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Preoperative Steroid-Related Complications in Japanese Pediatric Patients With Ulcerative Colitis

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Diseases of the Colon & Rectum

Purpose

This study was designed to clarify a limit for steroid therapy in patients with ulcerative colitis through analyzing the preoperative major steroid-related complications and to define when alternative therapies, including surgery, should be performed in pediatric ulcerative colitis patients.

Methods

The medical records of 28 pediatric and 57 adult patients with ulcerative colitis who underwent total proctocolectomy and ileal J-pouch-anal anastomosis were reviewed. The relationship between the preoperative dose of glucocorticoids and major steroid-related complications, as well as the surgery variables, was evaluated.

Results

Significantly higher incidences of growth retardation, osteoporosis, glaucoma, and cataracts were noted in pediatric patients than in adult patients. In pediatric patients, major steroid-related complications occurred at a significantly lower preoperative total dosage of glucocorticoids/body weight (mg/kg) or preoperative total dosage of glucocorticoids/body surface area (mg/m2) than in adult patients. A similar surgical procedure was performed in both pediatric and adult patients. The presence of major steroid-related complications can lower a patient's long-term quality of life.

Conclusions

Evidence-based guidelines for the recommended dose ofglucocorticoids according to body weight or body surface area are needed. To allow patients to feel well and maintain a good quality of life, early introduction of alternative treatments, including surgery, should be considered.

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Authors and Affiliations

  1. Second Department of Surgery, Mie University School of Medicine, Edobashi 2-174, Tsu, Mie, 514-8507, Japan

    Keiichi Uchida M.D., Toshimitsu Araki M.D., Yuji Toiyama M.D., Shigeyuki Yoshiyama M.D., Mikihiro Inoue M.D., Chikao Miki M.D. & Masato Kusunoki M.D., Ph.D.

  2. Second Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan

    Hiroki Ikeuchi M.D., Hidenori Yanagi M.D. & Takehira Yamamura M.D.

Authors
  1. Keiichi Uchida M.D.
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  2. Toshimitsu Araki M.D.
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  3. Yuji Toiyama M.D.
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  4. Shigeyuki Yoshiyama M.D.
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  5. Mikihiro Inoue M.D.
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  6. Hiroki Ikeuchi M.D.
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  7. Hidenori Yanagi M.D.
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  8. Chikao Miki M.D.
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  9. Takehira Yamamura M.D.
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  10. Masato Kusunoki M.D., Ph.D.
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Corresponding author

Correspondence to Masato Kusunoki M.D., Ph.D..

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Uchida, K., Araki, T., Toiyama, Y. et al. Preoperative Steroid-Related Complications in Japanese Pediatric Patients With Ulcerative Colitis. Dis Colon Rectum 49, 74–79 (2006). https://doi.org/10.1007/s10350-005-0213-7

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  • DOI: https://doi.org/10.1007/s10350-005-0213-7

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