Digestive Diseases and Sciences

, Volume 48, Issue 4, pp 750-754

First online:

Granulocyte Adsorptive Apheresis for Pediatric Patients with Ulcerative Colitis

  • Takeshi TomomasaAffiliated withDepartment of Pediatrics, Gunma University Faculty of Medicine
  • , Akio KobayashiAffiliated withShowa University Toyosu Hospital
  • , Hiroaki KanekoAffiliated withDepartment of Pediatrics, Gunma University Faculty of Medicine
  • , Sasaki MikaAffiliated withIwate Medical School
  • , Shun-ichi MaisawaAffiliated withMorioka Children's Hospital
  • , Yoshie ChinoAffiliated withNational Center for Child Health and Development
  • , Hohkibara SyouAffiliated withNagano Children's Hospital
  • , Atsushi YodenAffiliated withDepartment of Pediatric Surgery, Osaka Medical College
  • , Jyunko FujinoAffiliated withDepartment of Internal Medicine, Dokkyo University Koshigaya Hospital
    • , Makoto Tanikawa
    • , Takafumi Yamashita
    • , Shigeru Kimura
    • , Maiko Kanoh
    • , Koji Sawada
    • , Akihiro MorikawaAffiliated withDepartment of Pediatrics, Gunma University Faculty of Medicine

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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.

apheresis ulcerative colitis pediatric patients prednisolone steroid