Several new treatments for ulcerative colitis have been developed recently. The depletion of leukocytes by granulocyte and monocyte adsorption apheresis (GMA) was developed and adapted for patients with ulcerative colitis with rare adverse events. We investigated whether treatment with GMA and prednisolone (GMA + PSL) is more effective than PSL alone for patients with moderate to severe ulcerative colitis. Forty-seven patients with moderate to severe ulcerative colitis were retrospectively analyzed. Among the 47 patients, 27 received PSL, while 20 received GMA + PSL. The clinical activity of ulcerative colitis was evaluated using the Lichtiger clinical activity index (CAI) and serum levels of C-reactive protein. Mayo endoscopic score (MES) was used to examine endoscopic activity. The clinical remission rate was significantly higher in the GMA + PSL group than in the PSL group (65% vs 29.6%, p = 0.0206). The mucosal healing rate was also significantly higher in the GMA + PSL group than in the PSL group (60% vs 26%, p = 0.0343). The combination of GMA and steroids may be more effective than steroids alone for inducing clinical remission and mucosal healing in patients with moderate to severe ulcerative colitis.
Pneumatosis cystoides intestinalis is an uncommon disease that rarely causes intussusception. We report the case of a 16‐year‐old male patient with intermittent abdominal pain who was diagnosed with intussusception. The patient had no history of raw food ingestion, fever, diarrhea, or hematochezia. Computed tomography revealed intussusception characterized by a crab‐finger appearance, and pneumatosis cystoides intestinalis was diagnosed by colonoscopy. Treatment with hyperbaric enema and low‐flow oxygen therapy resulted in a prominent improvement of the lesion. No recurrence was observed for > 1 year. Intermittent abdominal pain without diarrhea or hematochezia in male adolescents may represent pneumatosis cystoid‐related intussusception, and the addition of low‐flow oxygen therapy may help avoid surgery.
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