Centrifugal leukocytapheresis therapy for ulcerative colitis without concurrent corticosteroid administration.

Abstract

Corticosteroid administration is an important therapy for active ulcerative colitis. However, long-term corticosteroid use is associated with serious complications such as osteoporosis, diabetes, and growth retardation. The effect of combination therapy corticosteroid plus leukocytapheresis has been previously reported, but that of leukocytapheresis with no corticosteroid is unknown. We carried out a preliminary study of six patients (two men and four women) with active ulcerative colitis (severe in two, moderately severe in four) who did not respond to 5-aminosalicylate derivatives, but refused corticosteroid use. Centrifugal leukocytapheresis was carried out once per week totaling four sessions per course. Treatment was considered effective when patients experienced clinical remission, which was defined as a frequency of diarrhea of four times or less and absence of visible blood in the stool, after one course. Leukocytapheresis was effective in five of six patients(83%). With cases stratified by severity, both severe cases and three of four moderately severe cases showed effectiveness. Clinical activity scores according to Lichtiger et al. in cases where leukocytapheresis was effective decreased from 9.8 to 6.6 at 1 week (P < 0.0001), declining further 2.4 at the end of the course. No obvious complications of leukocytapheresis were noted except for a decrease in hemoglobin by 1 g/dL. Centrifugal leukocytapheresis without corticosteroid treatment can induce remission in patients with active ulcerative colitis, and might be particularly beneficial for patients in whom adverse effects preclude the use of corticosteroids.

• Authors: Hiroyuki Okada, Ryuta Takenaka, Sakiko Hiraoka, Chiho Makidono, Shin-Ichiro Hori, Jun Kato, Hiroaki Okazaki, Hirofumi Kawamoto, Motowo Mizuno, Yasushi Shiratori
• Journal: Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy (Ther Apher Dial) Vol. 10 Issue 3 Pg. 242-6 (Jun 2006) ISSN: 1744-9979 [Print] Australia
• PMID: 16817788 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Adrenal Cortex Hormones
• Mesalamine

Topics

• Adolescent
• Adrenal Cortex Hormones
• Adult
• Aged
• Colitis, Ulcerative (therapy)
• Contraindications
• Endoscopy, Digestive System
• Female
• Humans
• Leukapheresis (methods)
• Male
• Mesalamine (pharmacology)
• Middle Aged
• Parenteral Nutrition, Total (methods)
• Severity of Illness Index
• Treatment Outcome