Hiperglikemia Pada Anak Dengan Diagnosis Diabetes Mellitus Type-1, Diferential Diagnostic Maturity Onset Diabetes Of The Young (Mody).
DOI:
https://doi.org/10.22219/sm.Vol14.SMUMM2.7162Abstract
Pendahuluan
Diabetes mellitus (DM) merupakan penyakit metabolik ditandai oleh hiperglikemia yang disebabkan berkurangnya produksi atau kerja insulin. DM dapat menyerang anak-anak. Kami melaporkan kasus hiperglikemia pada anak berusia 9 tahun dengan kadar C-peptida dalam batas normal.
Kasus
Anak perempuanberusia 9 tahun, dibawa ke rumah sakit dikeluhkan lemah badan selama satu minggu. Pasien juga dikeluhkan sering kencing terutama di malam hari selama sebulan dan bekas kencing dirubung oleh semut. Pemeriksaan fisik dalam batas normal. Pemeriksaan laboratorium hari pertama : hemoglobin 14,8 g/dl, leukosit 9.860 sel/ul, trombosit 297.000 sel/ul, gula darah acak 328 mg/dl. Pemeriksaan hari kedua : gula darah puasa 274 mg/dl, gula darah 2 jam post prandial 370 mg/dl, dan glukosuria. Pemeriksaan C-Peptida 2,74 ng/ml (normal 1,1 – 4,4 ng/ml)
Pembahasan
Pada pasien anak ini ditemukan gejala khas diabetes yaitu fatigue dan poliuri. Pada pemeriksaan laboratorium didapatkan hiperglikemia. Sesuai dengan pedoman dari PERKENI pasien ini didiagnosis sebagai DM, yaitu tipe-1, dengan diferential diagnosis Maturity onset diabetes of the young (MODY) mengingat kadar C-peptida dalam batas normal. DM tipe 1 disebabkan oleh karena kerusakan sel beta pankreas akibat adanya autoantibodi terhadap pankreas. Sedangkan MODY disebabkan oleh mutasi genetik pada sel β pankreas sehingga terjadi inefektifitas produksi atau gangguan pelepasan insulin. Pemeriksaan tambahan seperti deteksi antibodi sel islet disarankan untuk menetapkan diagnosis DM tipe 1, dan pemeriksaan genetik untuk mendeteksi terjadinya mutasi sel β pankreas.
Simpulan
Diagnosis Type-1 Diabetes mellitus, dengan diagnosis banding Maturity onset diabetes of the young(MODY)
Kata Kunci: hiperglikemia anak, C-peptida, Diabetes mellitus tipe-1, MODY
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References
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