Successful treatment of ulcerative colitis complicated by Sweet’s syndrome by corticosteroid therapy and leukocytapheresis

Terai, Tomohiro; Sugimoto, Mitsushige; Osawa, Satoshi; Sugimoto, Ken; Furuta, Takahisa; Kanaoka, Shigeru; Ikuma, Mutsuhiro

doi:10.1007/s12328-011-0215-z

Cited by 5 publications

(3 citation statements)

References 28 publications

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“…For adults who cannot be treated with systemic glucocorticoids, other first-line systemic treatments are colchicine (0.5 mg orally three times a day for 10–21 days) and potassium iodide (300 mg orally three times a day). Second-line therapy with indomethacin (150 mg orally for 7 days followed by 100 mg orally for 14 days) or with immunosuppressants, such as cyclosporine (2–10 mg/kg/day, tapering by 2 mg/kg/day every 2 days and discontinuing on day 21) in monotherapy or in combination with steroids, dapsone (1.5–2 mg/Kg/day), azathioprine (1.5–2 mg/kg/day), cyclophosphamide (1–1.5 mg/kg/day) and tumour necrosis factor (TNF)-α antagonists, have been reported to be successful in refractory SS cases 1 9 16 17. There have been case reports of patients with Crohn’s disease and refractory SS responding to infliximab, a monoclonal anti-TNF-α antibody 18–21.…”

Section: Discussionmentioning

confidence: 99%

Sweet’s syndrome complicating ulcerative colitis: a rare association

et al. 2016

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Sweet's syndrome (SS) is a neutrophilic dermatosis disorder of unknown aetiology, characterised by acute fever, neutrophilia, painful erythematous papules, nodules and plaques, and an infiltrate consisting predominantly of mature neutrophils in the upper dermis. Classical SS is a rare extra-intestinal manifestation of inﬂammatory bowel disease (IBD). It is more common in Crohn's disease than in ulcerative colitis (UC). There is a predilection for women, and for patients with colonic disease and active IBD. We report the case of a 39-year-old woman with a flare of moderate severity UC treated with mesalazine who presented with a 5-day history of acute fever, painful papules and plaques on forearms and legs, episcleritis and cervical pain. Skin biopsies showed papillary dermis inflammatory cell infiltration composed mainly of neutrophils, without evidence of leukocytoclastic vasculitis or panniculitis, compatible with SS. The patient had an excellent response to systemic corticosteroids. Symptoms promptly improved and skin lesions resolved after 7 weeks.

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Section: Discussionmentioning

confidence: 99%

Sweet’s syndrome complicating ulcerative colitis: a rare association

et al. 2016

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“…A noticeable improvement in clinical symptoms and colonoscopic findings of UC was observed with decreased serum levels of ALP, total bile acids, and total bile salts, while there was no aggravation of either UC or PSC till 1-year follow-up[ 75 ]. Terai et al [ 76 ] reported a case of a 41-year-old male patient with total colitis type UC complicated with Sweet’s Syndrome. The patient underwent treatment with 40 mg/day prednisolone and leukocytapheresis, and within four weeks, skin eruption completely disappeared, and clinical features of UC and laboratory parameters also subsided.…”

Section: Leukocytapheresismentioning

confidence: 99%

Apheresis: A cell-based therapeutic tool for the inflammatory bowel disease

Yasmin¹,

Najeeb²,

Naeem³

et al. 2022

WJCC

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Inflammatory Bowel Disease (IBD) is a hallmark of leukocyte infiltration, followed by the release of cytokines and interleukins. Disease progression to Ulcerative Colitis (UC) or Crohn’s Disease (CD) remained largely incurable. The genetic and environmental factors disrupt enteral bacteria in the gut, which hampers the intestinal repairing capability of damaged mucosa. Commonly practiced pharmacological therapies include 5-aminosalicylic acid with corticosteroids and tumor necrosis factor (TNF)-α. New interventions such as CDP571 and TNF-blocking RDP58 report the loss of patient response. This review discusses the non-pharmacologic selective granulocyte–monocyte-apheresis (GMA) and leukocytapheresis (LCAP) that have been proposed as treatment modalities that reduce mortality. GMA, an extracorporeal vein-to-vein technique, presents a strong safety profile case for its use as a viable therapeutic option compared to GMA's conventional medication safety profile. GMA reported minimal to no side effects in the pediatric population and pregnant women. Numerous studies report the efficacious nature of GMA in UC patients, whereas data on CD patients is insufficient. Its benefits outweigh the risks and are emerging as a favored non-pharmacological treatment option. On the contrary, LCAP uses a general extracorporeal treatment that entraps leukocytes and suppresses cytokine release. It has been deemed more efficacious than conventional drug treatments, the former causing better disease remission, and maintenance. Patients with UC/CD secondary to complications have responded well to the treatment. Side effects of the procedure have remained mild to moderate, and there is little evidence of any severe adverse event occurring in most age groups. LCAP decreases the dependence on steroids and immunosuppressive therapies for IBD. The review will discuss the role of GMA and LCAP.

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“…Histological examination of skin biopsies confirmed Sweet`s syndrome with inflammatory cell infiltration composed mainly of neutrophils without evidence of necrotizing vasculitis. The patient was treated with prednisolone and leukocytapheresis, and the erythematous nodules on the skin, as well as the abdominal symptoms, improved [ 46 ].…”

Section: Leukocytapheresis In Extraintestinal Manifestationsmentioning

confidence: 99%

Leukocytapheresis in patients with inflammatory bowel diseases

Woźniak¹,

Kurnatowska²,

Małecka‐Panas³

et al. 2021

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Leukocytapheresis, a blood purification therapy, exerts anti-inflammatory effects by removing activated leukocytes from the peripheral blood through extracorporeal circulation. It is a potential option of treatment for patients with inflammatory bowel diseases (IBD), especially those with ulcerative colitis (UC), who do not respond to conventional therapy. Given that it has a favourable safety profile and seems to have steroid sparing effects, its position in the treatment of UC is likely to expand. However, there is inadequate evidence to draw any conclusions about the efficacy of leukocytapheresis in patients with Crohn's disease, and it should only be used in accordance with special arrangements for consent. Considering the current level of knowledge, it is essential to conduct large, well-designed, randomized clinical trials to evaluate the effects of leukocytapheresis in the management of IBD patients.

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Successful treatment of ulcerative colitis complicated by Sweet’s syndrome by corticosteroid therapy and leukocytapheresis

Cited by 5 publications

References 28 publications

Sweet’s syndrome complicating ulcerative colitis: a rare association

Sweet’s syndrome complicating ulcerative colitis: a rare association

Apheresis: A cell-based therapeutic tool for the inflammatory bowel disease

Leukocytapheresis in patients with inflammatory bowel diseases

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