A study of corticosteroid therapy for active Crohn's disease.

概要

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In an attempt to evaluate the therapeutic effects of corticosteroid (PSL) on active Crohn's disease (CD), we retrospectively studied PSL treatment in 15 patients who had not yet been treated with PSL. PSL, 40 mg per day was given by mouth, and then diminished every two weeks. Therapeutic effects were evaluated by the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and the assessment method of the International Organization for the Study of Inflammatory Bowel Disease (IOIBD) after 4 and 8 weeks. In many cases ESR and CRP improved after 4 weeks, but after 8 weeks some cases became aggravated again. Though IOIBD was normalized in about 90 % of cases, ESR and CRP were improved in only 1 or 2 cases after 4 and 8 weeks. There were some cases in which aggravation had already occurred before we noticed it, because the symptoms had been masked by the PSL. At present, eight patients are still receiving PSL every other day because of difficulty in weaning them from it. Four patients were switched to nutritional therapy and 3 other patients underwent surgery after nutritional therapy. Therefore, we concluded that PSL therapy in active CD is effective for improvement of symptoms, but in many cases laboratory data indicated reaggravated as PSL was tapered.
日本大腸肛門病学会の論文