Early Persistent Blood Eosinophilia in Necrotizing Enterocolitis Is a Predictor of Late Complications

Background: Eosinophils infiltrate intestinal tissue during necrotizing enterocolitis (NEC) and adult bowel diseases. We theorized that epithelial damage causes eosinophilic activation and recruitment at NEC onset. Objective: We studied the relationship between persistent blood eosinophilia and medical or surgical complications during NEC. Methods: NEC cases and controls at MU Children’s Hospital (2008– 2013) underwent review. A Likert scale measured NEC severity. We utilized an SPSS database for statistical analyses. Results: Of 50 NEC cases, infants in group 1 (n = 15) had eosinophilia <2 days after onset and those in group 2 (n = 25) had NEC but no persistent eosinophilia. Group 3 (n = 46) consisted of controls, i.e. infants without NEC matched for birth weight and gestational age and group 4 (n = 4) of preterm infants with infection and ≤ 5 days of eosinophilia. Hematologic assessment defined persistent eosinophilia as ≥ 5% eosinophils for ≥ 5 days after NEC onset. Absolute eosinophil counts were 2 times higher in group 1 than in group 2 (p = 0.002). The mean duration of eosinophilia was 8 days in Received: March 25, 2015 Accepted after revision: May 12, 2015 Published online: July 7, 2015 Michael P. Sherman, MD, FAAP, Professor Department of Child Health, MU Women’s and Children’s Hospital University of Missouri, 404 N. Keene Street, Neonatology, Suite 206 Columbia, MO 65201 (USA) E-Mail shermanmp @ missouri.edu © 2015 S. Karger AG, Basel 1661–7800/15/1082–0137$39.50/0