Gestational Age-Specific Complete Blood Count Signatures in Necrotizing Enterocolitis
Objective: Necrotizing enterocolitis (NEC) is characterized by peripheral cell abnormalities, yet few studies have analyzed the complete blood count (CBC) specifically by gestational age (GA). Our objective was to describe GA-specific immune abnormalities in NEC through a comprehensive analysis of t...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-02-01
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| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2021.604899/full |
| _version_ | 1818580510623924224 |
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| author | Julia M. Pantalone Silvia Liu Oluwabunmi O. Olaloye Oluwabunmi O. Olaloye Erica C. Prochaska Erica C. Prochaska Toby Yanowitz Melissa M. Riley Melissa M. Riley Justin R. Buland Justin R. Buland Beverly S. Brozanski Beverly S. Brozanski Misty Good Misty Good Liza Konnikova Liza Konnikova Liza Konnikova Liza Konnikova Liza Konnikova |
| author_facet | Julia M. Pantalone Silvia Liu Oluwabunmi O. Olaloye Oluwabunmi O. Olaloye Erica C. Prochaska Erica C. Prochaska Toby Yanowitz Melissa M. Riley Melissa M. Riley Justin R. Buland Justin R. Buland Beverly S. Brozanski Beverly S. Brozanski Misty Good Misty Good Liza Konnikova Liza Konnikova Liza Konnikova Liza Konnikova Liza Konnikova |
| author_sort | Julia M. Pantalone |
| collection | DOAJ |
| description | Objective: Necrotizing enterocolitis (NEC) is characterized by peripheral cell abnormalities, yet few studies have analyzed the complete blood count (CBC) specifically by gestational age (GA). Our objective was to describe GA-specific immune abnormalities in NEC through a comprehensive analysis of the CBC differential.Methods: Using a cohort of 246 infants (177 cases, 69 controls) admitted to neonatal intensive care units at a single institution, we retrospectively analyzed CBCs around illness onset in NEC cases compared with controls. Cases included surgical NEC (S-NEC, 34.5%) and medical NEC (M-NEC, 65.5%). Infants were divided into those born at GA <33 and ≥33 weeks. Differences in CBC values were described as absolute and percent changes at NEC onset from baseline and at antibiotic completion after NEC. We used machine learning algorithms based on the CBC at NEC to generate predictive models for diagnosis.Results: At NEC onset, there was an acute drop in monocytes and lymphocytes along with a rise in bands in S-NEC infants born <33 weeks compared with M-NEC. In comparison, both M-NEC and S-NEC ≥33 weeks had a percent drop in neutrophils at diagnosis compared with controls. At antibiotic completion, monocytes in S-NEC <33 weeks significantly rose compared with M-NEC, yet for S-NEC ≥33 weeks, bands significantly dropped compared with M-NEC. Predictive modeling was able to accurately predict S-NEC from M-NEC and controls.Conclusion: There are discrete leukocyte patterns in NEC based on GA. The CBC at diagnosis may be useful in identifying patients who will require surgery. |
| first_indexed | 2024-12-16T07:18:45Z |
| format | Article |
| id | doaj.art-bbe1728849ac4fbea8c3663bafaf695c |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-16T07:18:45Z |
| publishDate | 2021-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-bbe1728849ac4fbea8c3663bafaf695c2022-12-21T22:39:42ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602021-02-01910.3389/fped.2021.604899604899Gestational Age-Specific Complete Blood Count Signatures in Necrotizing EnterocolitisJulia M. Pantalone0Silvia Liu1Oluwabunmi O. Olaloye2Oluwabunmi O. Olaloye3Erica C. Prochaska4Erica C. Prochaska5Toby Yanowitz6Melissa M. Riley7Melissa M. Riley8Justin R. Buland9Justin R. Buland10Beverly S. Brozanski11Beverly S. Brozanski12Misty Good13Misty Good14Liza Konnikova15Liza Konnikova16Liza Konnikova17Liza Konnikova18Liza Konnikova19University of Pittsburgh School of Medicine, Pittsburgh, PA, United StatesDepartment of Pathology, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Pediatrics, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Pediatrics, Yale School of Medicine, New Haven, CT, United StatesDepartment of Pediatrics, University of Pittsburgh, Pittsburgh, PA, United StatesDivision of Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, United StatesDepartment of Pediatrics, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Pediatrics, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Pediatrics, Washington University School of Medicine, St. Louis, MO, United StatesDepartment of Pediatrics, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Pediatrics, Washington University School of Medicine, St. Louis, MO, United StatesDepartment of Pediatrics, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Pediatrics, Washington University School of Medicine, St. Louis, MO, United StatesDepartment of Pediatrics, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Pediatrics, Washington University School of Medicine, St. Louis, MO, United StatesUniversity of Pittsburgh School of Medicine, Pittsburgh, PA, United StatesDepartment of Pediatrics, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Pediatrics, Yale School of Medicine, New Haven, CT, United StatesDepartment of Immunology, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Developmental Biology, University of Pittsburgh, Pittsburgh, PA, United StatesObjective: Necrotizing enterocolitis (NEC) is characterized by peripheral cell abnormalities, yet few studies have analyzed the complete blood count (CBC) specifically by gestational age (GA). Our objective was to describe GA-specific immune abnormalities in NEC through a comprehensive analysis of the CBC differential.Methods: Using a cohort of 246 infants (177 cases, 69 controls) admitted to neonatal intensive care units at a single institution, we retrospectively analyzed CBCs around illness onset in NEC cases compared with controls. Cases included surgical NEC (S-NEC, 34.5%) and medical NEC (M-NEC, 65.5%). Infants were divided into those born at GA <33 and ≥33 weeks. Differences in CBC values were described as absolute and percent changes at NEC onset from baseline and at antibiotic completion after NEC. We used machine learning algorithms based on the CBC at NEC to generate predictive models for diagnosis.Results: At NEC onset, there was an acute drop in monocytes and lymphocytes along with a rise in bands in S-NEC infants born <33 weeks compared with M-NEC. In comparison, both M-NEC and S-NEC ≥33 weeks had a percent drop in neutrophils at diagnosis compared with controls. At antibiotic completion, monocytes in S-NEC <33 weeks significantly rose compared with M-NEC, yet for S-NEC ≥33 weeks, bands significantly dropped compared with M-NEC. Predictive modeling was able to accurately predict S-NEC from M-NEC and controls.Conclusion: There are discrete leukocyte patterns in NEC based on GA. The CBC at diagnosis may be useful in identifying patients who will require surgery.https://www.frontiersin.org/articles/10.3389/fped.2021.604899/fullimmunologycomplete blood countgestational agenecrotizing entercolitispre-maturity |
| spellingShingle | Julia M. Pantalone Silvia Liu Oluwabunmi O. Olaloye Oluwabunmi O. Olaloye Erica C. Prochaska Erica C. Prochaska Toby Yanowitz Melissa M. Riley Melissa M. Riley Justin R. Buland Justin R. Buland Beverly S. Brozanski Beverly S. Brozanski Misty Good Misty Good Liza Konnikova Liza Konnikova Liza Konnikova Liza Konnikova Liza Konnikova Gestational Age-Specific Complete Blood Count Signatures in Necrotizing Enterocolitis Frontiers in Pediatrics immunology complete blood count gestational age necrotizing entercolitis pre-maturity |
| title | Gestational Age-Specific Complete Blood Count Signatures in Necrotizing Enterocolitis |
| title_full | Gestational Age-Specific Complete Blood Count Signatures in Necrotizing Enterocolitis |
| title_fullStr | Gestational Age-Specific Complete Blood Count Signatures in Necrotizing Enterocolitis |
| title_full_unstemmed | Gestational Age-Specific Complete Blood Count Signatures in Necrotizing Enterocolitis |
| title_short | Gestational Age-Specific Complete Blood Count Signatures in Necrotizing Enterocolitis |
| title_sort | gestational age specific complete blood count signatures in necrotizing enterocolitis |
| topic | immunology complete blood count gestational age necrotizing entercolitis pre-maturity |
| url | https://www.frontiersin.org/articles/10.3389/fped.2021.604899/full |
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