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Reference intervals for stool calprotectin in preterm neonates and their utility for the diagnosis of necrotizing enterocolitis

Journal of Perinatology volume 38, pages 1379–1385 (2018)Cite this article

Subjects

Abstract

Objective

Calprotectin is an antimicrobial protein found in stool when released by granulocytes. We sought to create stool calprotectin reference ranges in preterm neonates and to evaluate whether levels exceeding the upper reference interval are diagnostic for necrotizing enterocolitis (NEC).

Study design

Stool calprotectin was measured in premature neonates without gastrointestinal pathology to create reference intervals. For comparison, levels from infants undergoing “rule out NEC” evaluations were plotted on these reference intervals.

Results

Stool calprotectin reference intervals were created according to gestational age at birth and corrected gestational age. Levels during “rule out NEC” evaluations were more often above the upper reference interval with NEC vs. those without NEC.

Conclusions

Stools from preterm neonates have a higher range of calprotectin than stools from healthy term neonates. In evaluating preterm neonates for NEC with stool calprotectin, a calprotectin upper reference interval that incorporates corrected gestational age best predicts the diagnosis of NEC.

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Acknowledgements

We thank the following medical directors and NICU research nurses for their assistance in collecting the stool samples; Elizabeth O’Brien, Intermountain Medical Center; Patrick Carroll, Dixie Regional Medical Center, Eva Livingston, Dixie Regional Medical Center; Trisha A. Marchant, RNC-NIC and Kimberlee Weaver Lewis, Intermountain Medical Center; Jennifer Elmont and Susan R. Christensen, Utah Valley Regional Medical Center; Kathryn D. Woodbury and Melody Parry, McKay-Dee Hospital.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA

    B. C. MacQueen, R. D. Christensen & C. C. Yost

  2. Women and Newborn Research, Intermountain Medical Center, Murray, UT, USA

    R. D. Christensen & V. L. Baer

  3. Division of Hematology/Oncology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA

    R. D. Christensen

  4. Mednax Inc., Sunrise, FL, USA

    P. V. Gordon

  5. Sacred Heart Women’s and Children’s Hospital, Pensacola, FL, USA

    P. V. Gordon

  6. ARUP Laboratories, Salt Lake City, USA

    R. Schlaberg & J. Lowe

  7. Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA

    R. Schlaberg

Authors
  1. B. C. MacQueen
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  2. R. D. Christensen
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  4. P. V. Gordon
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  5. V. L. Baer
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Corresponding author

Correspondence to B. C. MacQueen.

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Conflict of interest

RS and JL are employees of ARUP laboratories where the calprotectin assays were run. The remaining authors declare that they have no conflict of interest.

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MacQueen, B.C., Christensen, R.D., Yost, C.C. et al. Reference intervals for stool calprotectin in preterm neonates and their utility for the diagnosis of necrotizing enterocolitis. J Perinatol 38, 1379–1385 (2018). https://doi.org/10.1038/s41372-018-0108-9

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