ベーチェット病眼症状に対する顆粒球・単核球除去療法(<特集>血球成分除去療法の新しい展開)

概要

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Intraocular inflammation (uveoretinitis) is one major complication of Behcet's disease (BD). We assess the efficacy of selective granulocytapheresis in patients with refractory uveoretinitis of BD. Fourteen patients were treated. Granulocytapheresis was done with an Adacolumn filled with cellulose acetate leucocyte carriers or beads that adsorb granulocytes and monocytes from the blood in the column. Each patient received 5 Adacolumn sessions at one session/week over 5 consecutive weeks. The study was designed to allow each patient to serve as his or her own control. The number of ocular attacks (mean±SD) per patient for the 6 months before Adacolumn was 4.21±1.6 and for the 6 months post Adacolumn was 2.93±1.39 (p=0.0275). Nine patients (64%) improved and 5 did not change or worsened. Further, for a sub-group (n=7) with a duration of BD≥5yr, the number of OA were 4.71±1.89 for the first 6 months and 2.29±1.38 for the second 6 months (p=0.0054). The corresponding values for a sub-group (n=7) with a duration of BD<5yr were 3.71±1.25 and 3.57±1.13, indicating that patients with a long duration of BD are better responders. We conclude that granulocytapheresis might be effective and safe for patients with refractory ocular BD.
2009-02-28