@article{f9ce533be8a14c3fb1c025b600ea766b,
title = "Granulocyte-monocyte adsorptive apheresis in pediatric inflammatory bowel disease: results, practical issues, safety, and future perspectives",
abstract = "BACKGROUND: The purpose of the study was to collect data on granulocyte-monocyte adsorptive apheresis (GMA) for the treatment of corticosteroid-dependent (SD) or corticosteroid-resistant (SR) inflammatory bowel disease (IBD) in children from 3 Nordic countries to evaluate its efficacy and safety and to assess practical issues. METHODS: Retrospective data on 37 children treated with GMA were collected. In all, 22 children had ulcerative colitis (UC), 13 Crohn's disease (CD), and 2 had indeterminate colitis (IC). Their mean age was 13.2 years, range 5-17 years, and mean duration of disease was 2.4 years, range 1 month to 6 years. Indication for treatment in the UC group was SD in 11 cases, SR in 6 cases, and other reasons in 5 cases. The corresponding numbers in the CD group were SD in 8 cases, SR in 2 cases, and other reasons in 3 cases. In the IC group, 1 had SD and 1 was refractory to steroids, azathioprine, and infliximab. Efficacy was evaluated by severity indices: the Pediatric Ulcerative Colitis Activity Index (PUCAI) and the Pediatric Crohn's Disease Activity Index (PCDAI) and tapering of corticosteroids. RESULTS: PUCAI and PCDAI decreased significantly in both groups after 3 months (P = 0.0007, P = 0.025). The dosage of corticosteroid was significantly reduced in the UC group by the end of GMA (P = 0.004) and this response continued after 3 months. Relapse was seen in 2 patients with UC and 3 patients with CD after 3 months follow-up. CONCLUSIONS: GMA seems to be an effective and safe treatment in 81\% of the SD or SR pediatric IBD patients, especially in those with UC.",
keywords = "Adolescent, Adrenal Cortex Hormones, Blood Component Removal, Child, Colitis, Ulcerative, Combined Modality Therapy, Crohn Disease, Drug Resistance, Female, Follow-Up Studies, Granulocytes, Humans, Immunosuppressive Agents, Male, Monocytes, Patient Compliance, Recurrence, Remission Induction, Retrospective Studies",
author = "T Ruuska and V Wewer and F Lindgren and P Malmborg and M Lindquist and L Marthinsen and L Browaldh and T Casswall and M Kalliom{\"a}ki and J Gr{\"o}nlund",
year = "2009",
doi = "10.1002/ibd.20859",
language = "English",
volume = "15",
pages = "1049--54",
journal = "Inflammatory Bowel Diseases",
issn = "1536-4844",
publisher = "Oxford University Press",
number = "7",
}