A 14-year-old boy presented with diarrhea and anemia. The patient had 5 episodes of diarrhea 3 months previously. However, more than 10 episodes of diarrhea accompanied by mucous and bloody stools and abdominal pain occurred 2 weeks previously, and the patient presented at the Department of Pediatrics. The face was pale, and a blood test showed severe anemia. The patient was suspected to have inflammatory bowel disease and was referred to the Department of Gastroenterology. Colonoscopy revealed a pancolitis type of ulcerative colitis (UC) , and treatment was begun. Because the patient was in the growth phase, steroids, associated with potential adverse effects on growth, were not used. Intensive granulocyte apheresis (GCAP) procedures were performed twice weekly, and oral mesalazine granules (4000 mg) were administered. After about 2 weeks, diarrhea resolved, the patient defecated solid stools 2 times, and the hemoglobin level normalized. The use of steroids, associated with various adverse effects, should be carefully considered in children. Our findings suggest that treatment with intensive GCAP twice weekly and mesalazine granules (4000 mg) can suppress even severe UC in steroid-naive children.
