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The Relevance of Immunoglobulin in the Prevention of Necrotizing Enterocolitis

  • H. M. Wolf
  • Martha M. Eibl
Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 310)

Abstract

Necrotizing enterocolitis (NEC) is a severe acquired gastrointestinal disease and an important cause of morbidity and mortality among stressed low-birth-weight infants in neonatal intensive care units. Although prematurity is the primary risk factor for NEC, it is generally accepted that the pathogenesis of the disease is multifactorial, and a combination of immaturity of the host’s gastrointestinal defense mechanisms, intestinal ischemia, and colonization of the gut by infectious agents leads to the development of the disease1. NEC develops in 2 to 7% of premature infants admitted to a neonatal intensive care unit2. Early abdominal signs indicative of NEC include abdominal distension, diarrhea, gastric retention, emesis, and macroscopic or occult gastrointestinal bleeding. When the disease progresses to unstable stage with vital signs that resemble sepsis, perforation of the intestine or an obstruction pattern on abdominal radiograph, patients require aggressive medical and/or surgical therapy. Histologically the disease, affecting primarily the terminal ileum and ascending colon, is characterized by coagulation necrosis of mucosa and submucosa, inflammation, ulceration, peritonitis, and intramural gas-filled cysts (i.e. pneumatosis intestinalis)3.

Keywords

Neonatal Intensive Care Unit Stool Sample Clostridium Difficile Necrotizing Enterocolitis Control Infant 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    A. M. Kosloske, J. Pediatr. 117:, S68 (1990).PubMedCrossRefGoogle Scholar
  2. 2.
    R. M. Kliegman and M. C. Walsh, Curr. Probl. Pediatr. 17: 219 (1987).Google Scholar
  3. 3.
    W. A. Ballance, B. B. Dahms, N. Shenker, and R. M. Kliegman, J. Pediatr. 117: S6, (1990).PubMedCrossRefGoogle Scholar
  4. 4.
    B. J. Stoll, W. P. Kanto, Jr., R. I. Glass, A. J. Nahmias, and A. W. Brann, J. Pediatr. 96: 447 (1980).PubMedCrossRefGoogle Scholar
  5. 5.
    R. M. Kliegman and A. A. Fanaroff, Amer. J. Dis. Child. 135: 608 (1981).PubMedGoogle Scholar
  6. 6.
    M. M. Eibl, H. M. Wolf, H. Fürnkranz, and A. Rosenkranz, N. Engl. J. Med. 319: 1 (1988).PubMedCrossRefGoogle Scholar
  7. 7.
    A. M. Kosloske, Pediatrics 74: 1086 (1984).PubMedGoogle Scholar
  8. 8.
    B. Barlow and T. V. Santulli, Surgery 77: 687 (1975).PubMedGoogle Scholar
  9. 9.
    R. M. Kliegman and A. A. Fanaroff, N. Engl. J. Med. 310: 1093 (1984).PubMedCrossRefGoogle Scholar
  10. 10.
    W. A. Walker, Pediatrics 57: 901 (1976).PubMedGoogle Scholar
  11. 11.
    R. I. Glass, A.-M. Svennerholm, B. J. Stoll, M. R. Khan, K. M. Belayet Hossain, M. Imadul Huq, and J. Holmgren, N. Engl. J. Med. 308: 1389 (1983).PubMedCrossRefGoogle Scholar
  12. 12.
    J. K. Welsh and J. T. May, J. Pediatrics 94: 1 (1979).CrossRefGoogle Scholar
  13. 13.
    H. Yoshioka, K. Iseki, and K. Fujita, Pediatrics 72: 317 (1983).PubMedGoogle Scholar
  14. 14.
    L. Gothefors, S. Olling, and J. Winberg, Acta Paediatr. Scand. 64: 807 (1975).PubMedCrossRefGoogle Scholar
  15. 15.
    I. Narayanan, K. Prakash, N. S. Murthy, and V. V. Gujral, Lancet ii: 1111 (1984).CrossRefGoogle Scholar
  16. 16.
    J. E. Ford, B. A. Law, V. M. E. Marshall, and B. Reiter, J. Pediatr. 90: 29 (1977).PubMedGoogle Scholar
  17. 17.
    C. Mieters, H. Keinhorst, H. Hilpert, H. Gerber, H. Amster, and J. J. Pahud, Eur. J. Pediatr. 132: 239 (1979).CrossRefGoogle Scholar
  18. 18.
    H. Hilpert, H. Brüssow, C. Mietens, J. Sidoti, L. Lerner, and H. Werchau, J. Infect. Dis. 156: 158 (1987).PubMedCrossRefGoogle Scholar
  19. 19.
    S. Tzipori, D. Roberton, and C. Chapman, Brit. Med. J. 293: 1276 (1986).CrossRefGoogle Scholar
  20. 20.
    C. O. Tacket, G. Losonsky, H. Link, Y. Hoang, P. Guesry, H. Hilpert, and M. M. Levine, N. Engl. J. Med. 318: 1240 (1988).PubMedCrossRefGoogle Scholar
  21. 21.
    G. A. Losonsky, J. P. Johnson, J. A. Winkelstein, and R. H. Yolken, J. Clin. Invest. 76: 2362 (1985).PubMedCrossRefGoogle Scholar
  22. 22.
    P. M. Blum, D. L. Phelps, B. J. Ank, B. J. Krantman, and E. R. Stiehm, Pediatr. Res. 15: 1256 (1981).PubMedCrossRefGoogle Scholar
  23. 23.
    K. Kim, L. K. Pickering, H. L. DuPont, N. Sullivan, and T. J. Wilkins, J. Infect. Dis. 150: 57 (1984).PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1991

Authors and Affiliations

  • H. M. Wolf
    • 1
  • Martha M. Eibl
    • 1
  1. 1.Institute of ImmunologyUniversity of ViennaViennaAustria

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