Low Levels of Procalcitonin During Episodes of Necrotizing Enterocolitis
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The pathogenesis of necrotizing enterocolitis (NEC) remains poorly understood. We aimed to assess the extent of bacterial infection in the pathogenesis of NEC using serial procalcitonin measurements. Blood samples were drawn during the first 4 days following every clinical event requiring a workup for presumed NEC. Eight episodes were confirmed as NEC, 7 of which showed procalcitonin levels <1 ng/ml at presentation and <1.3 ng/ml thereafter, comparable to 24 healthy controls. The one infant with elevated procalcitonin had bacteremia in addition to NEC. Procalcitonin levels of 24 matched septic infants were higher than those of NEC infants, peaking at 4.1 ng/ml. We conclude that low procalcitonin values are the rule during episodes of NEC and provide further evidence that overactive local immune response, and not active infection, is primarily responsible for the mucosal damage in NEC.
KeywordsNecrotizing enterocolitis Preterm infants Procalcitonin Etiology
BRAHMS Diagnostica provided the testing kits for PCT determination but was not involved in any part of the study design, data collection, data analysis, or manuscript preparation. The authors wish to thank the nurses of NICU who meticulously collected the blood samples.
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