LAPORAN KASUS : ANEMIA HEMOLITIK AUTOIMUN PADA KEHAMILAN DENGAN COOMBS TES NEGATIF

Rina Gustuti; Nurul Fitriyah; Yusrawati

doi:10.58794/jubida.v4i2.1945

Authors

Rina Gustuti Divisi Fetomaternal Departemen Obstetri dan Ginekologi, Fakultas Kedokteran Universitas Andalas, RS. UNAND
Nurul Fitriyah PPDS Obgyn
Yusrawati Divisi Fetomaternal Departemen Obstetri dan Ginekologi, Fakultas Kedokteran Universitas Andalas, RSUP Dr. M. Djamil Padang

DOI:

https://doi.org/10.58794/jubida.v4i2.1945

Keywords:

Autoimmune Hemolytic Anemia, Coombs test, Hemolysis, Obstetric

Abstract

Pendahuluan: Anemia hemolitik autoimun yang terjadi pada masa kehamilan merupakan kondisi yang jarang dijumpai, namun berpotensi menimbulkan keadaan yang mengancam keselamatan ibu dan janin. Manifestasi klinis berupa anemia berat yang disertai ikterus, serta tidak adanya perbaikan kadar hemoglobin meskipun telah dilakukan transfusi darah, dapat menjadi petunjuk penting dalam menegakkan kecurigaan terhadap anemia hemolitik autoimun. Laporan Kasus: Wanita berusia 21 tahun dengan kehamilan pertama yang menunjukkan seluruh karakteristik klinis tersebut. Proses diagnostik menghadapi kendala karena pemeriksaan Coombs test memberikan hasil negatif, sehingga diagnosis tidak dapat ditegakkan secara langsung berdasarkan pemeriksaan penunjang standar. Penegakan diagnosis akhirnya didukung oleh respons klinis yang cepat dan signifikan setelah pemberian terapi kortikosteroid oral, yang memperkuat dugaan adanya mekanisme autoimun sebagai penyebab hemolisis. Setelah diagnosis ditegakkan dan terapi yang sesuai diberikan, terjadi perbaikan kondisi pasien dan peningkatan kadar hemoglobin, sehingga memungkin untuk dilakukan terminasi kehamilan. Kesimpulan: Keberhasilan tatalaksana maternal dan perinatal yang optimal dapat dicapai melalui pengenalan dini, kecurigaan klinis yang adekuat, serta penatalaksanaan yang cepat dan tepat pada kasus anemia hemolitik autoimun dalam kehamilan.

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