Ulcerative colitis with hepatitis B virus infection treated successfully by granulocyte monocyte apheresis.
Results show that GMA is a safe and efficacious strategy against UC complicated by HBV without affecting hepatitis because GMA had no remarkable effect on HBV activity.
First Case Report of De Novo Ulcerative Colitis Developing After Orthotopic Liver Transplantation Successfully Treated by Granulocyte and Monocyte Apheresis.
Background: Immunosuppressants such as tacrolimus and cyclosporine are prescribed long-term after orthotopic liver transplantation (OLT) to prevent allograft rejection. Although these immunosuppressants are known to effectively control ulcerative colitis (UC), some post-OLT patients develop exacerbation of preexisting UC or de novo UC. Although aminosalicylates and corticosteroid courses are usually effective to treat such UC, several patients have developed uncontrollable disease and required colectomies. Case report: We have reported a patient who developed de novo UC after OLT to treat liver cirrhosis and hepatocellular carcinoma associated with hepatitis B virus (HBV) infection. Existence of the HBV infection made us avoid to increase the corticosteroid dose or to use other immunosuppressants such as azathioprine or infliximab. Conclusions: In this patient, granulocyte and monocyte apheresis was highly effective in terms of inducing remission of de novo UC. No adverse event was noted.
Crohn’s disease complicated by hepatitis B virus successfully treated with the use of adsorptive depletion of myeloid lineage leucocytes to suppress inflammatory cytokine profile.
Yoko Yokoyama 1, Ken Fukunaga 2, Koji Kamikozuru 2, Toshiyuki Sato 2, Mikio Kawai 2, Koji Nogami 2, Kazuko Nagase 2, Misaki Nakamura 2, Masaki Immured 2, Nobuyuki Hida 2, Shiro Nakamura 2 , Cytotherapy. 2014 Jun;16(6):821-5.
Immunosuppressive therapy required to treat an active CD potentially can promote HBV reactivation and worsen liver function. In this study involving a CD case complicated by chronic HBV infection, intensive GMA as a non-pharmacologic treatment intervention was associated with clinical remission and endoscopic improvement without HBV reactivation. Furthermore, GMA was well-tolerated and was without any safety concern. However, suppression of tumor necrosis and interleukin-6by GMA in this clinical setting is potentially very interesting.
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