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The role of absolute monocyte counts in predicting severity of necrotizing enterocolitis

Journal of Perinatology volume 40, pages 922–927 (2020)Cite this article

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Abstract

Objective

Necrotizing enterocolitis (NEC) is an inflammatory bowel disease of preterm infants marked by an absolute monocyte count (AMC) drop in peripheral blood. Our objective was to determine whether the degree of AMC drop at illness onset correlates with eventual severity of disease.

Study design

The percentage change in AMC was retrospectively calculated for each of 29 rule-out NEC and 76 NEC cases from baseline to illness onset, and then compared across stages.

Results

Median AMC changes of +0.5% (p = 0.56) were found in rule-out NEC, compared with −44.5% (p < 0.0001) in Stage 2 and −81.9% (p < 0.0001) in Stage 3. An AMC change cutoff of −75% distinguishes Stages 2 and 3.

Conclusions

The severity of NEC correlated with the extent of AMC change in a dose-response fashion. Percent AMC change may be a useful marker for identifying NEC at onset and prognosticating disease severity.

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Fig. 1: CONSORT diagram.
Fig. 2: Change in AMC from baseline to illness onset, expressed as a percentage, grouped by final diagnosis (*p < 0.001).
Fig. 3: Receiver–operator curve, to distinguish Stages 2 and 3 NEC.
Fig. 4: Receiver–operator curve, to distinguish rule-out NEC from confirmed NEC.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Columbia University Medical Center, New York, NY, USA

    Suneetha Desiraju, David Bateman & Sudha Kashyap

  2. Columbia University College of Dental Medicine, New York, NY, USA

    Julian Bensadoun

Authors
  1. Suneetha Desiraju
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  2. Julian Bensadoun
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  3. David Bateman
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  4. Sudha Kashyap
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Contributions

SD designed the study and performed data collection. JB and DB performed statistical analysis. SK guided study design. The paper was written by SD with significant contributions by SK and DB.

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Correspondence to Suneetha Desiraju.

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The authors declare that they have no conflict of interest.

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Desiraju, S., Bensadoun, J., Bateman, D. et al. The role of absolute monocyte counts in predicting severity of necrotizing enterocolitis. J Perinatol 40, 922–927 (2020). https://doi.org/10.1038/s41372-020-0596-2

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