APSA PaperPouch outcomes among children with ulcerative colitis treated with calcineurin inhibitors before ileal pouch anal anastomosis surgery
Section snippets
Materials and methods
A retrospective review of the charts of consecutive patients with UC treated with calcineurin inhibitors before their IPAA surgery at a tertiary pediatric center between 1998 and 2003 was performed. Approval for the study was obtained from the institutional review board of the Children's Hospital Boston before it was initiated. Fifteen patients who underwent IPAA surgery and received systemic calcineurin inhibitors before their surgery were identified. One patient was lost to follow-up before 2
Results
Of 53 consecutive patients with UC who underwent IPAA at the Children's Hospital Boston between 1998 and 2003, 14 (26%) received systemic calcineurin inhibitor therapy to control their disease before undergoing colectomy (6 with cyclosporine and 8 with tacrolimus). The mean age of the patients was 14.6 years (range, 5.5-18.6 years). There were 8 girls and 6 boys. Twelve patients (86%) had pancolitis, and 2 (14%) had left-sided disease. Tacrolimus was given twice daily and titrated to maintain
Discussion
In this series, we described 14 children with severe UC who were treated with calcineurin inhibitors in an attempt to control their disease but who ultimately required IPAA surgery. Cyclosporine and tacrolimus are 2 types of calcineurin inhibitors used to treat severe UC in children. Calcineurin is a serine threonine phosphatase that is responsible for activating pro-inflammatory transcription factors. By inhibiting the nuclear factor of activated T cells, these drugs prevent the production of
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Presented at the 37th Annual Meeting of the American Pediatric Surgical Association, May 20–24, 2006, Hilton Head, SC.