Role of theophylline in pathogenesis of necrotizing enterocolitis

Neonatal necrotizing enterocolitis: Pathogenesis, classification, and spectrum of illness

“…In addition, over a dozen case-or cohort-controlled studies to date have been unable to consistently identify RDS, patent ductus arteriosus, exchange transfusion, cyanotic heart disease, apnea of prematurity, asphyxia, hypothermia, hypotension, or umbilical vessel catheterization as being more common in patients who developed NEC than in an age-and time-matched group of unaffected highrisk infants. 32,49,67,83,112,145,156,175,182,195,198,209,216 These' data suggest that most purported risk factors are common to the entire population of low-birth-weight infants and are not specific antecedent events for the pathogenesis of NEC. Umbilical artery catheterization has been implicated as a potentially ischemic event that might predispose patients to NEC.lg3 The catheter could directly occlude the mesenteric orifices in the aorta or serve as a nidus for thromboembolism.…”

Treatment of Apnea of Prematurity

“…[73] However, further studies failed to confirm these initial reports. [74] These studies were retrospective in nature and, thus, the issue remained inconclusive. A possible vasoconstriction following caffeine administration has been implicated as a mechanism.…”

Methylxanthines and Necrotizing Enterocolitis Revisited

“…A possible association between administration of methylxanthines and the development of necrotizing enterocolitis (NEC) was first suggested by Robinson et al (1), who described three cases of this disease occurring 10-18 days following initiation of oral theophylline or intravenous aminophylline therapy in very low birth weight infants. Subsequently , a retrospective case review failed to confirm an increased incidence of NEC in infants receiving methylxanthine therapy (2). This investigation also failed to demonstrate that prior treatment with methylxanthines worsened the severity of NEC in those infants who developed the disease .…”

“…Gastroduodenal disease was previously reported to occur in 4% of adult patients, based upon radiologic appearance (5). The prevalence increases substantially to 24-60% when assessment includes endoscopy and biopsy (2,3,6). Griffiths et al (7) used endoscopy to identify lesions not detectable by x-ray film in children with suspected gastroduodenal CD and report on their subsequent clinical outcome.…”