v8i2.607

Keywords:

Nefrolitiasis, Spondilitis ankilosis, Percutaneous Nephrolithotomy

Abstract

Latar Belakang : Spondilitis ankilosis merupakan penyakit peradangan sendi yang bisa mempengaruhi tulang-tulang axial yang dapat menyebabkan nyeri sendi, dan dapat berlanjut kepada penyatuan dari tulang belakang1. Prevalensi penyakit ini diperkirakan mencapai 16,7 dari 10.000 orang di daerah Asia.2 Meskipun penyakit ini utamanya menyerang sendi, tetapi dilaporkan pula bahwa terdapat kasus manifestasi ekstraartikuler seperti halnya nefrolitiasis. Nefrolitiasis menyumbang sekitar 13,6% dari penderita spondilitis ankylosis.3 Kasus Nefrolithiasis Staghorn sinistra dengan spondilitis ankilosis pernah dilaporkan, tetapi belum pernah dengan kasus nefrolithiasis staghorn bilateral4  Tujuan studi kasus ini adalah untuk mengetahui diagnosis dan tatalaksana spondilitis ankilosis dan nefrolitiasis staghorn bilateral.

Presentasi Kasus : Seorang pria berumur 38 tahun datang dengan keluhan nyeri hilang timbul pada pinggang sebelah kiri. Pasien sebelumnya telah didiagnosis dengan spondilitis ankilosis dan nefrolitiasis bilateral dekstra dan sinistra serta telah menjalani operasi Percutaneous Nephrolithotomy dekstra pada bulan Juni 2018. Pada pemeriksaan didapatkan keterbatasan gerak sendi tulang belakang dan nyeri ketok kostovertebra di sebelah kanan dan kiri. Dari pemeriksaan foto polos didapatkan gambaran batu staghorn bilateral

Kesimpulan : Pasien didiagnosis dengan spondilitis ankilosis dan nefrolitiasis staghorn bilateral. Prosedur penegakan diagnosis melalui anamnesis, pemeriksaan fisik dan pemeriksaan penunjang perlu dilakukan dengan tepat untuk menghindarai kesalahan diagnosa. Penatalaksanaan nefrolitiasis perlu memperhatikan banyak aspek seperti ukuran batu, ketersediaan sarana dan prasarana, serta mobilitas pasien, supaya dicapai tingkat kesembuhan yang tinggi.

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References

1. Van der Linden S, Brown M, Kenna T, Maksymowych W, Robinson P. Ankylosing spondylitis. InKelley and Firestein's Textbook of Rheumatology [10th Ed.] 2017 (Vol. 2, pp. 1256-1279). Elsevier.
2. Dean LE, Jones GT, MacDonald AG, Downham C, Sturrock RD, Macfarlane GJ. Global prevalence of ankylosing spondylitis. Rheumatology. 2013 Dec 9;53(4):650-7.
3. Korkmaz C, Ozcan A, Akçar N. Increased frequency of ultrasonographic findings suggestive of renal stones in patients with ankylosing spondylitis. Clin Exp Rheumatol. 2005 May 1;23(3):389-92.
4. Ergenoglu P, Askin S, Poyraz P, Turunc T, Acil M, Eker E, Cok OY, Ulger H, Aribogan A. Percutaneous nephrolithotomy in an ankylosing spondylitis patient: Point of view of an anaesthesiologist. The American Journal of Case Report. 2008;9:395-8.
5. Shoag J, Tasian GE, Goldfarb DS, Eisner BH. The new epidemiology of nephrolithiasis. Advances in chronic kidney disease. 2015 Jul 1;22(4):273-8.
6. Schipper, L. G., Fransen, J., Barrera, P. & Riel, P. L. C. M. Van. Methotrexate in combination with sulfasalazine is more effective in rheumatoid arthritis patients who failed sulfasalazine than in patients na?ve to both drugs. Rheumatology Journal. 2009 May; 48:828–833
7. Ben CT, Ajlani H, Ben FM, Ben TA, Ben HM, Khedher A. Renal involvement in ankylosing spondylitis: concerning 210 cases. La Revue de medecine interne. 2005 Dec;26(12):966-9.
8. Jakobsen AK, Jacobsson LT, Patschan O, Askling J, Kristensen LE. Is nephrolithiasis an unrecognized extra-articular manifestation in ankylosing spondylitis? A prospective population-based Swedish national cohort study with matched general population comparator subjects. PLoS One. 2014 Nov 25;9(11):e113602.
9. Korkmaz C, Sayer JA. ANKH and renal stone formation in ankylosing spondylitis. The Journal of rheumatology. 2012 Aug 1;39(8):1756-.
10. Bozzini G, Verze P, Arcaniolo D, Dal Piaz O, Buffi NM, Guazzoni G, Provenzano M, Osmolorskij B, Sanguedolce F, Montanari E, Macchione N. A prospective randomized comparison among SWL, PCNL and RIRS for lower calyceal stones less than 2 cm: a multicenter experience. World journal of urology. 2017 Dec 1;35(12):1967-75.
11. Ganpule AP, Vijayakumar M, Malpani A, Desai MR. Percutaneous nephrolithotomy (PCNL) a critical review. International Journal of Surgery. 2016 Dec 1;36:660-4.
12. Izol V, Aridogan IA, Borekoglu A, Gokalp F, Hatipoglu Z, Bayazit Y, Zeren S. Percutaneous nephrolithotomy in prone position in patients with spinal deformities. International journal of clinical and experimental medicine. 2015;8(11):21053.
13. Falahatkar S, Mokhtari G, Teimoori M. An update on supine versus prone percutaneous nephrolithotomy: a meta-analysis. Urology journal. 2016 Oct 10;13(5):2814-22.

Additional Files

Published

2021-07-15

How to Cite

1.
Chandra S, Addin SR, Santosa A, Nugroho EA, Soedarso MA, Wibisono DS, Daniswara N. Seorang Pasien dengan Batu Staghorn Bilateral dan Spondilitis Ankilosis : Laporan Kasus Langka. Medica Hospitalia J. Clin. Med. [Internet]. 2021 Jul. 15 [cited 2024 Dec. 23];8(2):237-41. Available from: http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/607

Issue

Vol. 8 No. 2 (2021): Med Hosp; Juli 2021

Section

Case Report

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