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Decrease in the eosinophil levels in neonates with necrotizing enterocolitis requiring surgery1218
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Published:
Mar 2, 2025
Keywords:
Enterocolitis necrosante, eosinófilos, Neonatos, Unidad de Cuidados Intensivos Neonatales
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Abstract
SUMMARY
Introduction: Necrotizing enterocolitis continues to be the most frequent and serious acquired digestive pathology in the neonatal period. There are few studies in our environment on the numbers of sinophils in patients with this diagnosis.
Objective: The objective was to compare eosinophil levels in two severity groups of neonates with necrotizing enterocolitis (NEC).
Methods: Observational, cross-sectional and comparative study based on the eosinophil count at admission and at diagnosis in patients with NEC, with medical vs surgical management.
Results: Patients with surgical treatment had a lower percentage of eosinophils on admission (p=0.034), a lower proportion of eosinophilia (>3%) (p=0.025) and a lower percentage of eosinophils at the time of NEC diagnosis (p=0.045). . The patients with surgical treatment had a lower gestational age (29.6 ± 2.6 vs 32.0 ± 2.5, p=0.002), a higher frequency of a history of blood transfusion (64.3% vs 36.4%, p=0.050), a higher proportion of patients who worsened the stage of NEC (28.6% vs 5.2%, p=0.018), older age at hospital discharge: 73 (80) vs 39 (37) days, (p=0.008) and higher mortality (28.6% vs 1.3%, p=0.002 ).
Conclusions: The decrease in the eosinophil count in this sample of patients was compromised with more serious events, the lack of an eosinophil hematological response could be an indicator of poor prognosis, due to the nature of our study we should still consider it as a finding.
Introduction: Necrotizing enterocolitis continues to be the most frequent and serious acquired digestive pathology in the neonatal period. There are few studies in our environment on the numbers of sinophils in patients with this diagnosis.
Objective: The objective was to compare eosinophil levels in two severity groups of neonates with necrotizing enterocolitis (NEC).
Methods: Observational, cross-sectional and comparative study based on the eosinophil count at admission and at diagnosis in patients with NEC, with medical vs surgical management.
Results: Patients with surgical treatment had a lower percentage of eosinophils on admission (p=0.034), a lower proportion of eosinophilia (>3%) (p=0.025) and a lower percentage of eosinophils at the time of NEC diagnosis (p=0.045). . The patients with surgical treatment had a lower gestational age (29.6 ± 2.6 vs 32.0 ± 2.5, p=0.002), a higher frequency of a history of blood transfusion (64.3% vs 36.4%, p=0.050), a higher proportion of patients who worsened the stage of NEC (28.6% vs 5.2%, p=0.018), older age at hospital discharge: 73 (80) vs 39 (37) days, (p=0.008) and higher mortality (28.6% vs 1.3%, p=0.002 ).
Conclusions: The decrease in the eosinophil count in this sample of patients was compromised with more serious events, the lack of an eosinophil hematological response could be an indicator of poor prognosis, due to the nature of our study we should still consider it as a finding.
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Lagarde Santillan, L. M., Bracho Blanchet, E., Silva Ramírez , H., Bernárdez Zapata , I., & Rendon Macías , M. E. (2025). Decrease in the eosinophil levels in neonates with necrotizing enterocolitis requiring surgery. Revista Del Centro De Investigación De La Universidad La Salle, 16(64), 3930. https://doi.org/10.26457/recein.2025.3930
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References
BIBLIOGRAFÍA:
1. Bracho-Blanchet, E., Torrecilla-Navarrete, M. E., Zalles-Vidal, C., Ibarra-Ríos, D., Fernandez-Portilla, E., & Dávila-Pérez, R. (2015). Factores pronóstico para mortalidad en neonatos con enterocolitis necrosante. Cirugia Y Cirujanos, 83(4),286-291. https://doi.org/10.1016/j.circir.2015.02.002
2. Garg, P. M., O’Connor, A., Ansari, A. Y., Vu, B., Hobart, H. L., Paschal, J. L., Multani, H., Josephson, C. D., & Okhomina, V. (2021). Hematological predictors of mortality in neonates with fulminant necrotizing enterocolitis. Journal of Perinatology, 41(5), 1110-1121. https://doi.org/10.1038/s41372-021-01044-3
3. Gasque-Góngora JJ. Revisión y actualización de enterocolitis necrosante. Rev Mex Pediat 2015; 82(5):175-85.
4. Gordon, P. V., & Clark, R. H. (2011). In response to the case report of allergic enterocolitis in a preterm neonate: How prevalent is systemic eosinophilia with NEC? Journal of Perinatology, 31(4), 297-298. https://doi.org/10.1038/jp.2010.192
5. Juul, S. E., Haynes, J., & McPherson, R. J. (2004). Evaluation of eosinophilia in hospitalized preterm infants. Journal of Perinatology, 25(3), 182-188. https://doi.org/10.1038/sj.jp.7211226
6. Lopetuso, L. R., Scaldaferri, F., & Pizarro, T. T. (2012). Emerging role of the interleukin (IL)-33/ST2 axis in gut mucosal wound healing and fibrosis. Fibrogenesis & Tissue Repair, 5(1). https://doi.org/10.1186/1755-1536-5-18
7. Lutfi, S., Mahmah, Alburaki, W., Salama, H., & Rahman, S. U. (2012). The value of blood eosinophils count in infants with feeding intolerance in the neonatal intensive care setting. Journal of neonatal-perinatal medicine. https://doi.org/10.3233/npm-2012-52711
8. Maheshwari, A. (2015). Immunologic and hematological abnormalities in necrotizing enterocolitis. Clinics in Perinatology, 42(3), 567-585. https://doi.org/10.1016/j.clp.2015.04.014
9. Niño, D. F., Sodhi, C. P., & Hackam, D. J. (2016). Necrotizing enterocolitis: New insights into pathogenesis and mechanisms. Nature Reviews Gastroenterology & Hepatology, 13(10), 590-600. https://doi.org/10.1038/nrgastro.2016.119
10. Samuels, N., Van De Graaf, R. A., De Jonge, R. C. J., Reiss, I., & Vermeulen, M. J. (2017b). Risk factors for necrotizing enterocolitis in neonates: A Systematic Review of Prognostic studies. BMC Pediatrics, 17(1). https://doi.org/10.1186/s12887-017-0847-3
11. Tan X, Hsueh W, Gonzalez-Crussi F. Cellular localization of tumor necrosis factor (TNF)-alpha transcripts in normal bowel and in necrotizing enterocolitis. TNF gene expression by Paneth cells, intestinal eosinophils, and macrophages. Am J Pathol 1993;142(6):1858-65.
12. Wahidi, L. S., Sherman, J. D., Miller, M. M., Zaghouani, H., & Sherman, M. P. (2015). Early persistent blood eosinophilia in necrotizing enterocolitis is a predictor of late complications. Neonatology. https://doi.org/10.1159/000431305
1. Bracho-Blanchet, E., Torrecilla-Navarrete, M. E., Zalles-Vidal, C., Ibarra-Ríos, D., Fernandez-Portilla, E., & Dávila-Pérez, R. (2015). Factores pronóstico para mortalidad en neonatos con enterocolitis necrosante. Cirugia Y Cirujanos, 83(4),286-291. https://doi.org/10.1016/j.circir.2015.02.002
2. Garg, P. M., O’Connor, A., Ansari, A. Y., Vu, B., Hobart, H. L., Paschal, J. L., Multani, H., Josephson, C. D., & Okhomina, V. (2021). Hematological predictors of mortality in neonates with fulminant necrotizing enterocolitis. Journal of Perinatology, 41(5), 1110-1121. https://doi.org/10.1038/s41372-021-01044-3
3. Gasque-Góngora JJ. Revisión y actualización de enterocolitis necrosante. Rev Mex Pediat 2015; 82(5):175-85.
4. Gordon, P. V., & Clark, R. H. (2011). In response to the case report of allergic enterocolitis in a preterm neonate: How prevalent is systemic eosinophilia with NEC? Journal of Perinatology, 31(4), 297-298. https://doi.org/10.1038/jp.2010.192
5. Juul, S. E., Haynes, J., & McPherson, R. J. (2004). Evaluation of eosinophilia in hospitalized preterm infants. Journal of Perinatology, 25(3), 182-188. https://doi.org/10.1038/sj.jp.7211226
6. Lopetuso, L. R., Scaldaferri, F., & Pizarro, T. T. (2012). Emerging role of the interleukin (IL)-33/ST2 axis in gut mucosal wound healing and fibrosis. Fibrogenesis & Tissue Repair, 5(1). https://doi.org/10.1186/1755-1536-5-18
7. Lutfi, S., Mahmah, Alburaki, W., Salama, H., & Rahman, S. U. (2012). The value of blood eosinophils count in infants with feeding intolerance in the neonatal intensive care setting. Journal of neonatal-perinatal medicine. https://doi.org/10.3233/npm-2012-52711
8. Maheshwari, A. (2015). Immunologic and hematological abnormalities in necrotizing enterocolitis. Clinics in Perinatology, 42(3), 567-585. https://doi.org/10.1016/j.clp.2015.04.014
9. Niño, D. F., Sodhi, C. P., & Hackam, D. J. (2016). Necrotizing enterocolitis: New insights into pathogenesis and mechanisms. Nature Reviews Gastroenterology & Hepatology, 13(10), 590-600. https://doi.org/10.1038/nrgastro.2016.119
10. Samuels, N., Van De Graaf, R. A., De Jonge, R. C. J., Reiss, I., & Vermeulen, M. J. (2017b). Risk factors for necrotizing enterocolitis in neonates: A Systematic Review of Prognostic studies. BMC Pediatrics, 17(1). https://doi.org/10.1186/s12887-017-0847-3
11. Tan X, Hsueh W, Gonzalez-Crussi F. Cellular localization of tumor necrosis factor (TNF)-alpha transcripts in normal bowel and in necrotizing enterocolitis. TNF gene expression by Paneth cells, intestinal eosinophils, and macrophages. Am J Pathol 1993;142(6):1858-65.
12. Wahidi, L. S., Sherman, J. D., Miller, M. M., Zaghouani, H., & Sherman, M. P. (2015). Early persistent blood eosinophilia in necrotizing enterocolitis is a predictor of late complications. Neonatology. https://doi.org/10.1159/000431305