Atopy is a Risk Factor for Acute Appendicitis? A Prospective Clinical Study

Harlak, Ali; Güleç, Mustafa; Menteş, Öner; Kılbaş, Zafer; Öngürü, Önder; Açıkel, Cengizhan; Çalışkaner, Zafer; Erel, Fuat

doi:10.1007/s11605-008-0511-1

Cited by 17 publications

(64 citation statements)

References 27 publications

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“…However, eosinophilic infiltration in appendectomy specimen, peripheral eosinophil count or the degree of inflammation in SPT was not associated with the risk of appendicitis. 24 As our study subjects did not have data on atopic sensitization, we could not address the relationship between atopic status and the risk of appendicitis in this manner. However, a history of food allergy in our study was not associated with the risk of appendicitis.…”

Section: Discussionmentioning

confidence: 99%

“…There is only one previous case-control study conducted in Turkey assessed the relationship between atopic sensitization status and the risk of appendicitis based on a convenience sample in a single institution. 24 The study reported that atopy status, determined by skin prick test (SPT) for inhalants or foods, was associated with an increased risk of appendicitis (34% in cases vs 8% in controls, p<0.001). The study hypothesized that atopic sensitization, especially food allergy, might cause eosinophilic infiltration in appendix resulting mucosal swelling and narrowing of appendix leading to inflammation and infection.…”

Section: Discussionmentioning

confidence: 99%

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Asthma and Risk of Appendicitis in Children: A Population-Based Case-Control Study

Hasassri

Jackson

Ghawi

et al. 2017

Academic Pediatrics

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Objective To assess whether asthma is associated with risk of appendicitis in children. Methods We used a population-based case-control study design utilizing a comprehensive medical record review and predetermined criteria for appendicitis and asthma. All children (age<18 years) who resided in Olmsted County, Minnesota, and developed appendicitis between 2006 and 2012 were matched to controls (1:1) with regard to birthday, gender, registration date, and index date. Asthma status was ascertained using predetermined criteria. Active (current) asthma was defined as the presence of asthma symptoms or asthma-related events (eg, medication use, clinic visits, emergency department, or hospitalization) within one year prior to the index date. Inactive asthma was defined as subjects without these events. A conditional logistic regression model was used. Results Among the 309 appendicitis cases identified, when stratified by asthma status, active asthma was associated with significantly increased risk of appendicitis when compared to inactive asthma (OR=2.48; 95% CI, 1.22–5.03) and to no asthma (OR=1.88; 95% CI, 1.07–3.27) (overall p-value=0.035). When controlling for potential confounders such as gender, age, and smoking status, active asthma was associated with a higher odds of developing appendicitis compared to non-asthmatics (adjusted OR=1.75, 95% CI 0.99–3.11) whereas inactive asthma was not (overall p-value=0.049). Tobacco smoke exposure within three months was associated with an increased risk of appendicitis (adjusted OR=1.66; 95% CI, 1.02, 2.69). Among asthma medications, leukotriene receptor antagonists reduced the risk of appendicitis (OR=0.18; 95% CI, 0.04–0.74). Conclusions Active asthma may be an unrecognized risk factor for appendicitis in children while a history of inactive asthma does not pose such risk. Further investigation exploring the underlying mechanisms is warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Asthma and Risk of Appendicitis in Children: A Population-Based Case-Control Study

Hasassri

Jackson

Ghawi

et al. 2017

Academic Pediatrics

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“…Previous studies have reported increased allergic reactions as assessed by a skin prick test positivity or eosinophil cationic protein levels in appendicitis patients. [16,17] A prospective study reported an increase in the skin prick test positivity rate in acute appendicitis patients compared with a control group (34.2% vs 8%; P < .001). [16] Similarly, acute appendicitis patients demonstrated higher levels of eosinophil cationic protein than a control group, suggesting local eosinophilic reaction and degranulation in these patients.…”

Section: Discussionmentioning

confidence: 99%

Increased risk of appendectomy in patients with asthma

Kim

Park

et al. 2019

Medicine

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“…The concept is attractive: the appendix is a lymphoid organ, therefore, an immune response to a local antigen could be a factor in the pathogenesis of AA (15). The gastrointestinal system is one of the main entrances into the body for allergens during all life stages (9). Atopy may be a risk factor for appendicitis (9).…”

Section: Discussionmentioning

confidence: 99%

“…Two sections of 5-micron thickness were cut from each paraffin block and stained by hematoxylin & eosin (8). The criteria for AA was polymorphous nuclear neutrophils infiltration at the muscularis propria (9). APA was defined by the presence of neutrophils infiltrate in muscular propria and AGA was defined by the presence of necrosis of the wall of the appendix in a background of transmural inflammation (10).…”

Section: Pathologic Analysismentioning

confidence: 99%

Th2 cytokine profile in appendicular lavage fluid is compatible with allergy as an etiology for acute appendicitis

Carvalho

Barros

et al. 2019

Preprint

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Acute appendicitis is the most frequent surgical abdominal emergency, but its etiology remains poorly understood. Histological examination of the appendix, following its removal due to acute appendicitis, consistently shows features in common with bronchial asthma, suggesting an allergic reaction as a candidate etiologic factor. Here we propose the concept of appendicular lavage and used it to study the levels of the Th2 cytokines IL-4, IL-5 and IL-9 in patients with a clinical diagnosis of acute appendicitis. The study group included 20 patients with a histological diagnosis of phlegmonous appendicitis, 13 patients with gangrenous appendicitis, and a control group of 8 patients with clinical diagnosis of appendicitis but with normal histology. Cytokines levels were higher in acute appendicitis. The difference was more pronounced when comparing phlegmonous appendicitis with non-pathological appendix (p=0.01) for IL-4 (48,3 vs 21,3 pg/mL), IL-5 (29,2 vs 8,0 pg/mL) and IL-9 (34,1 vs 16,6 pg/mL). This Th2 cytokine profile is compatible with the hypothesis of allergy as an etiologic factor for acute appendicitis and may have important implications for the diagnosis, prevention and treatment of this condition.

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Atopy is a Risk Factor for Acute Appendicitis? A Prospective Clinical Study

Cited by 17 publications

References 27 publications

Asthma and Risk of Appendicitis in Children: A Population-Based Case-Control Study

Asthma and Risk of Appendicitis in Children: A Population-Based Case-Control Study

Increased risk of appendectomy in patients with asthma

Th2 cytokine profile in appendicular lavage fluid is compatible with allergy as an etiology for acute appendicitis

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