Preoperative steroid-related complications in Japanese pediatric patients with ulcerative colitis

Keiichi Uchida, Toshimitsu Araki, Yuji Toiyama, Shigeyuki Yoshiyama, Mikihiro Inoue, Hiroki Ikeuchi, Hidenori Yanagi, Chikao Miki, Takehira Yamamura, Masato Kusunoki

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)

Abstract

PURPOSE: This study was designed to clarify a limit for steroid therapy in patients with ulcerative colitis through analyzing the preoperative major steroid-related complications and to define when alternative therapies, including surgery, should be performed in pediatric ulcerative colitis patients. METHODS: The medical records of 28 pediatric and 57 adult patients with ulcerative colitis who underwent total proctocolectomy and ileal J-pouch-anal anastomosis were reviewed. The relationship between the preoperative dose of glucocorticoids and major steroid-related complications, as well as the surgery variables, was evaluated. RESULTS: Significantly higher incidences of growth retardation, osteoporosis, glaucoma, and cataracts were noted in pediatric patients than in adult patients. In pediatric patients, major steroid-related complications occurred at a significantly lower preoperative total dosage of glucocorticoids/body weight (mg/kg) or preoperative total dosage of glucocorticoids/body surface area (mg/m2) than in adult patients. A similar surgical procedure was performed in both pediatric and adult patients. The presence of major steroid-related complications can lower a patient's long-term quality of life. CONCLUSIONS: Evidence-based guidelines for the recommended dose ofglucocorticoids according to body weight or body surface area are needed. To allow patients to feel well and maintain a good quality of life, early introduction of alternative treatments, including surgery, should be considered.

Original languageEnglish
Pages (from-to)74-79
Number of pages6
JournalDiseases of the Colon and Rectum
Volume49
Issue number1
DOIs
Publication statusPublished - 01-2006
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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