[Therapeutic strategy for severe and fulminating ulcerative colitis].
Recent advantages of medical treatment for severe and fulminating ulcerative colitis are described. When considering therapeutic alternative for patients with severe and fulminating UC, it is the most paramount importance to assess accurately severity of disease. Next, the following is helpful guides to treat, (1)general management of patients illness, including correction of electrolytes imbalance, and sufficient fluid and alimentation therapy to avoid life-threatening complications, (2)timely surgical intervention, if disease is intractable. Two new promising approaches to severe and fulminating UC are introduced herein. One is fast-acting cyclosporine continuous intravenous administration, the other is leucocytapheresis employing new membrane filter, Cellsoba, manufactured by Asahi Medical Co. However, it remains controversial when and how physicians should abandon to surgical intervention.