[Prevalence of neutropenic enterocolitis in adults with severe neutropenia and associated mortality.].
BACKGROUND
Neutropenic enterocolitis (NEC) is characterized by inflammatory damage and necrosis of the intestinal mucosa, mainly of the terminal ileum and the cecum. It is more frequent in patients with leukemia and/or undergoing antineoplastic chemotherapy, and the main risk factor is neutropenia <1000/mm3.


OBJECTIVE
To know the prevalence of NEC and the mortality associated with it in adults with hematologic conditions and neutropenia <1000/mm3.


METHODS
All adult patients who were hospitalized for malignant hematologic conditions with neutropenia <1000/mm3 were enrolled in the study; those with neutropenia >1000/mm3 were excluded. The diagnosis of NEC was based on the clinical data and imaging tests (abdominal plain X-rays and CT scan). Demographics of all patients were collected, as well as the data related with the course and treatment of the underlying hematologic condition and the NEC.


RESULTS
117 patients were enrolled in the study; 75.2% of them with some type of acute leukemia. The diagnosis of NEC was made in 8 patients (6.8%). NEC occurred in 10.5% of the patients with acute myeloid leukemia and in 8.0% of those with acute lymphocytic leukemia. Three patients died, which resulted in a 37.5% mortality rate. No association was found between the severity of neutropenia and the onset of NEC or NEC-related mortality.


CONCLUSIONS
The prevalence of NEC in patients with hematologic conditions admitted for severe neutropenia is 6.8% and the mortality rate associated with this complication is 37.5%.
Servicio de Cirugía de Colon y Recto, UMAE Hospital de Especialidades Dr. Bernardo Sepúlveda G, Centro Médico Nacional Siglo XXI IMSS, México, DF. dr.danieldorantes@gmail.com
D
D
Dorantes-Díaz
J
J
Garza-Sánchez
J A
JA
Cancino-López
J L
JL
Rocha-Ramírez
F M
FM
Rojas-Illanes
J W
JW
Parrado-Montaño
V M
VM
Hernández-Escalante
D000293:Adolescent; D000328:Adult; D044504:Enterocolitis, Neutropenic / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications / Q000209:etiology* / Q000401:mortality; D015995:Prevalence; D014057:Tomography, X-Ray Computed; D055815:Young Adult