Granulocyte and monocyte/macrophage apheresis in paediatric patients with ulcerative colitis: a case series in Spain

Abstract

Paediatric ulcerative colitis (UC) can cause malnutrition and growth retardation but its treatment can be limited by the potential adverse events of corticosteroids and anti-TNF agents in children. However, adsorptive granulocyte monocyte/macrophage apheresis (GMA) using Adacolumn^® reduces intestinal inflammation through multiple immunomodulatory effects. This case series shows the safety and efficacy of GMA in paediatric UC, illustrating several GMA uses: in chronically active UC, for corticosteroid reduction in steroid-dependent UC, in UC with secondary loss of response to anti-TNF therapy, as bridge therapy in UC with failure of anti-TNF therapy, and to substitute toxic drug treatments.

Keywords: adolescent; azathioprine; child; corticosteroids; granulocyte-monocyte apheresis; leukocytapheresis; paediatric ulcerative colitis; tumour necrosis factor inhibitors.