The Role of Absolute Monocytic Count in Early Diagnosis of Nercotizing Enterocolitis in Premature Neonates. A Prospective Analytical Study

Background: Necrotizing enterocolitis (NEC) is characterized by macrophage infiltration in the intestine. As intestinal macrophages are derived from recruitment of blood monocytes into gut mucosa, it in turn reduces blood monocytes concentration which can be helpful marker for NEC. Aim : To evaluate the contribution of absolute monocytic numbers in separating NEC from other potential causes of preterm feeding intolerance. Subjects and methods: This was a prospective research which was conducted (after exclusion of 44 (25.1%) neonates after their death) for 131 neonates (70.2% with feeding intolerance and 29.8% with NEC). All the included neonates were subjected to full history taking, clinical evaluation including also Ballard score , and full investigations including absolute monocytic count . Results : Statistically substantial variation between preterm with FI and preterm with NEC regards nutritional history with p-value <0.001 most of FI preterm was on trophic feeding while most of NEC preterm were on TPN. Statistically significant decrease of Ballard score in NEC preterm than feeding intolerance with p-value=0.014 as infants in feeding intolerance group developed feeding intolerance at an earlier postnatal age than those with NEC. AMC after 3-5 days after FI had statistically significant difference between NEC and FI with p-value 0.000. Conclusions: Absolute monocytic count in 3 rd to 5 th day after signs of feeding intolerance has predictive role in differentiation of NEC from other causes of feeding intolerance, but it had no significant difference between different stages of NEC.