{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:05:31Z","timestamp":1756339531972,"version":"3.44.0"},"reference-count":46,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,5,17]]},"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>Retinopathy of prematurity (ROP) and necrotising enterocolitis (NEC) are complications of prematurity. Despite being quite different in terms of incidence, pathogenesis and consequences, both share a pathogenic role of aberrant vascularisation: increased in ROP, deficient for NEC. Current therapy for ROP includes the use of anti-vascular endothelial growth factor (anti-VEGF) agents, which are able to interrupt retinal hypervascularity. Despite being delivered intravitreously, anti-VEGF used in ROP can be absorbed into circulation and exert systemic effects. We present here a case of an ex-27 weeks gestational age infant, presenting multiple NEC risk factors, treated at 2 months of age with low-dose ranibizumab, who developed a large bowel NEC episode in the first week after treatment. We believe that this further report of an association between anti-VEGF agents and NEC could be interesting for the identification of children at risk of severe adverse events and stimulating further research on the topic.<\/jats:p>","DOI":"10.1136\/bcr-2023-259537","type":"journal-article","created":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T21:41:56Z","timestamp":1717623716000},"page":"e259537","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Delayed episode of necrotising enterocolitis in an ex-preterm infant after intravitreal administration of low-dose ranibizumab for the treatment of retinopathy of prematurity"],"prefix":"10.1136","volume":"17","author":[{"given":"Francesco","family":"Morotti","sequence":"first","affiliation":[{"name":"Neonatal Intensive Care Unit, Children's Hospital, ASST Spedali Civili di Brescia, Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2634-1498","authenticated-orcid":false,"given":"Salvatore","family":"Aversa","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Children's Hospital, ASST Spedali Civili di Brescia, Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabiana","family":"Barbieri","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Children's Hospital, ASST Spedali Civili di Brescia, Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco Maria","family":"Risso","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Children's Hospital, ASST Spedali Civili di Brescia, Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,6,5]]},"reference":[{"key":"2025082708383944000_17.6.e259537.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2007.11.009"},{"key":"2025082708383944000_17.6.e259537.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60178-6"},{"key":"2025082708383944000_17.6.e259537.3","doi-asserted-by":"crossref","first-page":"e51","DOI":"10.1016\/j.ophtha.2021.05.031","article-title":"International classification of retinopathy of Prematurity, third edition","volume":"128","author":"Chiang","year":"2021","journal-title":"Ophthalmology"},{"key":"2025082708383944000_17.6.e259537.4","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2018-3061","article-title":"Screening examination of premature infants for retinopathy of prematurity","volume":"142","author":"Fierson","year":"2018","journal-title":"Pediatrics"},{"key":"2025082708383944000_17.6.e259537.5","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.121.12.1684"},{"key":"2025082708383944000_17.6.e259537.6","doi-asserted-by":"crossref","DOI":"10.3390\/jcm12113650","article-title":"Most up-to-date analysis of epidemiological data on the screening guidelines and incidence of retinopathy of prematurity in Europe\u2014A","volume":"12","author":"Modrzejewska","year":"2023","journal-title":"J Clin Med"},{"key":"2025082708383944000_17.6.e259537.7","doi-asserted-by":"publisher","DOI":"10.1111\/aos.12049"},{"key":"2025082708383944000_17.6.e259537.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31344-3"},{"key":"2025082708383944000_17.6.e259537.9","unstructured":"Ginglen JG , Butki N . Necrotizing Enterocolitis. In: StatPearls. Treasure Island (FL): StatPearls Publishing, 2024. 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