Management of fulminating ulcerative colitis in childhood with chimeric anti-CD25 antibody.
Fulminating acute ulcerative colitis (UC) is a potentially life threatening medical emergency. Up to 30% of individuals respond poorly to corticosteroids alone and second line medical or surgical therapies are indicated. We describe the successful use of chimeric anti-CD25 therapy in 4 such children poorly responsive to combined therapy with intravenous steroids and calcineurin inhibitors with a pretreatment predictive risk of colectomy of 85-100%. Clinical disease activity scores normalized within 72 hours of anti-CD25 administration and colonic histology provided evidence of mucosal healing within 10-14 days. None required emergency colectomy. Anti-CD25 is efficacious in fulminating UC and randomized placebo controlled trials appear indicated.
Schwarzer
A
A
University Hospital Mannheim, Karl-Ruprecht-University of Heidelberg, Heidelberg, Germany.
Ricciardelli
I
I
Kirkham
S
S
Binnie
K
K
Shah
N
N
Elawad
M A
MA
Hill
S M
SM
Furman
M
M
Smith
V V
VV
Sebire
N
N
Milla
P J
PJ
Londei
M
M
Lindley
K J
KJ
D000208:Acute Disease; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000888:Antibodies, Anti-Idiotypic / Q000627:therapeutic use*; D065095:Calcineurin Inhibitors; D002648:Child; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D006801:Humans; D015375:Receptors, Interleukin-2 / Q000276:immunology*; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000888:Antibodies, Anti-Idiotypic; D065095:Calcineurin Inhibitors; D015375:Receptors, Interleukin-2