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J Pediatr. 2017 Jan;180:135-140.e1. doi: 10.1016/j.jpeds.2016.09.016. Epub 2016 Oct 10.

Blood Level of Inter-Alpha Inhibitor Proteins Distinguishes Necrotizing Enterocolitis From Spontaneous Intestinal Perforation.

Author information

1
Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK; Department of Pediatrics, Women and Infants Hospital, Alpert Medical School of Brown University, Providence, RI. Electronic address: Birju-Shah@ouhsc.edu.
2
Department of Pediatrics, Women and Infants Hospital, Alpert Medical School of Brown University, Providence, RI.
3
ProThera Biologics Inc., Providence, RI; Department of Pathology and Laboratory Medicine, Alpert Medical School of Brown University, Providence, RI.

Abstract

OBJECTIVE:

To examine circulating levels of inter-alpha inhibitor protein (IaIp) in infants with necrotizing enterocolitis (NEC), spontaneous intestinal perforation (SIP), and matched controls to assess the diagnostic accuracy of IaIp to differentiate NEC from SIP and to compare receiver operating characteristics of IaIp for NEC with C-reactive protein (CRP).

STUDY DESIGN:

A prospective, nested case-control study of infants with feeding intolerance was carried out. Blood and clinical data were collected from 27 infants diagnosed with NEC or SIP and from 26 matched controls admitted to our unit. Infants with modified Bell criteria stage 2 or greater were included as NEC. Clinical, radiologic, and/or surgical findings were used to identify infants with SIP. Controls were matched for gestational age, postnatal age, sex, and birth weight.

RESULTS:

Mean ± SD IaIp blood levels were 147 ± 38 mg/L, 276 ± 67 mg/L, and 330 ± 100 mg/L in infants with NEC, SIP, and matched controls, respectively (P < .004 and P < .01). Receiver operating characteristics analysis to establish the predictive value of NEC demonstrated areas under curve of 0.98 and 0.63 for IaIp and CRP, respectively.

CONCLUSIONS:

IaIp levels were significantly decreased in infants with NEC compared with SIP and matched controls. The diagnostic accuracy of IaIp for NEC was superior to that of CRP.

KEYWORDS:

CRP; NEC; biomarker; diagnosis; intensive care unit; neonate; neurodevelopment; preterm

PMID:
27745748
PMCID:
PMC5183497
DOI:
10.1016/j.jpeds.2016.09.016
[Indexed for MEDLINE]
Free PMC Article

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