Poorly controlled ulcerative colitis treated by colectomy during remission induced by extracorporeal leukocyte removal therapy.
Both monocyte-granulocytapheresis (M-GCAP) and leukocytapheresis (LCAP) are categorized as extracorporeal leukocyte removal therapies (ECCTs). These therapies have been recognized as efficient adjuncts for patients of steroid-resistant ulcerative colitis (UC). This study aimed to consider the adaptation and the limitation of these new therapies from the clinical standpoint based on a case of UC showing strong resistance to high-dose continuous steroid injection therapy. The patient successfully underwent a scheduled colectomy while maintaining remission after applying M-GCAP and LCAP independently. Surgical therapy was chosen because of a deep ulcer in the patient's sigmoid colon, which was assumed to constitute a future risk for perforation. This case suggests that combining ECCT with steroid therapy can maintain such poorly controlled and high-risk UC patients safely for the scheduled colectomy while improving the prognosis by reducing the dosage of steroid efficiently prior to operation.
Fukunaga
Ken
K
Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa, Nishinomiya 663-8501, Japan.
Fukuda
Yoshihiro
Y
Sawada
Koji
K
Hori
Kazutoshi
K
Matoba
Yoshika
Y
Sagayama
Ken
K
Ohnishi
Kunio
K
Fukui
Shin
S
Shimoyama
Takashi
T
D000328:Adult; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D004351:Drug Resistance; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006098:Granulocytes; D006801:Humans; D007937:Leukapheresis; D009000:Monocytes; D011239:Prednisolone / Q000627:therapeutic use; D012074:Remission Induction
D005938:Glucocorticoids; D011239:Prednisolone