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- W2076545457 abstract "We read with interest the review article: ‘the management of Crohn's disease and ulcerative colitis (UC) during pregnancy and lactation’ by Dr Schulze et al.1 Their report indicates that most of the currently approved IBD medications except methotrexate are not associated with adverse pregnancy outcomes, and may be used to maintain quiescent disease or to induce remission in patients with flares or active disease. Unfortunately, this review makes no mention of leucocytapheresis, which has been reported as an effective therapy in pregnant IBD patients.2-4 In the report by Okada et al.,2 a 30-year-old pregnant woman with UC had relapsed during tapering of corticosteroid. Leucocytapheresis was performed without increasing the corticosteroid dose. The patient received a total of four apheresis sessions without complications. She achieved disease remission and a normal pregnancy outcome. In the report by Takahashi et al.,3 three pregnant women with active UC were treated with leucocytapheresis with an Adacolumn [JIMRO Co. Ltd., Takasaki, Japan], up to 10 sessions within 3–6 weeks. All patients achieved complete remission without any adverse event, and had normal pregnancy outcomes. In the report by D'Ovidio, et al.,4 a 37-year-old pregnant woman with chronically active and steroid-dependent UC refused more aggressive pharmacological intervention. To minimise symptoms and the risk of severe clinical relapse, maintenance leucocytapheresis therapy was performed throughout the pregnancy. The course of pregnancy was uneventful with no side effects; the mother and the baby were both in good health after delivery. Therefore, all these preliminary experiences support leucocytapheresis as an effective nonpharmacologic treatment intervention. We believe that leucocytapheresis may be considered as a potential first-line medication, because experience (albeit in a small number of cases) indicates pregnant patients who respond can avoid pharmacological interventions. Declaration of personal and funding interests: None." @default.
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- W2076545457 date "2014-12-15" @default.
- W2076545457 modified "2023-09-27" @default.
- W2076545457 title "Letter: leucocytapheresis as a nonpharmacologic treatment for patients with ulcerative colitis during pregnancy" @default.
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- W2076545457 doi "https://doi.org/10.1111/apt.13021" @default.
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