Evaluation of Changes in the Number of Eosinophils Before and After Phototherapy in Neonatal Hyperbilirubinemia

 The prevalence of asthma is higher in icteric babies. It is thought that eosinophilia and asthma are complications of phototherapy rather than hyperbilirubinemia.

 Since there is little data in this regard, we evaluated the relationship between phototherapy and the level of eosinophils in this study.

 In this cross-sectional prospective study, we assessed icteric neonates admitted to the neonatal and intensive care unit of Children’s Medical Center of Tehran during 2017 - 2018. Laboratory data including serum bilirubin and count of blood cell differentiation for eosinophils, before, during, and after phototherapy besides demographic data like age, gender, gestational age, and duration of phototherapy were collected.

 Totally, 163 neonates (52.1% male and 47.9% female) with a mean age of 5.49 ± 4.01 days, enrolled in the study. The prevalence of term neonates was 81% and 19% were preterm. The mean of serum total bilirubin was 17.91 ± 3.37 mg/dL. Compared to the mean value of eosinophils before phototherapy, this value in the first (P = 0.001) and second (P < 0.001) days were significantly higher. In female neonates, there was a significant increase in eosinophils in the first (P = 0.001) and second (P < 0.001) day of the post-treatment period. However, in male subjects, this increase was significant only in the second day after phototherapy (P = 0.001). In neonates less than one week of age, this count was significantly increased on the first (P = 0.003) and second (P < 0.001) day after phototherapy. In cases with hemolytic hyperbilirubinemia, eosinophils count before phototherapy and the second day was significant (P = 0.006). The mean of eosinophils in first and second days after phototherapy was not correlated with the severity of hyperbilirubinemia but there is a significant negative correlation between the mean total bilirubin of patients with mean eosinophils before phototherapy.

 Our findings showed that there was a significant relationship between hyperbilirubinemia and its therapeutic phototherapy with an increasing level of peripheral eosinophils count in neonates.