Association Between Eosinophilia and Late-onset Circulatory Collapse in Preterm Infants: A case-Control Study

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 relationship 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 eosinophil 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 glucocorticoid treatment. These results indicate that eosinophilia may be a factor associated with LCC caused by adrenal insufficiency.