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Immunological and Hematological Abnormalities in Necrotizing Enterocolitis #MMPMID26250918
Maheshwari A
Clin Perinatol 2015[Sep]; 42 (3): 567-85 PMID26250918show ga
Objective: Necrotizing enterocolitis (NEC) is a leading cause of morbidity and mortality in preterm infants born prior to 32 weeks gestation or with a birth weight less than 1500 grams. In this article, we review the immunological and hematological abnormalities associated with NEC. Methods: A literature search was performed using the databases PubMed, EMBASE, and Scopus. Keywords were shortlisted from PubMed?s Medical Subject Heading (MeSH) thesaurus prior to the actual search and combined with text words likely to be used in titles and abstracts. Results: During NEC, disruption of the gut mucosal barrier results in bacterial translocation that triggers a damaging local and systemic inflammatory response. The premature intestine is at risk of inflammatory injury because of developmental limitations in both the innate and adaptive arms of the mucosal immune system. The systemic inflammatory response during NEC is characterized by elevated circulating cytokine levels and hematological abnormalities such as thrombocytopenia, increased or decreased neutrophil counts, low monocyte counts, and anemia. These findings might convey important diagnostic and prognostic information. Conclusions: The premature intestine displays a ?pro-inflammatory? bias that increases the risk of NEC. Consistent patterns of hematological changes are frequently encountered in infants with NEC and may provide important diagnostic and prognostic information.