Acute drop in blood monocyte count differentiates NEC from other causes of feeding intolerance Journal Article

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Authors: Remon, J.; Kampanatkosol, R.; Kaul, R. R.; Muraskas, J. K.; Christensen, R. D.; Maheshwari, A.
Article Title: Acute drop in blood monocyte count differentiates NEC from other causes of feeding intolerance
Abstract: OBJECTIVE: Necrotizing enterocolitis (NEC) is characterized by macrophage infiltration into affected tissues. Because intestinal macrophages are derived from recruitment and in situ differentiation of blood monocytes in the gut mucosa, we hypothesized that increased recruitment of monocytes to the intestine during NEC reduces the blood monocyte concentration and that this fall in blood monocytes can be a useful biomarker for NEC. STUDY DESIGN: We reviewed medical records of very-low-birth-weight (VLBW) infants treated for NEC and compared them with a matched control group comprised of infants with feeding intolerance but no signs of NEC. Clinical characteristics and absolute monocyte counts (AMCs) were recorded. Diagnostic accuracy of AMC values was tested using receiver-operator characteristics (ROC). RESULT: We compared 69 cases and 257 controls (median 27 weeks, range 26 to 29 in both the groups). In stage II NEC, AMCs decreased from median 1.7 x 10(9) l(-1) (interquartile range (IQR) 0.98 to 2.4) to 0.8 (IQR 0.62 to 2.1); P 20% indicated NEC with sensitivity of 0.70 (95% confidence interval (CI) 0.57 to 0.81) and specificity of 0.71 (95% CI 0.64 to 0.77). CONCLUSION: We have identified a fall in blood monocyte concentration as a novel biomarker for NEC in VLBW infants.
Journal Title: Journal of Perinatology
Volume: 34
Issue: 7
ISSN: 0743-8346
Publisher: Unknown  
Journal Place: United States
Date Published: 2014
Start Page: 549
End Page: 554
Language: eng
DOI/URL:

10.1038/jp.2014.52
Notes: LR: 20150113; GR: R01 HD059142/HD/NICHD NIH HHS/United States; GR: R01HD059142/HD/NICHD NIH HHS/United States; JID: 8501884; 0 (Biological Markers); NIHMS570376; OID: NLM: NIHMS570376; OID: NLM: PMC4074443; 2013/11/21 [received]; 2014/02/02 [revised]; 2014/02/24 [accepted]; 2014/03/27 [aheadofprint]; ppublish