Hematologic abnormalities in severe neonatal necrotizing enterocolitis

A simple presurgical necrotizing enterocolitis-mortality scoring system

“…The lower leukocyte counts we found in surgically treated infants as well as in Bell stage III (P ¼ 0.05) are in keeping with previous findings. 3,12,13 However, neither in the present study nor in another study by Voss et al 14 of infants with a mean GA of 31 weeks, were there differences in leukocyte count between survivors and non-survivors. However, in more mature infants with NEC, low leukocyte counts were associated with increased mortality.…”

“…4,16 Even though we observed a tendency toward lower platelet counts in more severe NEC and in non-survivors, the differences were not statistically significant, as was also found in some other studies. 3,14 Nevertheless, the AUC for prediction of poor outcome was 0.59 and inclusion of platelet count into the NECscore increased its predictive power. As Ragazzi et al 17 found considerably lower platelet counts in a cohort of more mature infants, the extent of platelet drop may also depend on the maturity of the infants.…”

“…3,4 However, these changes are late signs and are thus not very helpful for decision making and risk stratification in the early phase of the disease. Recently, C-reactive protein (CRP) has been described to be abnormal in advanced NEC.…”

Hematologic Abnormalities in Severe Neonatal Necrotizing Enterocolitis: 25 Years Later

“…[3][4][5] Lower platelet counts have been reported to be associated with greater disease severity. In the description by Hutter et al 3 of the 40 initial patients, mean platelet nadir was 46,500±58,400 in those who died, compared to 69,300±640,000/mm 3 in survivors. In a 1977 study by Patel, 4 20/23 nonsurvivors exhibited platelet counts less than 150,000/mm 3 while 12/24 survivors were thrombocytopenic.…”

“…1,2 Despite major advances in understanding the multisystem pathophysiology of NEC, treatment of NEC remains largely supportive. The hematological abnormalities associated with NEC were first described 25 years ago by Hutter et al 3 The abnormalities observed in a series of 40 patients with NEC included thrombocytopenia, with and without disseminated intravascular coagulation (DIC), neutrophilia or neutropenia, and hemolytic anemia. 3 Since 1976, an impressive expansion of knowledge has improved the understanding of cellular mechanisms behind disturbed hematopoiesis accompanying the disease, NEC.…”