Recent advances in neutropenic enterocolitis: Insights into the role of gut microbiota.

Autor: Kapandji N; Intensive Care Unit, Saint Louis Academic Hospital, 1 avenue Claude Vellefaux, 75010 Paris, France; ProbiHote Team, MICALIS Institute, 78350 Jouy-en-Josas, INRAE, France. Electronic address: natacha.kapandji@aphp.fr., Azoulay E; Intensive Care Unit, Saint Louis Academic Hospital, 1 avenue Claude Vellefaux, 75010 Paris, France. Electronic address: elie.azoulay@aphp.fr., Zafrani L; Intensive Care Unit, Saint Louis Academic Hospital, 1 avenue Claude Vellefaux, 75010 Paris, France. Electronic address: lara.zafrani@aphp.fr.
Jazyk: angličtina
Zdroj: Blood reviews [Blood Rev] 2022 Jul; Vol. 54, pp. 100944. Date of Electronic Publication: 2022 Feb 14.
DOI: 10.1016/j.blre.2022.100944
Abstrakt: Neutropenic enterocolitis (NE) is a life-threatening complication associated with neutropenia and the main cause of acute abdominal syndrome in neutropenic patients, especially those receiving intensive chemotherapy. This review aims to delineate actual insights into this clinical entity, to emphasize diagnostic and therapeutic management, and to generate hypotheses on pathophysiology to identify avenues for research. Diagnosis is based on the association of neutropenia, fever, abdominal symptoms, and radiologic bowel wall thickening. Main complications are sepsis, perforations, and gastrointestinal bleeding. Several mechanisms may be responsible for mucosal injury: treatment-induced necrosis of the intestinal specific infiltrates, spontaneous intramural hemorrhage, or microvascular thrombosis. The prevailing cause is the direct cytotoxicity of chemotherapy. However, the role of gut dysbiosis in NE remains to be fully elucidated. Therapeutic management includes early multidrug antibiotherapy, transfusion support, hematopoietic growth factor treatment, fluid resuscitation, correction of electrolytes imbalance, and bowel rest. Indication and timing for surgical management are still debated.
(Copyright © 2022 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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