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Goals and Background: Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by dense infiltration of lymphocytes, plasma cells, neutrophils, and monocyte-macrophages into the colonic mucosa. Leukocytapheresis is a procedure for selectively removing white blood cells from withdrawn blood. It i s used for the treatment of several autoimmune diseases. This study was performe d to evaluate the effectiveness of leukocytapheresis for inducing and maintainin g remission in corticosteroid-resistant UC, as compared with corticosteroid res ponsive UC. Study: Forty-five patients with active UC who were treated with a d ose of 1 mg/kg per day or more of prednisolone given systemically for at least 2 weeks were evaluated. Twenty patients (6 males, 14 females) in whom improvement was induced only by high doses of prednisolone were allocated as the corticoste roid-responsive group. The other 25 patients (11 males, 14 females) who did not respond to the above-mentioned dose of prednisolone therapy were allocated as the corticosteroid-resistant group and received leukocytapheresis therapy once a week for 5 weeks. Of patients who had a remission, the corticosteroid-respons ive group continued to have the conventional therapy and the corticosteroid-res istant group were given leukocytapheresis once every 4 weeks for at least 2 year s as maintenance therapy. Results: Remission was induced by 5 weeks of leukocyta pheresis in 23 of the 25 (92%) patients with corticosteroid-resistant active U C. The number of days required to achieve remission of UC was fewer in patients who received leukocytapheresis than in those who did not. Follow-up study of th e patients who had remission showed similar relapse rates at 2 years in the pati ents who received leukocytapheresis and those given high doses of prednisolone a lone. Conclusions: Leukocytapheresis is an effective treatment of acute corticos teroid-resistant UC but does not prevent the recurrence of UC.
Goals and Background: Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by dense infiltration of lymphocytes, plasma cells, neutrophils, and monocyte-macrophages into the colonic mucosa. Leukocytapheresis is a procedure for selectively removing white blood cells from withdrawn blood. It is used for the treatment of several autoimmune diseases. This study was performe d to evaluate the effectiveness of leukocytapheresis for inducing and maintain in remission in corticosteroid-resistant UC, as compared with corticosteroid res ponsive UC. Study: Forty-five patients with active UC who were treated with ad ose of 1 mg / kg per day or more of prednisolone given systemically for at least 2 weeks were evaluated. Twenty patients (6 males, 14 females) in whom improvement was induced only by high doses of prednisolone were allocated as the corticoste roid-responsive group. The other 25 patients (11 males, 14 females) who did not respond to the above-mentioned dose of prednisolone therapy were allocated as the corticosteroid-resistant group and received leukocytapheresis therapy once a week for 5 weeks. Of patients who had a remission, the corticosteroid-respons ive group continued to have the conventional therapy and the corticosteroid-res istant group were given leukocytapheresis Results: Remission was induced by 5 weeks of leukocyta pheresis in 23 of the 25 (92%) patients with corticosteroid-resistant active U C. The number of days required to achieve remission of UC was fewer in patients who received leukocytapheresis than in those who who did not. Follow-up study of th e patients who had remission caught similar recurpse rates at 2 years in the pati ents who received leukocytapheresis and those given high doses of prednisolone a lone. Conclusions: Leukocytapheresis is an effective treatment of acute corticosarco-resistant UC but does not prevent the recurrence of UC.