Granulocyte adsorptive apheresis for pediatric patients with ulcerative colitis |
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Authors: | Tomomasa Takeshi Kobayashi Akio Kaneko Hiroaki Mika Sasaki Maisawa Shun-Ichi Chino Yoshie Syou Hohkibara Yoden Atsushi Fujino Jyunko Tanikawa Makoto Yamashita Takafumi Kimura Shigeru Kanoh Maiko Sawada Koji Morikawa Akihiro |
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Affiliation: | (1) Department of Pediatrics, Gunma University Faculty of Medicine, 3-39-15 Showamachi, Maebashi, Gunma, 371-8511, Japan;(2) Showa University Toyosu Hospital, Japan;(3) Department of Pediatrics, Gunma University Faculty of Medicine, Japan;(4) Iwate Medical School, Japan;(5) Morioka Children's Hospital, Japan;(6) National Center for Child Health and Development, Japan;(7) Nagano Children's Hospital, Japan;(8) Department of Pediatric Surgery, Osaka Medical College, Japan;(9) Department of Internal Medicine, Dokkyo University Koshigaya Hospital, Japan |
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Abstract: | Granulocytapheresis (GCAP) has produced efficacy in adult patients with ulcerative colitis (UC) by adsorbing activated granulocytes and monocytes/macrophages. We retrospectively investigated efficacy and safety of GCAP in pediatric patients with active UC. Twelve steroid-refractory children (12.2±3.1 years old) were treated with GCAP, one session/week for 5–10 consecutive weeks. In 8 patients, clinical symptoms improved after two GCAP sessions. Normal body temperature, stool frequency, and disappearance of blood in stool were seen after 24.3±11.5 days. The endoscopic grade improved from 2.6±0.3 to 0.4±0.2. One patient who initially responded, developed bloody diarrhea later and 2 cases remained unchanged. The dose of steroid was tapered during GCAP therapy by 50%. No serious adverse effects were noted. Four of 8 cases relapsed 3.5 ± 2.2 months after the last GCAP while on maintenance therapy, the other 4 were in remission up to 22.8±18.1 months. In conclusion, GCAP appears to be effective and well tolerated in children with steroid-refractory UC. |
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Keywords: | apheresis ulcerative colitis pediatric patients prednisolone steroid |
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