Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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The relationship between eosinophilia and bronchopulmonary dysplasia in premature infants at less than 34 weeks' gestation

  • Yang, Joo Yun (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Cha, Jihei (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Shim, So-Yeon (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Cho, Su Jin (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Park, Eun Ae (Department of Pediatrics, Ewha Womans University School of Medicine)
  • Received : 2013.09.13
  • Accepted : 2013.11.21
  • Published : 2014.04.15
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Abstract

Purpose: Eosinophilia is common in premature infants, and its incidence increases with a shorter gestation period. We investigated the clinical significance of eosinophilia in premature infants born at <34 weeks gestation. Methods: We analyzed the medical records of premature infants born at <34 weeks gestation who were admitted to the neonatal intensive care unit at Ewha Womans University Mokdong Hospital between January 2003 and September 2010. Eosinophilia was defined as an eosinophil percentage of >3% of the total leukocytes. Perinatal parameters and clinical parameters were also analyzed. Results: Of the 261 infants born at <34 weeks gestation, 22.4% demonstrated eosinophilia at birth. The eosinophil percentage peaked in the fourth postnatal week at 7.5%. The incidence of severe eosinophilia increased after birth up to the fourth postnatal week when 8.8% of all patients had severe eosinophilia. Severity of eosinophilia was positively correlated with a lower gestational age, birth weight, and Apgar score. Respiratory distress syndrome, bronchopulmonary dysplasia, nephrocalcinosis, intraventricular hemorrhage, and sepsis were associated with a higher eosinophil percentage. The eosinophil percentage was significantly higher in infants with bronchopulmonary dysplasia from the first postnatal week and the percentage was the highest in the fourth postnatal week, with the maximal difference being 4.1% (P<0.001). Conclusion: Eosinophilia is common in premature infants and reaches peak incidence and severity in the fourth postnatal week. The eosinophil percentage was significantly higher in bronchopulmonary dysplasia patients from the first postnatal week. Severe eosinophilia was significantly associated with the incidence of bronchopulmonary dysplasia even after adjusting for other variables.

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References

  1. Rothenberg ME. Eosinophilia. N Engl J Med 1998;338:1592-600. https://doi.org/10.1056/NEJM199805283382206
  2. Beishuizen A, Vermes I, Hylkema BS, Haanen C. Relative eosinophilia and functional adrenal insufficiency in critically ill patients. Lancet 1999;353:1675-6. https://doi.org/10.1016/S0140-6736(99)01346-X
  3. Juul SE, Haynes JW, McPherson RJ. Evaluation of eosinophilia in hospitalized preterm infants. J Perinatol 2005;25:182-8. https://doi.org/10.1038/sj.jp.7211226
  4. Gibson EL, Vaucher Y, Corrigan JJ Jr. Eosinophilia in premature infants: relationship to weight gain. J Pediatr 1979;95:99-101.
  5. Sullivan SE, Calhoun DA. Eosinophilia in the neonatal intensive care unit. Clin Perinatol 2000;27:603-22. https://doi.org/10.1016/S0095-5108(05)70041-5
  6. Bhat AM, Scanlon JW. The pattern of eosinophilia in premature infants: a prospective study in premature infants using the absolute eosinophil count. J Pediatr 1981;98:612. https://doi.org/10.1016/S0022-3476(81)80776-7
  7. Brostrom EB, Katz-Salamon M, Lundahl J, Hallden G, Winbladh B. Eosinophil activation in preterm infants with lung disease. Acta Paediatr 2007;96:23-8.
  8. Yamamoto C, Kojima T, Hattori K, Nogi S, Imamura H, Tsubura A, et al. Eosinophilia in premature infants: correlation with chronic lung disease. Acta Paediatr 1996;85:1232-5.
  9. Pierce MR, Bancalari E. The role of inflammation in the pathogenesis of bronchopulmonary dysplasia. Pediatr Pulmonol 1995; 19:371-8. https://doi.org/10.1002/ppul.1950190611
  10. Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med 2001;163:1723-9. https://doi.org/10.1164/ajrccm.163.7.2011060
  11. Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L, et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann Surg 1978;187:1-7. https://doi.org/10.1097/00000658-197801000-00001
  12. Raghavender B, Smith JB. Eosinophil cationic protein in tracheal aspirates of preterm infants with bronchopulmonary dysplasia. J Pediatr 1997;130:944-7. https://doi.org/10.1016/S0022-3476(97)70281-6
  13. Sharma SC. Eosinophil count in premature infants. Indian J Pediatr 1982;49:119-21. https://doi.org/10.1007/BF02914965
  14. Han JY, Kil TH, Yoon JM, Kim JB, Ko KO, Lee YH, et al. Hematologic profiles and eosinophilia in very low birth weight infants. Korean J Perinatol 2011;22:285-94.
  15. Fayon M, Babin JP. Hypereosinophilia in premature newborn infants. Pediatrie 1988;43:667-72.
  16. Calbi M, Scarpellino B, Giacchetti L. Usefulness of neonatal eosinophil counts as a marker of atopy? Pediatr Allergy Immunol 1993;4:86-8. https://doi.org/10.1111/j.1399-3038.1993.tb00072.x
  17. Patel L, Garvey B, Arnon S, Roberts IA. Eosinophilia in newborn infants. Acta Paediatr 1994;83:797-801. https://doi.org/10.1111/j.1651-2227.1994.tb13146.x
  18. Yen JM, Lin CH, Yang MM, Hou ST, Lin AH, Lin YJ. Eosinophilia in very low birth weight infants. Pediatr Neonatol 2010;51:116-23. https://doi.org/10.1016/S1875-9572(10)60021-6
  19. Weller PF. Eosinophils: structure and functions. Curr Opin Immunol 1994;6:85-90. https://doi.org/10.1016/0952-7915(94)90038-8
  20. Cole CH, Fiascone JM. Strategies for prevention of neonatal chronic lung disease. Semin Perinatol 2000;24:445-62. https://doi.org/10.1053/sper.2000.20083

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