title: The efficacy of serial serum amyloid A measurements for diagnosis and follow-up of necrotizing enterocolitis in premature infants.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the efficacy of serial serum amyloid A (SAA) measurements in diagnosis and follow-up of necrotizing enterocolitis (NEC) in preterm infants.
  
  
  METHODS
  A total of 144 infants were enrolled in this observational study. The infants were classified into three groups: group 1 (infants with NEC and sepsis), group 2 (infants with sepsis), and group 3 (no sepsis and NEC, control group). Data including serial whole blood count (WBC), SAA measurements that were obtained at the initial work-up of NEC and/or sepsis episode (0 day), at 24, 48 h, 7, and 10 day were evaluated. In addition, initial and serial follow-up abdominal radiographies were obtained.
  
  
  RESULTS
  A total of 50 infants were diagnosed NEC. Mean SAA values (43.2 +/- 47.5 mg/dl) of infants in group 1 at 0 h were significantly higher than those in group 2 and group 3. The percentage of infants with abnormal SAA levels was significantly higher in group 1 compared with that in group 2 at 24 h. In addition, the percentage of infants with abnormal SAA levels was slightly but not statistically higher in stage 2 and stage 3 NEC group compared with that stage 1 NEC at 0, 24, 48 h. SAA levels started to decline at 48 h of onset through day 10. The cut-off value for SAA for differentiating NEC from sepsis was 23.2 mg/dl.
  
  
  CONCLUSIONS
  SAA may be recognized as an accurate laboratory marker in addition to clinical and radiographic findings for NEC diagnosis. It can also be used for determining the severity of NEC and response to therapy in infants with NEC.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Uludag University School of Medicine, Görükle, Bursa, Turkey. drmerih@yahoo.com
authors.forename: Merih
authors.initials: M
authors.lastname: Cetinkaya
authors.forename: Hilal
authors.initials: H
authors.lastname: Ozkan
authors.forename: Nilgün
authors.initials: N
authors.lastname: Köksal
authors.forename: Okan
authors.initials: O
authors.lastname: Akaci
authors.forename: Taner
authors.initials: T
authors.lastname: Ozgür
mesh_terms: D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001772:Blood Cell Count; D016009:Chi-Square Distribution; D020345:Enterocolitis, Necrotizing / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000097:blood / Q000175:diagnosis*; D008297:Male; D012372:ROC Curve; D011860:Radiography, Abdominal; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D000685:Serum Amyloid A Protein
chemical_list: D015415:Biomarkers; D000685:Serum Amyloid A Protein