title: Possible role of early transabdominal ultrasound in patients undergoing cytapheresis for active ulcerative colitis.
abstract: BACKGROUND
  Cytaphresis (CAP) is an effective modality in the treatment of active ulcerative colitis (UC), but the time lag before a notable clinical response on scheduled therapy frequently causes a significant delay in the modification of treatment. We previously reported that the clinical response after CAP was predicted by early application of transabdominal ultrasound (TAUS), but the predictability of long-term outcome after CAP still remains uncertain. METHODS PATIENTS: Twenty-six patients with active UC who received CAP were followed for 1 year. In addition to CAP they received pharmaceutical regimens, such as corticosteroid, 5-aminosalicylic acid, and immunomodulator, as indicated clinically. The mean UC-DAI score was 9.7 before CAP, and 3.2 at 1 year after CAP. Prognostic factor: Total colonic wall thickness was measured by TAUS at 2 to 3 weeks after the initiation of the treatment, and decrement from baseline was calculated. Early ultrasonographic response (EUR) was defined as a decrement statistically. UC-DAI score of 2 or less at 1 year was defined as sustained clinical remission. Score of 6 or more was defined as clinical relapse.
  
  
  RESULTS
  EUR was defined as a decrement in wall thickness by at least 2.5 mm from the baseline. EUR was noted in 11 patients, and the remaining 15 did not attain EUR.
  
  
  METHODS
  In the UC-DAI score measured at 1 year after initiation of treatment 90.9% of patients with EUR, whereas 40.0% with non-EUR (p<0.05) showed sustained clinical remission. Regarding relapse, within 1 year 9.1% of patients with EUR relapsed whereas 46.7% with non-EUR (p<0.05) relapsed.
  
  
  CONCLUSIONS
  Early application of TAUS may predict the long-term clinical outcome after CAP in patients with active UC.
authors.affiliation: Center for Digestive and Liver Diseases, Ohfuna Chuo Hospital, Japan. atushi.y@kza.biglobe.ne.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshida
authors.forename: Kenji
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Ueno
authors.forename: Eiki
authors.initials: E
authors.lastname: Yoshimatsu
authors.forename: Keiji
authors.initials: K
authors.lastname: Matsui
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Fujikawa
authors.forename: Hirohito
authors.initials: H
authors.lastname: Shimizu
authors.forename: Kentaroh
authors.initials: K
authors.lastname: Takatsuka
authors.forename: Shogo
authors.initials: S
authors.lastname: Iwabuchi
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D003093:Colitis, Ulcerative / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000628:therapy*; D003106:Colon / Q000000981:diagnostic imaging; D016238:Cytapheresis; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D007155:Immunologic Factors; D019804:Mesalamine