Ostalo

https://doi.org/10.20471/acc.2019.58.03.18

Leukocytapheresis in the Management of Severe Steroid-Dependent Ulcerative Colitis

Željko Krznarić orcid.org/0000-0003-3758-4540 ; Zagreb University Hospital Centre, Department of Gastroenterology and Hepatology, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
Pave Markoš ; Zagreb University Hospital Centre, Department of Gastroenterology and Hepatology, Zagreb, Croatia
Branka Golubić Ćepulić ; School of Medicine, University of Zagreb, Zagreb, Croatia; Department of Transfusion Medicine and Transplantation Biology, Zagreb University Hospital Centre, Zagreb, Croatia
Silvija Čuković-Čavka ; Zagreb University Hospital Centre, Department of Gastroenterology and Hepatology, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
Viktor Domislović ; Zagreb University Hospital Centre, Department of Gastroenterology and Hepatology, Zagreb, Croatia
Ines Bojanić ; School of Medicine, University of Zagreb, Zagreb, Croatia; Department of Transfusion Medicine and Transplantation Biology, Zagreb University Hospital Centre, Zagreb, Croatia
Ana Barišić ; Zagreb University Hospital Centre, Department of Gastroenterology and Hepatology, Zagreb, Croatia
Domina Kekez ; Department of Oncology, Zagreb University Hospital Centre, Zagreb, Croatia

Sažetak

Ulcerative colitis (UC) is a multifactorial disease of unknown precise etiology and immunopathogenesis. Peripheral blood granulocytes and monocytes/macrophages are the major sources of cytokines, which regulate inflammation. Leukocytapheresis (LCAP) is a method where blood is processed by apheresis system that removes lymphocytes and plasma before being returned to the body. We report the first case in Croatia where we used LCAP in the treatment of a patient with severe steroid-dependent UC. After 12 LCAP procedures, good clinical response was obtained and there were no significant adverse side effects noticed. The patient remained in clinical remission over two years in which he underwent regular follow ups at outpatient clinic. Over a 10-year follow-up period after LCAP, the patient had only occasional clini-cal symptoms of disease activity. The clinical course was complicated with the development of metastatic colorectal carcinoma, which points to the importance of regular disease monitoring rather than the in-creased risk of malignant disease after LCAP. Patients with UC are a demanding group of patients that warrant the search for novel treatment strategies other than conventional pharmacological therapies. Alt-hough LCAP is still not a common treatment modality in our daily practice, data from recent studies sug-gest it to be an effective and safe procedure in the management of active UC patients.

Ključne riječi

Leukapheresis; Colitis, ulcerative; Colorectal neoplasms; Croatia; Case reports

Hrčak ID:

230266

URI

https://hrcak.srce.hr/230266

Datum izdavanja:

1.9.2019.

Podaci na drugim jezicima: hrvatski

Posjeta: 1.398 *