Interleukin-6 serum levels predict surgical intervention in infants with necrotizing enterocolitis
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In brief
In brief
Retrospective study of 40 infants demonstrates that elevated IL-6 serum levels at disease onset can predict which NEC cases will require surgical intervention versus medical management. However, IL-6 cannot distinguish surgical NEC from gram-negative sepsis, limiting its specificity as a standalone decision tool.
Written by the GCMD Library team from the article.
Background
Symptoms at suspicion of necrotizing enterocolitis (NEC) are often nonspecific and several biomarkers have been evaluated for their discriminative power to both diagnose and predict the course from NEC suspicion to complicated disease requiring surgical intervention. Thus, we aimed to assess the utility of interleukin-6 (IL-6) to predict surgical intervention in infants suffering from NEC and, furthermore, to discriminate infants with starting NEC or late-onset sepsis (LOS).
Methods
IL-6 serum levels at disease onset were retrospectively analyzed in 24 infants suffering from NEC as well as 16 neonates with LOS.
Results
IL-6 serum levels at disease onset were significantly higher in infants suffering from NEC necessitating surgical intervention in the disease course compared to infants with medical NEC (5000 [785–5000] vs. 370 [78–4716] pg/ml, p = 0.0008) as well as gram-positive LOS (5000 [785–5000] vs. 84 [12–269] pg/ml, p = 0.0001). Infants suffering from gram-negative LOS exhibited elevated IL-6 serum levels at disease onset comparable to infants with surgical NEC (5000 [1919–5000] vs. 5000 [785–5000] pg/ml, p = 1.00).
Conclusion
The proinflammatory cytokine IL-6 appears to be a promising marker to distinguish surgical NEC from medical NEC at the onset of disease but cannot discriminate between surgical NEC and gram-negative LOS.
Level of evidence
II