Valeria D’Ovidio 1, Donatella Meo, Maria Gozer, Marco E Bazuro, Piero Vernia, J Clin Apher. 2015 Feb;30(1):55-7.
Tag: Pregnancy
Scientific corner
Ulcerative colitis and granulocyte-monocyte-apheresis: Safety and efficacy of maintenance therapy during pregnancy.
To minimize symptoms and the risk of severe clinical relapse, a maintenance GMA treatment was performed throughout pregnancy. The course of pregnancy was uneventful with no side effects; the mother and the baby were all healthy and well at the delivery.
Scientific corner
Flare up of ulcerative colitis during pregnancy treated by adsorptive granulocyte and monocyte apheresis: therapeutic outcomes in three pregnant patients.
Hiroki Takahashi 1, Kaori Sugawara, Mikako Sugimura, Masahiro Iwabuchi, Yutaka Mano, Katsuaki Ukai, Keiichi Tadokoro, Arch Gynecol Obstet. 2013 Aug;288(2):341-7.
In these three cases with active ulcerative colitis during pregnancy, granulocytapheresis as a non-pharmacologic treatment was effective and safe. In case 3 that did not respond well to the initial granulocytapheresis sessions, a moderate dose of prednisolone enhanced the efficacy of granulocytapheresis and tapering of prednisolone shortly after administration was not associated with relapse.
Scientific corner
Granulocyte and monocyte adsorption apheresis for Behçet’s disease in a pregnant woman.
Yuko Higashi 1, Mitsuyoshi Shimokawa, Kazuhiro Kawai, Takuro Kanekura, J Dermatol. 2013 Dec;40(12):1042-4.
We present a 39-year-old pregnant woman with Behçet’s disease who was treated successfully with granulocyte and monocyte adsorption apheresis (GMA). There were no complications or adverse effects during her pregnancy and delivery. The neonate manifested no abnormalities.
Scientific corner
Therapeutic efficacy of leukocytapheresis in a pregnant woman with severe active ulcerative colitis
H Okada 1, C Makidono, R Takenaka, S Hiraoka, A Fujiwara, J Kato, Y Kawahara, H Kawamoto, M Mizuno, Y Shiratori
Leukocytapheresis has recently been used to induce remission in patients with ulcerative colitis (UC) who fail to respond to corticosteroids. We could not find a report in the literature on leukocytapheresis for UC with gestational exacerbation. We have recently encountered this unique condition and report the details here. A 30-year-old Japanese woman with left-sided severe UC was corticosteroid-dependent and had recurrence of the active disease during tapering of corticosteroid. She declined any dose increase and the use of any immunosuppressive agent because she was in the 13th week of pregnancy. Then, concomitant leukocytapheresis was performed without increasing the corticosteroid dose. Recovery was rapid and dramatic. Mucous and bloody stool decreased after the first session, and she had remission 2 weeks later. She underwent a total of four sessions without complications. After 6 weeks, she was discharged from our hospital and underwent maintenance treatment as an outpatient with mesalazine and corticosteroid tapering. Subsequently, she gave birth to a healthy baby girl by an uncomplicated vaginal delivery while keeping the remitted stage of UC.
Scientific corner
The present status and the recent development of the treatment for inflammatory bowel diseases: desirable effect of extracorporeal immunomodulation
Masakazu Takazoe 1, Torao Tanaka, Kenji Kondo, Toshiki Ichimori, Toshio Shinoda Ther Apher 2002 Aug;6(4):305-11. doi: 10.1046/j.1526-0968.2002.00445.x.
The immunological and genetic pathogeneses of inflammatory bowel disease (IBD) have been well elucidated in the recent years. The pharmacologic treatment of IBDs accordingly becomes to focus upon the individual pathologic step (targeting therapy), whereas the therapeutic action is not yet a pinpoint one. It has been known recently that new drugs such as biological immunomodulating agents and anti-inflammatory cytokines have better short-term effects in some respects than the conventional drugs, and they might alter the treatment strategy of IBDs in the near future. The limitation of pharmacologic treatments mainly results from adverse effects of the drugs, i.e. infection susceptibility, oncogenesis, teratogenesis and so forth. The extracorporeal therapy such as leukocytapheresis and photopheresis is reportedly effective for IBDs probably through immunomodulation such as decrease in circulating activated T-lymphocytes and activated granulocytes that play a central role in the pathogenesis of IBD. It can be said that these extracorporeal treatment methods have advantage of rapid action and lack of serious adverse effects to drug therapy.
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