Comparison of clinical characteristics of neonatal necrotizing enterocolitis and food protein-induced proctocolitis in neonates with bloody stool as the initial symptoms

Abstract

Objective To analyze the clinical characteristics of neonatal necrotizing enterocolitis (NEC) and food protein-induced proctocolitis (FPIPC) in neonates with bloody stool as the initial manifestation. Methods We retrospectively analyzed the clinical data of 207 neonates with NEC (n=57; 27.5%) and FPIPC (n=150; 72.5%), who presented with bloody stool as the initial symptom and were treated in the outpatient clinic of our hospital between January 2018 and December 2018. The clinical symptoms and signs, laboratory test results, imaging findings, treatment and prognosis were compared between the two groups. Results The neonates with FPIPC were more likely to have such clinical manifestations as diarrhea, fat globules in the feces and elevated peripheral blood eosinophil count than those with NEC (P < 0.05). The neonates with NEC often had disease onset at a younger age and were more likely to have abdominal distension, vomiting, fever, elevated C-reactive protein, white blood cells in the feces, pneumatosis intestinalis, and portal venous gas than those with FPIPC group (P < 0.05). Conclusion In neonates admitted for bloody stool as the initial symptom, NEC often occurs at a younger age than FPIPC and is associated with a higher incidence of sepsis. The neonates with FPIPC often have more obvious elevation of eosinophil count, which can be accompanied by pneumatosis intestinalis or portal gas accumulation.

Keywords

• neonates
• bloody stool
• food protein-induced proctocolitis
• neonatal necrotizing enterocolitis