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.