title: Extracorporeal leukocyte removal therapy for patients with ulcerative colitis.
abstract: BACKGROUND
  The purpose of the present paper was to investigate efficacy of leukocytapheresis (LCAP) or granulocytapheresis (GCAP) in pediatric patients with ulcerative colitis (UC), including reduction of the total dose and side-effects of corticosteroids.
  
  
  METHODS
  Courses of five Japanese adolescents with UC were analyzed. Four patients had recurrent UC with repeated remissions and exacerbations despite therapy including 5-aminosalicylic acid in combination with a corticosteroid. The other patient had a first attack. Effectiveness of adding LCAP or GCAP was assessed with regard to short-term changes in clinical activity, complications, and longer-term outcome.
  
  
  RESULTS
  Clinical improvement was attained in three patients, while the other two did not improve and underwent colectomy. One of the two patients had moderately severe complications from LCAP and showed increased clinical activity during LCAP. The other, who began therapy with LCAP alone, had moderate improvement only after addition of a corticosteroid.
  
  
  CONCLUSIONS
  Additional studies are needed to determine optimum timing of LCAP or GCAP and initiation of remission-maintenance therapy.
authors.affiliation: Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Kumagai
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Yamato
authors.forename: Kohji
authors.initials: K
authors.lastname: Maeda
authors.forename: Eisuke
authors.initials: E
authors.lastname: Nakashima
authors.forename: Kosuke
authors.initials: K
authors.lastname: Ushijima
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kimura
mesh_terms: D000293:Adolescent; D000328:Adult; D003093:Colitis, Ulcerative / Q000628:therapy*; D006801:Humans; D007937:Leukapheresis; D008297:Male; D016896:Treatment Outcome