D'Ovidio Valeria, Meo Donatella, Gozer Maria, Bazuro Marco E, Vernia Piero
GI Unit, Department of Internal Medicine and Medical Specialties, Policlinico Umberto I, University of Rome "La Sapienza", Sapienza, University of Rome, Italy.
J Clin Apher. 2015 Feb;30(1):55-7. doi: 10.1002/jca.21349. Epub 2014 Sep 2.
Inflammatory bowel disease characteristically affects young adults in their reproductive ages. Thus the medication used for the treatment of active disease should not compromise fertility and, also, should not have teratogenic effect on baby. A lot of data are available about effects of steroids, antibiotics, and mesalazine but no data are available about safety and efficacy of granulocyte-monocyte-apheresis (GMA) during pregnancy. In this case report, the 37 year-old pregnant woman with chronically active and steroid dependent ulcerative colitis (UC), at risk of abortion, refused more aggressive pharmacological therapeutic options and gave the informed consent to GMA. To minimize symptoms and the risk of severe clinical relapse, a maintenance GMA treatment was performed throughout pregnancy. The course of pregnancy was uneventful with no side effects; the mother and the baby were all healthy and well at the delivery.
炎症性肠病的典型特征是影响处于生育年龄的年轻人。因此,用于治疗活动性疾病的药物不应损害生育能力,也不应对胎儿有致畸作用。关于类固醇、抗生素和美沙拉嗪的影响有很多数据,但关于妊娠期间粒细胞-单核细胞分离术(GMA)的安全性和有效性尚无数据。在本病例报告中,一名37岁患有慢性活动性和类固醇依赖型溃疡性结肠炎(UC)且有流产风险的孕妇,拒绝了更积极的药物治疗选择,并签署了GMA知情同意书。为了尽量减少症状和严重临床复发的风险,在整个孕期进行了维持性GMA治疗。孕期过程顺利,无副作用;母亲和婴儿在分娩时均健康状况良好。