Preliminary experience with plasma exchange in patients with ulcerative colitis
We decided to test the effect of plasma exchange (PE) in selected patients with inflammatory bowel disease in which conventional medical treatment proved insufficient. Twenty-six patients with ulcerative colitis (UC) were treated with PE, six patients with fulminant colitis and 20 with long lasting...
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Veröffentlicht in: | Transfusion science 2000-06, Vol.22 (3), p.155-160 |
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creator | Selset Aandahl, G Jacobsen, C.D Rode, L Rathe Oedegaard, E |
description | We decided to test the effect of plasma exchange (PE) in selected patients with inflammatory bowel disease in which conventional medical treatment proved insufficient. Twenty-six patients with ulcerative colitis (UC) were treated with PE, six patients with fulminant colitis and 20 with long lasting severe colitis. After very promising results initially, 17 patients with long lasting severe colitis were selected in a careful prospective study. Twelve patients completed the treatment protocol. Two litres of plasma were exchanged every second or third day, 5–6 times in two weeks. The replacement fluid was fresh frozen plasma. The activity indices and histological evaluation were used as criteriae for treatment response. A reduction of 35% in the activity index is considered a significant improvement. In all but three patients (out of 12), the activity indices were reduced two weeks after end of treatment. Six patients had a reduction of more than 35%, three patients had a reduction between 22–28% and three had a reduction less than 10%. None became worse. In this carefully studied group, the immediate beneficial effects of PE was only demonstrable by the activity indices and not evident by blind evaluation of biopsies from the mucosa. In two of the six patients with fulminant colitis, PE was followed by an immediate dramatic clinical improvement. In the follow up period (2–14 years) 14 of the 26 patients reported marked and long lasting improvement of inflammatory bowel disease. We conclude that PE might be beneficial in subsets of patients with UC. |
doi_str_mv | 10.1016/S0955-3886(00)00039-4 |
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Twenty-six patients with ulcerative colitis (UC) were treated with PE, six patients with fulminant colitis and 20 with long lasting severe colitis. After very promising results initially, 17 patients with long lasting severe colitis were selected in a careful prospective study. Twelve patients completed the treatment protocol. Two litres of plasma were exchanged every second or third day, 5–6 times in two weeks. The replacement fluid was fresh frozen plasma. The activity indices and histological evaluation were used as criteriae for treatment response. A reduction of 35% in the activity index is considered a significant improvement. In all but three patients (out of 12), the activity indices were reduced two weeks after end of treatment. Six patients had a reduction of more than 35%, three patients had a reduction between 22–28% and three had a reduction less than 10%. None became worse. In this carefully studied group, the immediate beneficial effects of PE was only demonstrable by the activity indices and not evident by blind evaluation of biopsies from the mucosa. In two of the six patients with fulminant colitis, PE was followed by an immediate dramatic clinical improvement. In the follow up period (2–14 years) 14 of the 26 patients reported marked and long lasting improvement of inflammatory bowel disease. We conclude that PE might be beneficial in subsets of patients with UC.</description><identifier>ISSN: 0955-3886</identifier><identifier>EISSN: 1879-3126</identifier><identifier>DOI: 10.1016/S0955-3886(00)00039-4</identifier><identifier>PMID: 10831917</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Colectomy ; Colitis, Ulcerative - complications ; Colitis, Ulcerative - surgery ; Colitis, Ulcerative - therapy ; Disease-Free Survival ; Female ; Follow-Up Studies ; Health technology assessment ; Humans ; Hypersensitivity - etiology ; Male ; Middle Aged ; Pilot Projects ; Plasma Exchange - adverse effects ; Plasma Exchange - standards ; Prospective Studies ; Severity of Illness Index</subject><ispartof>Transfusion science, 2000-06, Vol.22 (3), p.155-160</ispartof><rights>2000 Elsevier Science Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c363t-fa111e89db9c62fb717af9290ff0263ff4508b9fec4cce819da340893509bce63</citedby><cites>FETCH-LOGICAL-c363t-fa111e89db9c62fb717af9290ff0263ff4508b9fec4cce819da340893509bce63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10831917$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Selset Aandahl, G</creatorcontrib><creatorcontrib>Jacobsen, C.D</creatorcontrib><creatorcontrib>Rode, L</creatorcontrib><creatorcontrib>Rathe Oedegaard, E</creatorcontrib><title>Preliminary experience with plasma exchange in patients with ulcerative colitis</title><title>Transfusion science</title><addtitle>Transfus Sci</addtitle><description>We decided to test the effect of plasma exchange (PE) in selected patients with inflammatory bowel disease in which conventional medical treatment proved insufficient. Twenty-six patients with ulcerative colitis (UC) were treated with PE, six patients with fulminant colitis and 20 with long lasting severe colitis. After very promising results initially, 17 patients with long lasting severe colitis were selected in a careful prospective study. Twelve patients completed the treatment protocol. Two litres of plasma were exchanged every second or third day, 5–6 times in two weeks. The replacement fluid was fresh frozen plasma. The activity indices and histological evaluation were used as criteriae for treatment response. A reduction of 35% in the activity index is considered a significant improvement. In all but three patients (out of 12), the activity indices were reduced two weeks after end of treatment. Six patients had a reduction of more than 35%, three patients had a reduction between 22–28% and three had a reduction less than 10%. None became worse. In this carefully studied group, the immediate beneficial effects of PE was only demonstrable by the activity indices and not evident by blind evaluation of biopsies from the mucosa. In two of the six patients with fulminant colitis, PE was followed by an immediate dramatic clinical improvement. In the follow up period (2–14 years) 14 of the 26 patients reported marked and long lasting improvement of inflammatory bowel disease. We conclude that PE might be beneficial in subsets of patients with UC.</description><subject>Adult</subject><subject>Aged</subject><subject>Colectomy</subject><subject>Colitis, Ulcerative - complications</subject><subject>Colitis, Ulcerative - surgery</subject><subject>Colitis, Ulcerative - therapy</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health technology assessment</subject><subject>Humans</subject><subject>Hypersensitivity - etiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pilot Projects</subject><subject>Plasma Exchange - adverse effects</subject><subject>Plasma Exchange - standards</subject><subject>Prospective Studies</subject><subject>Severity of Illness Index</subject><issn>0955-3886</issn><issn>1879-3126</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMlKBDEQhoMozrg8gtIn0UNr1aS3nEQGNxAU1HNIpytOpDeTHpe3N04P4s1TQfFV_fwfYwcIpwiYnT2CSNOYF0V2DHACAFzEyQabYpGLmOMs22TTX2TCdrx_DVCCCNtsglBwFJhP2f2Do9o2tlXuK6LPnpylVlP0YYdF1NfKNyqs9UK1LxTZNurVEIDBj8Cy1uTC5p0i3dV2sH6PbRlVe9pfz132fHX5NL-J7-6vb-cXd7HmGR9ioxCRClGVQmczU-aYKyNmAoyBWcaNSVIoSmFIJ1pTgaJSPIFC8BREqSnju-xo_Nu77m1JfpCN9ZrqWrXULb3MEQOf8QCmI6hd570jI3tnm9BWIsgfk3JlUv5okgByZVIm4e5wHbAsG6r-XI3qAnA-AhRqvlty0uuVu8o60oOsOvtPxDeLOYRO</recordid><startdate>20000601</startdate><enddate>20000601</enddate><creator>Selset Aandahl, G</creator><creator>Jacobsen, C.D</creator><creator>Rode, L</creator><creator>Rathe Oedegaard, E</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20000601</creationdate><title>Preliminary experience with plasma exchange in patients with ulcerative colitis</title><author>Selset Aandahl, G ; Jacobsen, C.D ; Rode, L ; Rathe Oedegaard, E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c363t-fa111e89db9c62fb717af9290ff0263ff4508b9fec4cce819da340893509bce63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Colectomy</topic><topic>Colitis, Ulcerative - complications</topic><topic>Colitis, Ulcerative - surgery</topic><topic>Colitis, Ulcerative - therapy</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Health technology assessment</topic><topic>Humans</topic><topic>Hypersensitivity - etiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pilot Projects</topic><topic>Plasma Exchange - adverse effects</topic><topic>Plasma Exchange - standards</topic><topic>Prospective Studies</topic><topic>Severity of Illness Index</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Selset Aandahl, G</creatorcontrib><creatorcontrib>Jacobsen, C.D</creatorcontrib><creatorcontrib>Rode, L</creatorcontrib><creatorcontrib>Rathe Oedegaard, E</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Transfusion science</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Selset Aandahl, G</au><au>Jacobsen, C.D</au><au>Rode, L</au><au>Rathe Oedegaard, E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preliminary experience with plasma exchange in patients with ulcerative colitis</atitle><jtitle>Transfusion science</jtitle><addtitle>Transfus Sci</addtitle><date>2000-06-01</date><risdate>2000</risdate><volume>22</volume><issue>3</issue><spage>155</spage><epage>160</epage><pages>155-160</pages><issn>0955-3886</issn><eissn>1879-3126</eissn><abstract>We decided to test the effect of plasma exchange (PE) in selected patients with inflammatory bowel disease in which conventional medical treatment proved insufficient. Twenty-six patients with ulcerative colitis (UC) were treated with PE, six patients with fulminant colitis and 20 with long lasting severe colitis. After very promising results initially, 17 patients with long lasting severe colitis were selected in a careful prospective study. Twelve patients completed the treatment protocol. Two litres of plasma were exchanged every second or third day, 5–6 times in two weeks. The replacement fluid was fresh frozen plasma. The activity indices and histological evaluation were used as criteriae for treatment response. A reduction of 35% in the activity index is considered a significant improvement. In all but three patients (out of 12), the activity indices were reduced two weeks after end of treatment. Six patients had a reduction of more than 35%, three patients had a reduction between 22–28% and three had a reduction less than 10%. None became worse. In this carefully studied group, the immediate beneficial effects of PE was only demonstrable by the activity indices and not evident by blind evaluation of biopsies from the mucosa. In two of the six patients with fulminant colitis, PE was followed by an immediate dramatic clinical improvement. In the follow up period (2–14 years) 14 of the 26 patients reported marked and long lasting improvement of inflammatory bowel disease. We conclude that PE might be beneficial in subsets of patients with UC.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>10831917</pmid><doi>10.1016/S0955-3886(00)00039-4</doi><tpages>6</tpages></addata></record> |
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subjects | Adult Aged Colectomy Colitis, Ulcerative - complications Colitis, Ulcerative - surgery Colitis, Ulcerative - therapy Disease-Free Survival Female Follow-Up Studies Health technology assessment Humans Hypersensitivity - etiology Male Middle Aged Pilot Projects Plasma Exchange - adverse effects Plasma Exchange - standards Prospective Studies Severity of Illness Index |
title | Preliminary experience with plasma exchange in patients with ulcerative colitis |
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