Association Between Eosinophilia and Late-onset Circulatory Collapse in Preterm Infants: A case-Control Study
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Published on: May 10, 2024
Tomoka Okamura1,2, Yosuke Washio1,2, Hirokazu Watanabe1,2
1Department of Neonatology, Maternal and Perinatal Center, Tokyo Women's Medical University.
Insights
Eosinophilia, a higher white blood cell count, may indicate adrenal insufficiency in preterm infants experiencing late-onset circulatory collapse (LCC). Treatment with glucocorticoids reduced eosinophil counts in these infants.
Area of Science:
- Neonatalogy
- Pediatric Endocrinology
- Hematology
Background:
- Late-onset circulatory collapse (LCC) in preterm infants is often linked to relative adrenal insufficiency.
- Eosinophilia is a known indicator associated with adrenal insufficiency.
Purpose of the Study:
- To investigate the relationship between eosinophilia and LCC in preterm infants.
- To determine if eosinophil counts differ in infants with LCC and if they change with glucocorticoid treatment.
Main Methods:
- A comparative study of preterm infants (< 28 weeks gestation) admitted to a neonatal intensive care unit between 2008-2010.
- Infants were divided into two groups: those with LCC who received glucocorticoids (LCC group) and those who did not (control group).
- Eosinophil counts were compared between groups and before/after treatment in the LCC group.
Main Results:
- The LCC group (n=12) showed significantly higher peak eosinophil counts compared to the control group (n=16) (median 1.392 × 10^9/L vs. 1.033 × 10^9/L, p=0.02).
- In the LCC group, eosinophil counts significantly decreased after glucocorticoid treatment (0.877 × 10^9/L vs. 0.271 × 10^9/L, p=0.003).
Conclusions:
- Eosinophilia is significantly associated with late-onset circulatory collapse in preterm infants.
- The findings suggest eosinophilia may serve as a marker for adrenal insufficiency contributing to LCC in this vulnerable population.
Abstract:
Late-onset circulatory collapse (LCC) in preterm infants is presumably caused by relative adrenal insufficiency. Because eosinophilia is known to be associated with adrenal insufficiency, we attempted to clarify the relation-ship between eosinophilia and LCC in preterm infants. We divided the cases of the infants (born at < 28 weeks' gestation) admitted to our neonatal intensive care unit in 2008-2010 into 2 groups: those diagnosed with LCC that received glucocorticoids (LCC group), and those who did not receive glucocorticoids (control group). We compared eosinophil counts between the 2 groups and between before and after glucocorticoid treatment in the LCC group. A total of 28 infants were examined: LCC group (n = 12); control group (n = 16). The peak eosin-ophil counts of the LCC group were significantly higher than those of the control group (median: 1.392 × 109/L vs. 1.033 × 109/L, respectively; p = 0.02). Additionally, in the LCC group, the eosinophil counts declined significantly after glucocorticoid treatment (0.877 × 109/L vs. 0.271 × 109/L, p = 0.003). Eosinophil counts in the LCC group were significantly higher than in the control group and decreased rapidly after gluco-corticoid treatment. These results indicate that eosinophilia may be a factor associated with LCC caused by adrenal insufficiency.
