Skip to main content Skip to main navigation menu Skip to site footer

Asma eksaserbasi akut dengan hipertensi urgensi dan obesitas: sebuah laporan kasus

Abstract

Introduction: Asthma is a chronic inflammatory disease characterized by the rapid and reversible narrowing of the airways. Various factors can influence exacerbations in asthma, and one of the comorbidities is obesity. Inflammation and compensatory mechanisms are related to the occurrence of urgent hypertension in patients with acute exacerbation of asthma, making the analysis and management of asthma exacerbation with comorbidities of obesity and urgent hypertension require special attention and consideration.

Case Presentation: This study reports a 17-year-old adolescent with a history of asthma experiencing an acute exacerbation. Comorbidities include obesity with a BMI of 34.6 kg/m2 and urgent hypertension with a blood pressure of 200/100 mmHg. Physical examination revealed wheezing in both lung fields and epigastric tenderness. Radiological examination, including chest X-ray, was within normal limits, while hematological examination showed neutrophilia (8.65 x 103/uL) and 81.4% neutrophil percentage. The patient experienced hypoglycemia (blood glucose of 75 mg/dL). Nebulized bronchodilator therapy with ipratropium bromide, albuterol sulfate, and budesonide corticosteroids was initiated, but respiratory distress persisted. Initial management included oxygenation, intravenous saline, and ranitidine injection, followed by intravenous maintenance fluid with D5 ½ NS, nebulized bronchodilators and corticosteroids, intravenous dexamethasone, intravenous ranitidine, and oral therapy with azithromycin, cetirizine, N-acetylcysteine, and bisoprolol. The patient underwent intensive care for two days with a total treatment duration of six days.

Conclusion: Asthma exacerbation with comorbidities of obesity and urgent hypertension requires holistic analysis and management to prevent complications and worsening exacerbations.

References

  1. Rosfadilla P, Sari AP. Asma Bronkial Eksaserbasi Ringan-Sedang Pada Pasien Perempuan Usia 46 Tahun. AVERROUS J Kedokt dan Kesehat Malikussaleh. 2022;8(1):17.
  2. Putri NMWJW, Mayangsari ASM, Sidiartha GL, Adnyana IGANS. Prevalens dan Faktor yang Berhubungan dengan Asma pada Anak Usia 13-14 Tahun di Daerah Rural. J Med Udayana. 2022;11(3):46–53. Available from: https://ojs.unud.ac.id/index.php/eum46
  3. Runtuwene IKT, Wahani AM., Pateda V. Prevalensi dan faktor-faktor risiko yang menyebabkan asma pada anak di RSU GMIM Bethesda Tomohon periode Agustus 2011 – Juli 2016. e-CliniC. 2016;4(2):4–7.
  4. Bush A. Pathophysiological mechanisms of asthma. Front Pediatr. 2019;7(MAR):1–17.
  5. Mattila T, Santonen T, Andersen HR, Katsonouri A, Szigeti T, Uhl M, et al. Scoping review—the association between asthma and environmental chemicals. Int J Environ Res Public Health. 2021;18(3):1–14.
  6. Miethe S, Karsonova A, Karaulov A, Renz H. Obesity and asthma. J Allergy Clin Immunol. 2020;146(4):685–93. Available from: https://doi.org/10.1016/j.jaci.2020.08.011
  7. Ubong Peters, PhD1, Anne Dixon, MA, BM, BCh1, and Erick Forno, MD M. Obesity and Asthma. J Allergy Clin Immunol. 2018;141(4):1169–79.
  8. Zolotareva O, Saik O V., Königs C, Bragina EY, Goncharova IA, Freidin MB, et al. Comorbidity of asthma and hypertension may be mediated by shared genetic dysregulation and drug side effects. Sci Rep. 2019;9(1):1–11.
  9. Dougherty RH, Fahy J V. Acute exacerbations of asthma: Epidemiology, biology and the exacerbation-prone phenotype. Clin Exp Allergy. 2009;39(2):193–202.
  10. Levy ML, Bacharier LB, Bateman E, Boulet LP, Brightling C, Buhl R, et al. Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update. npj Prim Care Respir Med. 2023;33(1).
  11. Marko M, Pawliczak R. Obesity and asthma: Risk, control and treatment. Postep Dermatologii i Alergol. 2018;35(6):563–71.
  12. Ferguson S, Teodorescu MC, Gangnon RE, Peterson AG, Consens FB, Chervin RD, et al. Factors Associated with Systemic Hypertension in Asthma. Lung. 2014;192(5):675–83.
  13. Zhang Z, Zhao L, Zhou X, Meng X, Zhou X. Role of inflammation, immunity, and oxidative stress in hypertension: New insights and potential therapeutic targets. Front Immunol. 2023;13(January):1–18.
  14. Imam SF, Zafar S, Oppenheimer JJ. Single maintenance and reliever therapy in treatment of asthma exacerbations. Ann Allergy, Asthma Immunol. 2022;129(6):703–8. Available from: https://doi.org/10.1016/j.anai.2022.07.024
  15. Williams DM, Rubin BK. Clinical pharmacology of bronchodilator medications. Respir Care. 2018;63(6):641–54.
  16. Al-Shamrani A, Al-Harbi AS, Bagais K, Alenazi A, Alqwaiee M. Management of asthma exacerbation in the emergency departments. Int J Pediatr Adolesc Med. 2019;6(2):61–7. Available from: https://doi.org/10.1016/j.ijpam.2019.02.001
  17. Dini M. Peptic ulcer disease and non-steroidal anti ‑ inflammatory drugs. Aust Prescr. 2017;40(3):91–3.
  18. Lee PH, Hong J, Jang AS. N-acetylcysteine decreases airway inflammation and responsiveness in asthma by modulating claudin 18 expression. Korean J Intern Med. 2020;35(5):1229–37.
  19. Alwarith J, Kahleova H, Crosby L, Brooks A, Brandon L, Levin SM, et al. The role of nutrition in asthma prevention and treatment. Nutr Rev. 2020;78(11):928–38.
  20. Tiotiu A, Novakova P, Kowal K, Emelyanov A, Chong-Neto H, Novakova S, et al. Beta-blockers in asthma: myth and reality. Expert Rev Respir Med. 2019;13(9):815–22. Available from: https://doi.org/10.1080/17476348.2019.1649147
  21. Morales DR, Jackson C, Lipworth BJ, Donnan PT, Guthrie B. Adverse respiratory effect of acute β -Blocker exposure in asthma: A systematic review and meta-analysis of randomized controlled trials. Chest. 2014;145(4):779–86.
  22. Huang KY, Tseng PT, Wu YC, Tu YK, Stubbs B, Su KP, et al. Do beta-adrenergic blocking agents increase asthma exacerbation? A network meta-analysis of randomized controlled trials. Sci Rep. 2021;11(1). Available from: https://doi.org/10.1038/s41598-020-79837-3
  23. Bennett M, Chang CL, Tatley M, Savage R, Hancox RJ. The safety of cardioselective β1-blockers in asthma: Literature review and search of global pharmacovigilance safety reports. ERJ Open Res. 2021;7(1):1–10. Available from: http://dx.doi.org/10.1183/23120541.00801-2020
  24. Christiansen SC, Zuraw BL. Treatment of Hypertension in Patients with Asthma. N Engl J Med. 2019;381(11):1046–57.

How to Cite

Ni Putu Ditadiliyana Putri, & Windiyanto, R. . (2024). Asma eksaserbasi akut dengan hipertensi urgensi dan obesitas: sebuah laporan kasus. Intisari Sains Medis, 15(1), 449–454. https://doi.org/10.15562/ism.v15i1.2009

HTML
0

Total
0

Share

Search Panel

Ni Putu Ditadiliyana Putri
Google Scholar
Pubmed
ISM Journal


Romy Windiyanto
Google Scholar
Pubmed
ISM Journal