Investigating neutropenic enterocolitis: a systematic review of case reports and clinical insights
Abstract Background Neutropenic enterocolitis is a serious gastrointestinal complication that can develop in patients undergoing chemotherapy or other immunosuppressive treatments. It is characterized by inflammation and necrosis of the bowel, and most commonly affects the cecum and ascending colon....
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BMC
2025-01-01
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| Online Access: | https://doi.org/10.1186/s12876-025-03601-y |
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| author | Samane Nematolahi Ali Amanati Hossein Molavi Vardanjani Mohammadreza Pourali Mahnaz Hosseini Bensenjan Farnoosh Nozari Mohebat Vali Seyed Reza Abdipour Mehrian Seyed Ali Nabavizadeh Farima Safari |
| author_facet | Samane Nematolahi Ali Amanati Hossein Molavi Vardanjani Mohammadreza Pourali Mahnaz Hosseini Bensenjan Farnoosh Nozari Mohebat Vali Seyed Reza Abdipour Mehrian Seyed Ali Nabavizadeh Farima Safari |
| author_sort | Samane Nematolahi |
| collection | DOAJ |
| description | Abstract Background Neutropenic enterocolitis is a serious gastrointestinal complication that can develop in patients undergoing chemotherapy or other immunosuppressive treatments. It is characterized by inflammation and necrosis of the bowel, and most commonly affects the cecum and ascending colon. Although individual case reports have described the features of NE, a comprehensive synthesis of all the published cases is required. Methods A systematic search of the literature databases was conducted to identify all NE case reports. Data on patient demographics, clinical presentation, diagnostic findings, treatment approaches, and outcomes were independently extracted by the five reviewers. Generalized estimating equations were used to examine the associations between variables. Results In total, 227 cases from 159 publications met the inclusion criteria. Most cases occur in patients with hematological cancers undergoing chemotherapy. Common presentations include abdominal pain, fever, and diarrhea. Imaging typically shows a thickening of the bowel wall. Broad-spectrum antibiotics and bowel rest were the primary initial treatment. The overall mortality rate was 33.5%. While statistical analyses did not find significant associations, factors showing clinically significant increased odds for mortality included sepsis, multiorgan failure, and isolated ileocecal valve involvement, potentially representing important prognostic indicators. Conclusion This systematic review and meta-analysis provides the largest consolidated analysis of NE cases. It identifies typical clinical features and helps characterize risk factors and prognostic indicators to aid in the early diagnosis and management of this potentially lethal complication. |
| format | Article |
| id | doaj-art-32a1de35926d4eec93fdb58aa87f750b |
| institution | Kabale University |
| issn | 1471-230X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj-art-32a1de35926d4eec93fdb58aa87f750b2025-01-19T12:25:42ZengBMCBMC Gastroenterology1471-230X2025-01-0125111510.1186/s12876-025-03601-yInvestigating neutropenic enterocolitis: a systematic review of case reports and clinical insightsSamane Nematolahi0Ali Amanati1Hossein Molavi Vardanjani2Mohammadreza Pourali3Mahnaz Hosseini Bensenjan4Farnoosh Nozari5Mohebat Vali6Seyed Reza Abdipour Mehrian7Seyed Ali Nabavizadeh8Farima Safari9Noncommunicable Diseases Research Center, Bam University of Medical SciencesProfessor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical SciencesResearch Center for Traditional Medicine and History of Medicine, Shiraz University of Medical SciencesSchool of Medicine, Bam University of Medical SciencesShiraz University of Medical SciencesShiraz University of Medical SciencesDepartment of Epidemiology, School of Health, Shiraz University of Medical SciencesClinical Research Development Center, Amir Oncology Teaching Hospital, Shiraz University of Medical SciencesOtolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical SciencesStudent Research Committee, School of Medicine, Shiraz University of Medical SciencesAbstract Background Neutropenic enterocolitis is a serious gastrointestinal complication that can develop in patients undergoing chemotherapy or other immunosuppressive treatments. It is characterized by inflammation and necrosis of the bowel, and most commonly affects the cecum and ascending colon. Although individual case reports have described the features of NE, a comprehensive synthesis of all the published cases is required. Methods A systematic search of the literature databases was conducted to identify all NE case reports. Data on patient demographics, clinical presentation, diagnostic findings, treatment approaches, and outcomes were independently extracted by the five reviewers. Generalized estimating equations were used to examine the associations between variables. Results In total, 227 cases from 159 publications met the inclusion criteria. Most cases occur in patients with hematological cancers undergoing chemotherapy. Common presentations include abdominal pain, fever, and diarrhea. Imaging typically shows a thickening of the bowel wall. Broad-spectrum antibiotics and bowel rest were the primary initial treatment. The overall mortality rate was 33.5%. While statistical analyses did not find significant associations, factors showing clinically significant increased odds for mortality included sepsis, multiorgan failure, and isolated ileocecal valve involvement, potentially representing important prognostic indicators. Conclusion This systematic review and meta-analysis provides the largest consolidated analysis of NE cases. It identifies typical clinical features and helps characterize risk factors and prognostic indicators to aid in the early diagnosis and management of this potentially lethal complication.https://doi.org/10.1186/s12876-025-03601-yNeutropenic enterocolitisMicrobiologyPathologyPrognosis |
| spellingShingle | Samane Nematolahi Ali Amanati Hossein Molavi Vardanjani Mohammadreza Pourali Mahnaz Hosseini Bensenjan Farnoosh Nozari Mohebat Vali Seyed Reza Abdipour Mehrian Seyed Ali Nabavizadeh Farima Safari Investigating neutropenic enterocolitis: a systematic review of case reports and clinical insights BMC Gastroenterology Neutropenic enterocolitis Microbiology Pathology Prognosis |
| title | Investigating neutropenic enterocolitis: a systematic review of case reports and clinical insights |
| title_full | Investigating neutropenic enterocolitis: a systematic review of case reports and clinical insights |
| title_fullStr | Investigating neutropenic enterocolitis: a systematic review of case reports and clinical insights |
| title_full_unstemmed | Investigating neutropenic enterocolitis: a systematic review of case reports and clinical insights |
| title_short | Investigating neutropenic enterocolitis: a systematic review of case reports and clinical insights |
| title_sort | investigating neutropenic enterocolitis a systematic review of case reports and clinical insights |
| topic | Neutropenic enterocolitis Microbiology Pathology Prognosis |
| url | https://doi.org/10.1186/s12876-025-03601-y |
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