Granulocyte adsorptive apheresis for pediatric patients with ulcerative colitis.
Granulocytapheresis (GCAP) has produced efficacy in adult patients with ulcerative colitis (UC) by adsorbing activated granulocytes and monocytes/macrophages. We retrospectively investigated efficacy and safety of GCAP in pediatric patients with active UC. Twelve steroid-refractory children (12.2 +/- 3.1 years old) were treated with GCAP, one session/week for 5-10 consecutive weeks. In 8 patients, clinical symptoms improved after two GCAP sessions. Normal body temperature, stool frequency, and disappearance of blood in stool were seen after 24.3 +/- 11.5 days. The endoscopic grade improved from 2.6 +/- 0.3 to 0.4 +/- 0.2. One patient who initially responded, developed bloody diarrhea later and 2 cases remained unchanged. The dose of steroid was tapered during GCAP therapy by 50%. No serious adverse effects were noted. Four of 8 cases relapsed 3.5 +/- 2.2 months after the last GCAP while on maintenance therapy, the other 4 were in remission up to 22.8 +/- 18.1 months. In conclusion, GCAP appears to be effective and well tolerated in children with steroid-refractory UC.
Department of Pediatrics, Gunma University Faculty of Medicine, Maebashi, Japan.
Takeshi
T
Tomomasa
Akio
A
Kobayashi
Hiroaki
H
Kaneko
Sasaki
S
Mika
Shun-Ichi
S
Maisawa
Yoshie
Y
Chino
Hohkibara
H
Syou
Atsushi
A
Yoden
Jyunko
J
Fujino
Makoto
M
Tanikawa
Takafumi
T
Yamashita
Shigeru
S
Kimura
Maiko
M
Kanoh
Koji
K
Sawada
Akihiro
A
Morikawa
D000293:Adolescent; D000327:Adsorption; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000276:immunology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000276:immunology / Q000628:therapy; D006098:Granulocytes / Q000276:immunology; D006801:Humans; D007937:Leukapheresis / Q000379:methods*; D008264:Macrophages / Q000276:immunology; D008297:Male; D009000:Monocytes / Q000276:immunology; D011239:Prednisolone / Q000008:administration & dosage; D012008:Recurrence; D016896:Treatment Outcome
D011239:Prednisolone