Extracorporeal leukocyte removal therapy for patients with ulcerative colitis.
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.
Kumagai
Masami
M
Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan.
Yamato
Yasuhiko
Y
Maeda
Kohji
K
Nakashima
Eisuke
E
Ushijima
Kosuke
K
Kimura
Akihiko
A
D000293:Adolescent; D000328:Adult; D003093:Colitis, Ulcerative / Q000628:therapy*; D006801:Humans; D007937:Leukapheresis; D008297:Male; D016896:Treatment Outcome