ACA IgM

ACA IgM
Antibodi ini dapat mempengaruhi kemampuan tubuh untuk mengatur pembekun darah yang masih belum diketahui.

Bagikan :


Definisi

Antibodi atau immunoglobulin memiliki peran penting pada sistem imunitas tubuh. Imunoglobulin merupakan protein yang terbentuk atau dihasilkan oleh sel imun yang disebut dengan plasma sel pada sistem imun untuk melawan benda asing dari luar tubuh seperti virus dan bakteri.

Antibodi kardiolipin (ACA) merupakan antibodi yang dihasilkan oleh sistem imun yang mungkin disalahkan sebagai target sistem imun tubuh sebagai kardiolipin, yaitu senyawa yang ditemukan pada bagian luar lapisan sel dan keping darah. Antibodi ini dapat memengaruhi kemampuan tubuh untuk mengatur pembekuan darah yang masih belum diketahui. Kardiolipin dan fosfat lain yang terkait merupakan molekul lipid memiliki peran penting dalam proses pembekuan darah.

Antibodi kardiolipin memiliki target kardiolipin dan terkait dana peningkatan pada kembuhnya kembali pembekuan darah pada pembuluh darah vena dan arteri seperti pada kaki (deep vein leg) atau paru-paru (embolisme paru). Selain itu, antibodi kardiolipin juga terkait dengan keping darah yang rendah, keguguran yang berulang, kehamilan prematur dan preeklamsia.

IgM merupakan antibodi pertama yang terbentuk ketika tubuh terpapar benda asing. IgM terdapat dalam darah dan cairan limpa (cairan yang membawa sel melawan infeksi dan penyakit lain dalam tubuh). IgM merupakan salah satu antibodi terbesar dalam antibodi dan antibodi alami di dalam tubuh, memiliki kemampuan untuk menghalangi antigen spesifik. Antibodi IgM memiliki kinerja yang sangat cepat pada inisiasi dan respon imun terhadap benda asin dengan menetralkan secara langsung patogen. Pemeriksaan IgM dilakukan untuk mengukur jumlah antibodi IgM di dalam darah. Pemeriksaan IgM biasanya dilakukan bersamaan dengan pemeriksaan IgG dan IgA untuk mendapatkan gambaran lebih jelas terhadap fungsionalitas imun seseorang dan kemampuan tubuh dalam menghadapi antigen.

 

Baca Juga: Bayi Prematur - Definisi, Penyebab, Gejala, dan Pengobatannya

 

Indikasi

Pemeriksaan antibodi kardiolipin IgM biasanya dilakukan untuk:

  • Mengetahui kemampuan sistem imun seseorang, mendeteksi, dan mengawasi kelebihan atau kekurangan antibodi kardiolipin
  • Pendarahan atau pembekuan darah yang tidak normal
  • Riwayat keguguran berulang (abortus habitualis)
  • Pemeriksaan ini juga dilakukan pada pasien dengan gangguan autoimun seperti lupus eritematosus sistemik. Pemeriksaan ini juga dapat membantu diagnosa dimana ditemukan adanya antibodi kardiolopin pada pasien atau pada jaringan lain, kondisi ini disebut dengan antibodi kardiolipin sindrom.

 

Kontraindikasi

Tidak ada kontraindikasi khusus terkait pemeriksaan antibodi kardiolipin IgM.

 

Persiapan Sebelum Pemeriksaan

Tidak ada persiapan khusus sebelum melakukan pemeriksaan antibodi kardiolipin IgM.  Pemeriksaan ini tidak mewajibkan Anda puasa sebelumnya kecuali anda juga melakukan pemeriksaan lain yang mengharuskan Anda berpuasa sebelumnya. Informasikan pada dokter mengenai kondisi medis, obat rutin dan suplemen yang Anda konsumsi yang dapat memengaruhi pemeriksaan. Pastikan kondisi Anda terhidrasi dan tidak dalam kondisi stres.

 

Prosedur Pemeriksaan

Pemeriksaan antibodi kardiolipin IgM menggunakan sampel darah. Petugas laboratorium akan membersihkan lengan Anda dengan alcohol swab dan mengambil sedikit darah dari pembuluh darah vena di lengan menggunakan spuit steril.

Bila darah diambil melalui pembuluh darah, permukaan kulit akan dibersihkan dengan antiseptik dan diikat dengan alat khusus (tourniquet) pada area lengan untuk memberikan tekanan dan menyebabkan pembuluh darah membengkak dengan darah. Jarum mengambil sampel akan dimasukkan melalui pembuluh darah (biasanya pada bagian lengan dalam atau siku atau pada bagian punggung tangan) dan darah akan diambil masuk ke dalam vial atau syringe. Setelah prosedur, tourniquet dilepaskan dan bekas area pengambilan darah akan ditutup dengan perban untuk menghentikan pendarahan.

Selanjutnya, darah akan dimasukan ke dalam tabung darah dan diperiksa oleh petugas laboratorium pada mesin khusus. Pemeriksaan ini mungkin akan memakan waktu sehari untuk mendapatkan hasil. Risiko pemeriksaan ini cukup minimal Beberapa orang merasakan nyeri, pusing, dan memar saat pengambilan darah. Namun, hal ini biasanya hilang dengan cepat. Prosedur pemeriksaan ini cukup sederhana dan biasanya akan memakan waktu hingga 10 menit untuk mengambil darah darah dan merapikannya.

 

Nilai Normal dan Abnormal

Nilai normal pemeriksaan dari Antikardiolipin IgM menunjukkan nilai negatif dan nilai abnormal menunjukkan nilai positif.

Rentang nilai normal pemeriksaan bervariasi antara jenis kelamin, usia dan dimana Anda melakukan pemeriksaan.

Nilai normal pemeriksaan Antikardiolipin IgM memiliki nilai <10.0 MPL U/ml dan nilai abnormal atau positif dengan nilai >40 MPL U/ml. Dokter akan menyarankan melakukan pemeriksaan kembali dengan nilai 10-40 GPL U/ml.

 

Hasil dan Saran (Pemeriksaan Lanjutan)

Hasil pemeriksaan Antikardiolipin IgM tidak dapat berdiri sendiri sehingga dokter juga akan menyarankan Anda melakukan pemeriksaan antibodi lainnya seperti IgG dan IgA. Jika kadar antikardiolipin IgM yang lebih tinggi maka Anda mungkin memiliki sindrom antibodi kardiolipin.

Anda mungkin akan disarankan melakukan pemeriksaan kembali untuk melihat apakah antibodi tersebut masih ada di dalam tubuh dengan waktu tunggu sekitar 12 minggu antara pemeriksaan. Bila Anda memiliki hasil negatif pada pemeriksaan Antikardiolipin IgM, hal tersebut menunjukkan kondisi yang normal.

 

Baca Juga: ACA IgG - Indikasi, Kontraindikasi, Hasil dan Saran

 

Konsultasikan ke Dokter yang Tepat

Bila hasil pemeriksaan antibodi kardiolipin IgM Anda tidak normal, Anda dapat berkonsultasi dengan dokter umum untuk mendapatkan diagnosis dan terapi yang sesuai serta pemeriksaan lanjutan bila dirasa perlu dalam penegakan diagnosis. Bila diperlukan, Anda juga dapat berkonsultasi dengan dokter spesialis penyakit dalam terkait kondisi Anda. Pada pasien anak-anak, dokter spesialis anak dapat memberikan informasi dan terapi yang lebih detail.

 

Mau tahu informasi seputar hasil pemeriksaan laboratorium, radiologi, dan lainnya? Cek di sini, ya!

 

 

Writer : dr Kevin Luke
Editor :
  • dr. Monica Salim
Last Updated : Rabu, 29 Mei 2024 | 06:43

Cardiolopin Antibody Test. (2021). Retrieved 05 June 2023, from https://www.testing.com/tests/cardiolipin-antibodies/

Anticardiolopin Antibody (ACL). (2022). Retrieved 05 June 2023, from https://www.southtees.nhs.uk/services/pathology/tests/anti-cardiolipin-antibody-acl/

Anticardiolipin Antibody. (2020). Retrieved 05 June 2023, from https://emedicine.medscape.com/article/2084956-overview

Cardiolipin Antibody. (2023). Retrieved 05 June 2023, from https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=cardiolipin_antibody 

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      • Use SELECT * only if you need all columns from table
      • LIMIT without ORDER BY causes non-deterministic results, depending on the query execution plan
      Backtrace
      • view::web.v2.single-post-healthpedia:37
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new9.28msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 6706 and `categories`.`deleted_at` is null
      Bindings
      • 0: 6706
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new9.04msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 7562 and `categories`.`deleted_at` is null
      Bindings
      • 0: 7562
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new9.07msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 551 and `categories`.`deleted_at` is null
      Bindings
      • 0: 551
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#11aicare_prod_new800μsselect * from `categories` where `categories`.`id` = 2 and `categories`.`deleted_at` is null limit 1
      Bindings
      • 0: 2
      Hints
      • Use SELECT * only if you need all columns from table
      • LIMIT without ORDER BY causes non-deterministic results, depending on the query execution plan
      Backtrace
      • view::web.v2.partials.article-popular:11
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new8.63msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 8248 and `categories`.`deleted_at` is null
      Bindings
      • 0: 8248
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new9.14msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 2070 and `categories`.`deleted_at` is null
      Bindings
      • 0: 2070
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new6.37msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 8530 and `categories`.`deleted_at` is null
      Bindings
      • 0: 8530
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new5.82msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 2941 and `categories`.`deleted_at` is null
      Bindings
      • 0: 2941
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new5.8msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 7639 and `categories`.`deleted_at` is null
      Bindings
      • 0: 7639
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new6msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 7480 and `categories`.`deleted_at` is null
      Bindings
      • 0: 7480
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new6.12msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 6285 and `categories`.`deleted_at` is null
      Bindings
      • 0: 6285
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new6.01msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 6289 and `categories`.`deleted_at` is null
      Bindings
      • 0: 6289
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new6.01msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 7329 and `categories`.`deleted_at` is null
      Bindings
      • 0: 7329
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • web_layout.blade.php#122aicare_prod_new1.52msselect * from `pages` where `slug` = 'about-us' limit 1
      Bindings
      • 0: about-us
      Hints
      • Use SELECT * only if you need all columns from table
      • LIMIT without ORDER BY causes non-deterministic results, depending on the query execution plan
      Backtrace
      • view::layouts.v2.web_layout:122
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • web_layout.blade.php#547aicare_prod_new7.74msselect * from `faqs` limit 1
      Hints
      • Use SELECT * only if you need all columns from table
      • The SELECT statement has no WHERE clause and could examine many more rows than intended
      • LIMIT without ORDER BY causes non-deterministic results, depending on the query execution plan
      Backtrace
      • view::layouts.v2.web_layout:547
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • web_layout.blade.php#551aicare_prod_new980μsselect * from `term_policies`
      Hints
      • Use SELECT * only if you need all columns from table
      • The SELECT statement has no WHERE clause and could examine many more rows than intended
      Backtrace
      • view::layouts.v2.web_layout:551
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    App\Models\Admin\Post
    251Post.php#?
    App\Models\Admin\Category
    21Category.php#?
    App\User
    3User.php#?
    App\Models\Admin\Tag
    3Tag.php#?
    App\Models\TermPolicy
    3TermPolicy.php#?
    App\Models\Admin\Page
    1Page.php#?
    App\Models\Admin\Faq
    1Faq.php#?
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        id
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        oNgw4fDUyleiERc9TPyK5INC5MtIGR7FwENx61v3
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        array:1 [ "url" => "https://ai-care.atmatech.id/healthpedia-pemeriksaan/aca-igm" ]
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        array:2 [ "old" => [] "new" => [] ]
        path_info
        /healthpedia-pemeriksaan/aca-igm
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
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        []
        
        request_request
        []
        
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        request_cookies
        0 of 0
        array:2 [ "XSRF-TOKEN" => "oNgw4fDUyleiERc9TPyK5INC5MtIGR7FwENx61v3" "laravel_session" => "B2tLYXye4Bgsl8C5VcOL3XW8LMgKDqeUjc8GWOi1" ]
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