Mariko Seishima 1, Yoko Mizutani, Yoshinao Shibuya, Chikako Nagasawa, Takahiko Aoki
Tag: cases
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Efficacy of granulocyte and monocyte adsorption apheresis for three cases of refractory pyoderma gangrenosum
Pyoderma gangrenosum presents with chronic skin ulcers and is histologically characterized by neutrophil infiltration throughout the dermis. It is also occasionally associated with ulcerative colitis, a type of inflammatory bowel disease, against which granulocyte and monocyte adsorption apheresis (GCAP) has recently shown remarkable efficacy. We performed GCAP on three refractory cases of pyoderma gangrenosum with painful bilateral leg ulcers and hereby report the results obtained. Patient 1 was a 43-year-old woman with a four-year history of recurrent painful skin ulcers treated with prednisolone and cyclosporine. Patient 2 was a 29-year-old woman who had been suffering from pyoderma gangrenosum with severe pain for two weeks, associated with an 11-year history of ulcerative colitis treated with prednisolone and salazosulfapyridine. Patient 3 was a 63-year-old man with a three-year history of recurrent ulcers with pain, suffering from rheumatoid arthritis treated with prednisolone and cyclophosphamide. The sizes of the lesions were reduced in all three patients following a weekly GCAP treatment for 10 or 11 consecutive weeks, and the re-epithelialization of ulcers were additionally observed in two patients. The pain disappeared dramatically in all three patients following two sessions of GCAP therapy. No adverse effects were observed for up to at least eight months after treatment. We therefore considered GCAP as one effective alternative to currently existing therapies, with regards to refractory cases of pyoderma gangrenosum.
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Case Report: Combination Therapy With Granulocyte Apheresis and Infliximab for Refractory Crohn’s Disease
P. Gonzalez Carro, F. Perez Roldan, O. Roncero Garcıa Escribano,R. Lafuente, M.L. Legaz Huidobro, and A. Amigo Echenagusıa
Journal of Clinical Apheresis 21: 249–251 (2006)
To our knowledge, no cases of combined therapy with infliximab and granulocyte apheresis have been previously reported. Our results suggest that this combined therapy is a possible alternative to treat CD patients in the event of loss of response to infliximab.
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Granulocyte apheresis for pouchitis with arthritis and pyoderma gangrenosum after restorative proctocolectomy for ulcerative colitis: a case report
Ritsuko Yanaru-Fujisawa, Takayuki Matsumoto, Shotaro Nakamura, Shuji Kochi, Mitsuo Iida, Futoshi Kohda, Minako Hirahashi, Takashi Yao, Ryuichi Case Reports Inflamm Bowel Dis. 2005 Aug;11(8):780 DOI: 10.1097/01.mib.0000172558.39767.b7
Our case and the case of Kanekura et al8 suggest that circulating leukocytes may play an important role in the pathogenesis of PG and that GCAP in combination with corticosteroids may be a promising strategy for intractable PG. Furthermore, as has been the case for active UC, GCAP may be a choice for severe pouchitis. An accumulation of data with respect to the effect of GCAP on pouchitis seems to be warranted.
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Granulocyte apheresis for pouchitis with arthritis and pyoderma gangrenosum after restorative proctocolectomy for ulcerative colitis: a case report
Ritsuko Yanaru-Fujisawa, Takayuki Matsumoto, Shotaro Nakamura, Shuji Kochi, Mitsuo Iida, Futoshi Kohda, Minako Hirahashi, Takashi Yao, Ryuichi Mibu Case Reports Inflamm Bowel Dis. 2005 Aug;11(8):780 DOI: 10.1097/01.mib.0000172558.39767.b7
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Dramatic response to granulocytapheresis in a Crohn’s disease case complicated by hepatitis C virus
Koji Sawada 1, Kunio Ohnishi, Takeshi Kusaka, Yoshika Matoba, Ken Fukunaga, Dig Dis Sci. 2005 Aug;50(8):1533-4.
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Treatment of Behçet’s disease with granulocyte and monocyte adsorption apheresis
Takuro Kanekura 1, Akira Gushi, Masahiro Iwata, Seita Fukumaru, Ryoko Sakamoto, Koichi Kawahara, Ikuro Maruyama, Tamotsu Kanzaki
The painful orogenital ulcerations of Behçet’s disease are among the major symptoms of patients and are often intractable. We assessed the efficacy of granulocyte and monocyte adsorption apheresis therapy in two patients, a 21-year-old man with orogenital ulcerations and a 50-year-old woman with genital ulceration and abdominal pain. They underwent 5 and 8 granulocyte and monocyte adsorption apheresis treatments at 5-day intervals, respectively. The painful orogenital ulcerations of the man responded dramatically and the genital ulcer of the woman decreased in size and her abdominal pain was improved. Our results demonstrate that granulocyte and monocyte adsorption apheresis may be useful for treating orogenital ulcerations of Behçet’s disease.
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Experience with granulocytapheresis in Crohn’s disease
Cuenca, F & Paredes, J & Mendoza, J & Cruz, D & Herrero, A & Díaz-Rubio, M.Revista española de enfermedades digestivas : organo oficial de la Sociedad Española de Patología Digestiva .2004,96. 501-3, 504. DOI:10.4321/S1130-01082004000700007.
Objective: To describe our experience with granulocyte apheresis to induce remission in patients with active Crohn’s disease refractory to conventional treatment. We summarize the results previously obtained with this technique.
Conclusions: Granulocyte apheresis is a safe and well tolerated therapeutic modality that can be a valid therapeutic alternative in the induction of remission in inflammatory bowel disease, although controlled clinical trials must be conducted to define long-term efficacy, as well as to establish „optimal patient“ selection, re-treatment interval, and number of sessions.
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Treatment of psoriatic arthritis with granulocyte and monocyte adsorption apheresis
Granulocyte and monocyte adsorption apheresis (GCAP) is a new extracorporeal apheresis treatment modality that removes pathogenic granulocytes. Recently, we found that GCAP is useful for treating pyoderma gangrenosum and pustular psoriasis. We thought that this treatment may also be effective for treating other disorders attributable to activated granulocytes and studied the efficacy of GCAP in 4 patients with psoriatic arthritis. Treatment with GCAP resulted in remarkable clearing of joint pain, suggesting that GCAP is valuable for treating arthritis as well as skin disorders. We present a detailed description of these patients and this novel therapy.
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Severe alcoholic hepatitis successfully treated by leukocytapheresis: a case report.
Yoshiyasu Tsuji 1, Ryukichi Kumashiro, Kunihide Ishii, Teruko Arinaga, Yoshihiro Sakamoto, Ryo Tanabe, Kei Ogata, Yuriko Koga, Tatsuya Ide, Naofumi Ono, Eisuke Tanaka, Hirohiko Abe, Michio Sata, Alcohol Clin Exp Res. 2003 Aug;27(8 Suppl):26S-31S.
GCAP is recommended as a potential therapeutic option for severe alcoholic hepatitis.
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Cytapheresis for the Treatment of Myeloperoxidase Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: Report of Five Cases
Midori Hasegawa 1, Nahoko Kawamura, Masami Kasugai, Sigehisa Koide, Masamitsu Murase, Sinsuke Asano, Takako Toba, Hiroko Kushimoto, Kazutaka Murakami, Makoto Tomita, Masahiko Shikano, Satoshi Sugiyama, Ther Apher. 2002 Dec;6(6):443-9.
In the pulmonary hemorrhage patient, evidence of pulmonary hemorrhage on chest computed tomography scanning diminished after combined therapy with cytapheresis and corticosteroids. Cytapheresis, when combined with a low-dose or intermediate-dose PSL regimen, is effective in the treatment of ANCA-associated vasculitis.
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