INDUCTION OF REMISSION FOR THE FIRST ONSET OF SEVERE PANCOLITIS TREATED BY LEUKOCYTAPHERESIS ALONE

Abstract

A 22-year-old female, nurse, was introduced and admitted to our hospital complaining of abdominal pain, bloody diarrhea, and fever. The diagnosis was the first onset of severe pancolitis (ulcerative colitis : UC) by barium enema X-ray study and endoscopic examina-tion etc. Because she worried about side effects of medical drugs such as corticosteroids and salazosulfapyridine, she wanted to be treated by leukocytapheresis (LCAP) first. Thus she was treated by this new therapy "LCAP" alone after informed consent. LCAP was performed with the Plasauto 2500 apheresis unit equipped with a Cellsorba (Asahi Medical Co. Ltd., Tokyo, Japan) leukocyte removal filter. Three thousand milliliters of whole blood were processed at a blood flow rate of 50 ml/min. LCAP was performed once weekly for 5 weeks as intensive therapy and once every 2 to 4 weeks as maintenance therapy. After the first session of the therapy, abdominal pain and fever disappeared. Her diarrhea also disappeared and the frequency of bowel habit decreased to 1-2 times/day after 3 sessions of LCAP from more than 7 times/day before LCAP. Endoscopic evaluation revealed remission after 7 sessions of LCAP without any drugs throughout this therapy and no deterioration was noted after the initiation of oral feeding. This suggests that LCAP alone may be effective to treat patients with the first onset of UC.