Eosinophilia in sick neonates

Manoura, Antonia; Hatzidaki, Eleftheria; Korakaki, Eftihia; Mitsaki, Marina; Valari, Vasiliki; Giannakopoulou, Christine

doi:10.1163/156855902760262745

Cited by 7 publications

(2 citation statements)

References 10 publications

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“…The association between RBC transfusion and the subsequent development of NEC is well documented. [20][21][22][23][24][25][26][27][28] Our current findings suggest that investigating eosinophils as participants in the pathogenesis of transfusionassociated NEC might be fruitful. We realize several weaknesses in our study, largely derivative of the retrospective methodology.…”

Section: Discussionmentioning

confidence: 65%

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

et al. 2011

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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 ...

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Section: Discussionmentioning

confidence: 65%

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

et al. 2011

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“…또한, EGID는 식품 알레르기와 관 련된 경우를 일부 포함하고 있을 뿐이며, 호산구가 침 윤된다고 모두 식품 알레르기는 아니다 18) . 신생아기의 혈액 내 호산구 증가증의 가장 흔한 원인 은 감염으로 알려져 있다 19) . 또한, 염증성 장질환, 소화 성 궤양 등 많은 위장관 염증성 질환에서 호산구 침윤 은 흔히 관찰된다 .…”

Section: 식품 알레르기의 진단unclassified

Clinical Perspectives of Food Allergy in Infants and Young Children

Hwang

2011

Korean J Pediatr Gastroenterol Nutr

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Food allergies affect 7∼8% of infants and young children, and their prevalence appears to have increased in recent years. Food allergy refers to an abnormal immunological reaction to a specific food. These reactions can be recurrent each time the food is ingested. Food allergy manifests itself with a wide spectrum of clinical characteristics including IgE-mediated diseases as immediate reactions, non-IgEmediated disorders as delayed reactions, and mixed hypersensitivities. As a consequence, the clinical picture of a food allergy is pleomorphic. A well-designed oral food challenge is the most reliable diagnostic test for infants and young children whose clinical history and physical examination point towards a specific food allergy. Food specific IgE antibody tests (RAST, MAST, skin prick test, Uni-CAP, etc) are an alternative tool to determine oral food challenge for IgE-mediated disorders, but not for non-IgE-mediated allergies. Moreover, parents often impose their children on unnecessary diets without adequate medical supervision. These inappropriate dietary restrictions may cause nutritional deficiencies. This review aims to introduce clinical perspectives of food allergy in infants and young children and to orient clinicians towards different strains of diagnostic approaches, dietary management, and follow-up assessment of tolerance development.

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