title: Ulcerative colitis and granulocyte-monocyte-apheresis: safety and efficacy of maintenance therapy during pregnancy.
abstract: Inflammatory bowel disease characteristically affects young adults in their reproductive ages. Thus the medication used for the treatment of active disease should not compromise fertility and, also, should not have teratogenic effect on baby. A lot of data are available about effects of steroids, antibiotics, and mesalazine but no data are available about safety and efficacy of granulocyte-monocyte-apheresis (GMA) during pregnancy. In this case report, the 37 year-old pregnant woman with chronically active and steroid dependent ulcerative colitis (UC), at risk of abortion, refused more aggressive pharmacological therapeutic options and gave the informed consent to GMA. To minimize symptoms and the risk of severe clinical relapse, a maintenance GMA treatment was performed throughout pregnancy. The course of pregnancy was uneventful with no side effects; the mother and the baby were all healthy and well at the delivery.
authors.affiliation: GI Unit, Department of Internal Medicine and Medical Specialties, Policlinico Umberto I, University of Rome "La Sapienza", Sapienza, University of Rome, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: D'Ovidio
authors.forename: Donatella
authors.initials: D
authors.lastname: Meo
authors.forename: Maria
authors.initials: M
authors.lastname: Gozer
authors.forename: Marco E
authors.initials: ME
authors.lastname: Bazuro
authors.forename: Piero
authors.initials: P
authors.lastname: Vernia
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000097:blood / Q000150:complications* / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006098:Granulocytes; D006801:Humans; D007231:Infant, Newborn; D007937:Leukapheresis / Q000379:methods*; D019804:Mesalamine / Q000627:therapeutic use; D009000:Monocytes; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000276:immunology / Q000628:therapy*; D011256:Pregnancy Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine
keywords: granulocyte-monocyte-apheresis; pregnancy; ulcerative colitis