Early Biomarkers in Neonatal Necrotizing Enterocolitis: A Pilot Study

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Mohamed Shawky Elfarargy
Mohamed S. El Farargy
Marwa Mohamed Atef
Omnia Safwat El-Deeb
Radwa Mahmoud Elsharaby
Hany Abd Elfattah Elhady


necrotizing enterocolitis, neonate, fecal calprotectin, biomarkers, procalcitonin, interleukin 18


Necrotizing enterocolitis (NEC) is a frequent serious disease of the digestive system in neonates. It is considered as an important cause of serious neonatal complication and death. Therefore, its early suspicion and proper management are important.

Early and sensitive detection of neonatal NEC through determination of levels of fecal calprotectin (FCP), serum levels of procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), epithelial neutrophil activating peptide 78 (ENA-78), and interleukin 18 (IL-18).

This prospective case control study was conducted in Tanta University Hospital from June 2016 to March 2018. The study included 20 healthy neonates (control group) and 20 NEC newborn patients. They were all subjected to the measurement of levels of FCP and serum levels of hs-CRP, PCT, ENA- 78, IL-18, Malondialdehyde (MDA), and total antioxidant capacity (TAC). Receiver operating characteristic (ROC) curve analysis was conducted for FCP, ENA-78, PCT, hs-CRP, and IL-18.

The study found a detectable increase in FCP level and serum levels of hs-CRP, PCT, ENA-78, IL-18, and MDA in NEC group in comparison to their levels in the control group. Also, it found a detectable decline in the levels of TAC in comparison to its level in the control group.

FCP, ENA-78, and PCT can be considered as early markers for diagnosis of NEC.

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