Study of the faecal calprotein levels In healthy preterm and full-term Infants and premature infants with necrotizing enterocolitis

الملخص EN

Background: Calprotectin, a calcium-binding protein found in neutrophilic granulocytes, monocytes, and macrophages, resists metabolic degradation and can be measured in feces.

Calprotectin has been proposed as a useful marker of gastrointestinal inflammation in infants.

Aims: aim of this study is to establish whether fecal calprotectin concentrations can be used to aid diagnosis of necrotizing enterocolitis in preterm infants and define reference values in healthy full-term infants according to the mode of feeding: breast feeding or standard infant formula.

Methods: This study was carried out on 48 newborn infants, 25 were breast fed and 23 were received a standard infant formula.

They were 22 boys and 26 girls, born in the maternity unit of Al-Ansar General Hospital and Dr.

Bakhsh General Hospital: 26 were born by normal vaginal delivery (IWD) with cephalic presentation, and 22 were born by Caesarian Section.

They were selected from Neonatal Intensive Care Unit of oAl-Ansar General Hospital, Jeddah and Dr.

Bakhsh General Hospital, Makkah Almukaramah, Saudi Arabia during the period from October 2005 to January 2007.

Every case was subjected to a complete history, thorough physical examination, and a full evaluation of prenatal and perinatal variables.

The following investigations were carried out for preterm infants with necrotizing enterocolitis: - Standardized laboratory evaluation for sepsis was performed, including: CBC, total WBCs count and differential; blood film, CRP, and blood cultures, microscopic stool analysis and for occult blood, and urinalysis before the administration of broad - spectrum antibiotics.

Fecal Calprotectin was measured by an enzyme-linked immunosorbent assay kit in spot stool samples in 22 healthy full-term infants, 18 healthy preterm infants, and 8 preterm infants with necrotizing enterocolitis.

Results: Our study showed that preterm infants with necrotizing enterocolitis had significantly raised fecal Calprotectin concentrations at the time of diagnosis compared with matched healthy preterm infants.

We found that no significant differences were found between boys and girls, and no correlation was found between Calprotectin concentration and day of sampling.

There was no obvious influence of the mode of feeding.

Conclusion: Calprotectin is a sensitive marker to easily detect inflammation throughout the whole gastrointestinal tract.

It therefore has potential as a noninvasive diagnostic screening test in preterm infants with necrotizing enterocolitis, providing information on intestinal inflammation.