Efficacy of granulocyte apheresis in pediatric patients with ulcerative colitis: a pilot study.
OBJECTIVE
Granulocyte apheresis (GCAP), involving the removal of granulocytes from the blood, may improve clinical symptoms and facilitate a reduction in the dose of steroids in adult patients with ulcerative colitis. As a preliminary trial, GCAP was used to taper the dose of steroids in 4 pediatric patients with ulcerative colitis.


METHODS
Three males and 1 female ranging from 11 to 17 years old were treated with GCAP once per week for 5 consecutive weeks/course. The ages of patients at clinical onset ranged from 8 to 12 years and the length of time from the clinical onset to GCAP treatment ranged from 28 to 58 months (median, 38.5 months).


RESULTS
In 2 patients, symptoms and signs indicating disease activity improved after 2 courses of GCAP. Laboratory data and endoscopic findings also improved after treatment and the clinical efficacy was judged to be excellent in these patients. In 1 patient, GCAP improved laboratory and endoscopic hallmarks, but bloody stools persisted. Finally, the treatment was ineffective in the fourth patient who eventually underwent surgery.


CONCLUSIONS
GCAP is effective in improving clinical symptoms and may play an important role in converting steroid therapy to other treatments in children with steroid-refractory or steroid-dependent ulcerative colitis.
Ikeda
Hitoshi
H
Department of Pediatric Surgery, Dokkyo University School of Medicine, Koshigaya Hospital, Koshigaya, Japan. hike@dokkyomed.ac.jp
Ishimaru
Yuki
Y
Takayasu
Hajime
H
Fujino
Junko
J
Kisaki
Yoshiyuki
Y
Otani
Yushi
Y
Yamagishi
Junko
J
Tahara
Kazunori
K
D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002648:Child; D003093:Colitis, Ulcerative / Q000628:therapy*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006098:Granulocytes; D006801:Humans; D007937:Leukapheresis; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D010865:Pilot Projects; D011239:Prednisolone / Q000627:therapeutic use; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D019804:Mesalamine; D011239:Prednisolone