title: Low levels of procalcitonin during episodes of necrotizing enterocolitis.
abstract: 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.
authors: Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel. dan.turner@sickkids.ca
authors: Dan
authors: D
authors: Turner
authors: Cathy
authors: C
authors: Hammerman
authors: Bernard
authors: B
authors: Rudensky
authors: Yechiel
authors: Y
authors: Schlesinger
authors: Eytan
authors: E
authors: Wine
authors: Aleixo
authors: A
authors: Muise
authors: Michael S
authors: MS
authors: Schimmel
mesh_terms: D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D020345:Enterocolitis, Necrotizing / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006023:Glycoproteins; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D006023:Glycoproteins; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide