Allergic enterocolitis presenting as recurrent necrotizing enterocolitis in preterm neonates

Srinivasan, P; Brandler, M; D’Souza, Antoni; Millman, P; Moreau, Hans

doi:10.1038/jp.2009.153

Cited by 49 publications

(28 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The incidence of CMPA in the first year of life is 2-7% and is reported as 0.34-2 % in preterms 2 , although there seems to be an increase in recent years in preterm population. Since 1990, 20 cases who were diagnosed to have CMPA during neonatal period have been reported in English literature [1][2][3][4][5][6][7][8][9][10][11][12][13][14] . The most common clinical sign of CMPA is bloody stool in a well-appearing infant.…”

mentioning

confidence: 99%

Different presentations of cow`s milk protein allergy during neonatal period

Aktaş¹,

Ergenekon²,

Ünal³

et al. 2017

Turk J Pediatr

View full text Add to dashboard Cite

mentioning

confidence: 99%

Different presentations of cow`s milk protein allergy during neonatal period

Aktaş¹,

Ergenekon²,

Ünal³

et al. 2017

Turk J Pediatr

View full text Add to dashboard Cite

“…In older infants the combination of bloody stools and eosinophilia suggests atopic conditions involving the bowel, such as allergic enterocolitis, 11 cow's milk allergy 12 or foodinduced eosinophilic proctocolitis. 13,14 However, when bloody stools occur in a prematurely born infant cared for in a NICU, NEC must be a prime consideration, 15,16 although, as suggested by Srinivasan et al 11 , allergic enteropathy can be causative and can be difficult to distinguish from NEC. We aimed to further investigate this issue by applying a rigorous definition of eosinophilia 2 to all neonates with bloody stools identified in a multihospital database.…”

Section: Discussionmentioning

confidence: 99%

Neonates presenting with bloody stools and eosinophilia can progress to two different types of necrotizing enterocolitis

et al. 2011

View full text Add to dashboard Cite

Objective: We hypothesized that neonates with bloody stools and concomitant eosinophilia are likely to have atopic enteropathy rather than necrotizing enterocolitis (NEC).Study Design: This was a retrospective cross-sectional study using electronic medical records and paper charts. Records of neonates admitted to any Intermountain Healthcare NICU between 1 January 2005 and 30 June 2010 were eligible if 'bloody stools' were listed in any archive. Qualifying records were divided into two groups depending on whether or not within 72 h of passing bloody stool eosinophil counts were above the 95th percentile reference range limit for age.Result: Bloody stools were identified in 275 predominantly Caucasian neonates. Fifty-four of these had eosinophilia and 221 had normal eosinophil counts. Those with eosinophilia were born at a slightly younger gestational age (31.3±4.6 vs 32.6±4.0 weeks, mean±s.d., P ¼ 0.032). Contrary to our hypothesis, those with eosinophilia did not have a lower rate of pneumatosis or bowel resection, or death ascribed to NEC. Eosinophilia was more common among those who had a red blood cell (RBC) transfusion within 48 h before passing bloody stools (P<0.001). Those with a recent RBC transfusion were the only neonates to have NEC surgery or to die from NEC. Preceding the bloody stools, those with no antecedent transfusion had been fed a larger volume (P ¼ 0.014), and had trends toward receiving calorically enriched feedings (P ¼ 0.055) and recent addition of human milk fortifier (P ¼ 0.060). Eosinophil counts following RBC transfusion tended to increase for 3-6 days, but when bloody stools were not preceded by transfusion the eosinophil counts were more static over that period. Conclusion:In this predominantly Caucasian group of neonates with bloody stools, the presence of eosinophilia did not identify a benign condition distinct from NEC. A total of 44% of these neonates had transfusion-associated NEC. Eosinophils could have a previously unrecognized role in the pathogenesis of this NEC subtype. Keywords: necrotizing enterocolitis; bloody stools; eosinophilia; RBC transfusion; transfusion-associated NEC; atopic enteropathy Introduction Eosinophilia is diagnosed when the concentration of eosinophils in the blood exceeds the upper reference range limit. 1 Until recently, this upper limit was not well defined for neonates, allowing imprecision in defining eosinophilia and in identifying associations between it and various clinical conditions. Using laboratory values from over 63 000 neonates we recently reported the 5th and 95th percentile values for blood eosinophil concentrations at various gestational and postnatal ages. 2 The 95th percentile upper limit ranges from 1180 eosinophils ml À1 in the first week to about 1560 ml À1 after 3 weeks. 2 Given this more precise definition of neonatal eosinophilia, we commenced the present study of the association between bloody stools and eosinophilia.When bloody stools are observed in a neonate, the possibility of necrotizing enterocolitis (NEC) enters the ...

show abstract

“…Se excluyeron historias clínicas de lactantes que no tuvieron prueba de eliminación y provocación abierta o que hubieran consultado por otras causas: síndrome de malabsorción, enfermedades metabólicas, hepáticas, renales, etc. 1,[3][4][5][6][7][8]10,[16][17][18][19][20]22,23,25,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] .La Información de las historias clínicas, fue recolectada del sistema de información HIS-ISIS ® del HU-FSFB y MEDSYS V4.0 ® de la Asociación Médica de los Andes (AMA), en un cuestionario. Se realizó una prueba piloto en 10 pacientes.…”

Section: Pacientes Y Métodounclassified

Síntomas digestivos y respuesta clínica en lactantes con alergia a la proteína de leche de vaca

Vera

Ramírez

2013

Rev. chil. pediatr.

View full text Add to dashboard Cite

Allergic enterocolitis presenting as recurrent necrotizing enterocolitis in preterm neonates

Cited by 49 publications

References 9 publications

Different presentations of cow`s milk protein allergy during neonatal period

Different presentations of cow`s milk protein allergy during neonatal period

Neonates presenting with bloody stools and eosinophilia can progress to two different types of necrotizing enterocolitis

Síntomas digestivos y respuesta clínica en lactantes con alergia a la proteína de leche de vaca

Contact Info

Product

Resources

About