The effect of granulocytapheresis treatment on the mental health status of patients with inflammatory bowel disease

Studies on granulocytapheresis have emerged with the need for alternative treatments in patients with inflammatory bowel disease (IBD) refractory to conventional therapy.. In our study; It was aimed to examine the changes in the patients' quality of life, depression and anxiety after the granulocytapheresis procedure in patients with IBD. Our study included a total of 41 patients (14 female, 27 male), 22 active Ulcerative Colitis (UC), 19 Chrohn Diseases (CD), who underwent granulocytapheresis using Cellsorba E column between June 2021 and July 2022 in Medicana İzmir Hospital. The median age of the patients was 34 (19-66). Before the procedure, SF 36 , illness anxiety and Beck anxiety-depression, illness anxiety questionnaires, which show the patients' quality of life, anxiety and depression, were administered to all patients. The granulocytapheresis procedure was performed in 10 sessions (2 days a week / 5 weeks in total) with concomitant medications. The same questionnaires were repeated one week after the procedure was completed. Beck anxiety, Beck depression and illness anxiety scores were found to be statistically significantly lower after the application (p=0.018, p<0.001, p=0.005). The Physical Function score (p=0.017), general health perception (p=0.001), vitality (p=0.002), social functionality (p<0.001), mental health (p<0.001), health change (p=0.017). scores were found to be statistically significantly higher after the application. A more significant decrease was observed in Beck anxiety scores in women compared to men. (t:2,854, p: 0.008) In the disease anxiety scores, those with higher education level (t: 2.810, p: 0.010), non-smokers (t: 2.667, p: 0.013), non-antidepressant users (t: 2.650, p: 0.013) more significant decrease was observed. There was a significant increase in health change scores (t: 2.667, p: 0.013), mental health scores (t: 2.086, p: 0.044) in regularly working patients. In conclusion; After 10 sessions of granulocytapheresis in patients with IBD resistant to standard treatments, a significant improvement was observed in patients' quality of life, depression and anxiety. With the procedure, monocytes were significantly removed from the circulation, improvement was observed in the acute phase response such as sedimentation and CRP, and as a complication of the apheresis procedure, the hb, htc, and platelet values of the patients decreased partially at a level that did not require intervention.