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Granulocyte, macrophage, monocyte apheresis for refractory ulcerative proctitis
Purushothaman Premchand1, Ken Takeuchi, Ingvar Bjarnason
1Department of Gastroenterology, Guy's School of Medicine, London SE5 9PJ, UK. purushothaman.premchand@gstt.nhs.uk
European Journal of Gastroenterology & Hepatology
|August 19, 2004
Summary
Granulocyte monocyte/macrophage adsorption apheresis offers a safe and effective treatment for severe refractory ulcerative colitis, potentially avoiding colectomy. This novel therapy achieved sustained remission in a proctitis case, demonstrating significant clinical benefits with minimal side effects.
Area of Science:
- Gastroenterology
- Immunology
- Medical Technology
Background:
- Refractory ulcerative colitis often necessitates colectomy despite conventional treatments.
- Current advanced therapies like ciclosporin and infliximab have limitations, including toxicity and acting as a temporary measure before surgery.
Observation:
- A case of severe refractory proctitis, initially considered for colectomy, was treated with granulocyte monocyte/macrophage adsorption apheresis.
- The patient received five sessions of this apheresis therapy.
Findings:
- Full clinical remission was achieved after only two sessions of granulocyte monocyte/macrophage adsorption apheresis.
- This remission was sustained for over a year with the addition of azathioprine.
- The treatment was associated with negligible side effects.
Implications:
- Granulocyte monocyte/macrophage adsorption apheresis presents a promising, low-toxicity alternative for managing refractory ulcerative colitis.
- This apheresis technique may help patients avoid colectomy and achieve long-term remission.
- Further research into apheresis for inflammatory bowel disease is warranted.