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Do hematological biomarkers predict surgical necrotizing enterocolitis?

Pediatric Research (2024)Cite this article

Abstract

Necrotizing enterocolitis (NEC) is a devastating gastrointestinal emergency in preterm infants and the clinical presentation of NEC may vary with gestational age. We lack reliable biomarkers for early diagnosis of NEC limiting timely intervention. Hematological changes in NEC are actively researched for their potential role as biomarkers. The pattern and severity of hematological abnormalities have been correlated with rapid progression, the need for surgery, increased risk of mortality, and morbidity. In this issue of Pediatric Research, Chong et al. report GA-specific hematological biomarkers in preterm infants with NEC that could predict the need for surgery. Thrombocytopenia at NEC onset was an independent predictor of surgical intervention in extremely preterm infants. Persistent thrombocytopenia and lymphopenia at 72 h and elevated C-reactive protein at 48 h after NEC onset, predicted surgery in infants of 28 to <32 weeks GA. Persistent thrombocytopenia at 24 h after the onset of NEC was predictive of mortality in infants who underwent surgery. Well-designed, prospective, multi-center studies are needed to confirm the role of hematological biomarkers in early diagnosis and prognostication in NEC.

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Funding

Funding

Dr. Mohan Pammi is funded by the following extramural source: NIH 1R01HD112886.

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Authors and Affiliations

  1. Department of Pediatrics/Neonatology, The University of Toledo, ProMedica Russell J. Ebeid Children’s Hospital, Toledo, OH, USA

    Srinivasan Mani

  2. Department of Pediatrics/Neonatology, Brenner Children’s at Atrium Health Wake Forest Baptist and Wake Forest University School of Medicine, Winston Salem, NC, USA

    Parvesh Mohan Garg

  3. Dept. of Pediatrics, Division of Neonatology, Baylor College of Medicine & Texas Children’s Hospital, Houston, TX, USA

    Mohan Pammi

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  1. Srinivasan Mani
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Correspondence to Mohan Pammi.

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Mani, S., Garg, P.M. & Pammi, M. Do hematological biomarkers predict surgical necrotizing enterocolitis?. Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03066-x

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