[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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The patient was a 14-year-old boy who was admitted to a hospital on August 28, 2006, with a 6-month history of chronic diarrhea and weight loss of about 11 kg. Endoscopy revealed the diagnosis of ulcerative colitis. The patient was treated with mesalazine and prednisolone while being managed on total parenteral nutrition, however, the disease proved refractory to the steroid. Three courses of steroid pulse therapy were thus performed. Endoscopy performed after the steroid pulse therapy revealed inflammation of the ascending colon and a deep ulcer. Cytomegalovirus enteritis as a complication was also suspected, therefore, administration of ganciclovir was initiated. Since the patient was found to have refractory ulcerative colitis, one course of leukocytapheresis (LCAP) was initiated on October 13, which resulted in healing of the multiple erosions of the colonic mucosa as well as of the deep ulcer. Because the disease appeared to have entered into remission, the steroid dose was tapered off. The patient, however, developed disease relapse in September 2007, despite receiving mesalazine monothearpy for about 10 months. One course of LCAP was initiated again on October 3, which led to both clinical and endoscopic improvement. Thus, LCAP appears to be effective as induction remission therapy for pediatric refractory ulcerative colitis, however, several issues remain to be resolved in relation to the maintenance of remission over the long-term following the induction of remission.

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