Granulocytapheresis with Adacolumn in the Treatment of Four Patients with Intractable Ulcerative Colitis :

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Four patients (3 men and 1 woman) with intractable ulcerative colitis (UC) were treated using granulocytapheresis (GCAP) with Adacolumn. Mean age at the first GCAP was 37.5±11 years. Mean observation period before GCAP was 157±105 months. A clinical activity index (CAI, Rachmilewitz criteria) and Matts' endoscopic classification were used for the estimation. GCAP was not effective in two cases, however it was very effective in the others. The CAI score of one male patient decreased from 8 to 5, and Matts' grade from 3 to 2, after the 5th GCAP. This patient could be taken off corticosteroid and the immunosuppressant. Then he received GCAP every month. Both his CAI score and Matts' grade had decreased to I sixteen months after the first GCAP. Four sessions of GCAP enabled us to reduce the prednisolone dose from 20 to 5 mg/day, and lowered the CAI score (8 to 4) of another male patient before total colectomy. Further examination is needed of the indications, times and intervals of GCAP in the treatment of intractable UC.

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