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Steroid response in moderate to severe pediatric ulcerative colitis: a single center’s experience

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Abstract

Background

We aimed to analyze clinical and inflammatory markers of steroid non-response in patients with moderate/severe ulcerative colitis (UC) at the time of diagnosis.

Methods

This study included patients who were graded as having moderate/severe UC and received corticosteroids as first-line therapy. Demographic, clinical and laboratory findings and pediatric ulcerative colitis activity scores (PUCAS) were recorded. Response to corticosteroids was assessed 30 days after the induction and long-term therapy.

Results

Twenty-eight children were diagnosed as having moderate/severe UC. Their mean age ± SD was 1 2.2 ± 4 years, and 17% were under 5 years of age. PUCAS at their initial admission was 56.9 ± 11.8. UC was observed at the left colon in 9 patients (32.1%), and pancolitis in 19 (67.9%). At the end of the 30th day, UC was completely remitted in 15 patients (53.5%), partially remitted in 2 (7.1%), and no response in 11 (39.2%). Short-term follow-up showed partial remission in 2 patients, and overall remission with steroid in 17 (60.7%). Non-responders were given second-line treatment; steroid dependency was documented in 2 patients (7.1%) and another 2 (7.1%) patients underwent colectomy. Predictors for steroid non-response were analyzed and only PUCAS at the initial admission was found to be associated with non-response to steroids (51.4 ± 11.4 vs. 65.4 ± 6.8, P<0.05).

Conclusions

Approximately half of the pediatric patients had complete response to steroid therapy in a long period. PUCAS could be used as a potential marker of “failed response” to steroid, but should be supported with a number of prospective randomized controlled studies.

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Authors and Affiliations

  1. Faculty of Medicine, Department of Pediatric Gastroenterology, Hepatology and Nutrition, Ege University, Bornova, Izmir, Turkey

    Murat Cakir, Funda Ozgenc, Hasan Ali Yusekkaya, Cigdem Omur Ecevit & Rasit Vural Yagci

Authors
  1. Murat Cakir
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  2. Funda Ozgenc
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  3. Hasan Ali Yusekkaya
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  4. Cigdem Omur Ecevit
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  5. Rasit Vural Yagci
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Correspondence to Murat Cakir.

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Cakir, M., Ozgenc, F., Yusekkaya, H.A. et al. Steroid response in moderate to severe pediatric ulcerative colitis: a single center’s experience. World J Pediatr 7, 50–53 (2011). https://doi.org/10.1007/s12519-011-0245-0

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  • DOI: https://doi.org/10.1007/s12519-011-0245-0

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