Plasma Citrulline Levels in Preterm Neonates with Necrotizing Enterocolitis

Abstract

ecrotizing enterocolitis (NEC) causes high morbidity and mortality especially in premature infants (Lin and Stoll, 2006), That results in inflammation and bacterial invasion of the bowel wall (Lin, 2006). It is the most common acquired disease of the gastrointestinal tract (GIT) in premature infants and newborns. In this study, our aim was primary to measure plasma citrulline levels in preterm neonates with confirmed NEC, comparing it to properly match healthy neonates. Secondary was to know whether citrulline level can be used as a useful measure of intestinal recovery or not. We enrolled 60 preterms (30 cases proved to be NEC, and 30 controls) with detailed prenatal, natal and post natal history. Full clinical examination, investigations were done. Plasma citrulline was significantly lower in NEC group than control group with median citrulline levels of NEC and control groups were 2 μmol/l and 20μmol/l, respectively. Citrulline has excellent diagnostic value with cut off Citrulline level ≤11μmol/l that could discriminate between cases and controls with a sensitivity of 86.7%, specificity of 93.3%.