Diagnostic value of blood inflammatory markers for detection of acute appendicitis in children

Abstract

Background: Acute appendicitis (AA) is a common surgical problem that is associated with an acute-phase reaction. Previous studies have shown that cytokines and acute-phase proteins are activated and may serve as indicators for the severity of appendicitis. The aim of this study was to compare diagnostic value of different serum inflammatory markers in detection of phlegmonous or perforated appendicitis in children.Methods: Data were collected prospectively on 211 consecutive children. Laparotomy was performed for suspected AA for 189 patients. Patients were subdivided into groups: nonsurgical abdominal pain, early appendicitis, phlegmonous or gangrenous appendicitis, perforated appendicitis.White blood cell count (WBC), serum C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), acid α 1 -glycoprotein (α 1 GP), endotoxin, and erythrocyte sedimentation reaction (ESR) were estimated ad the time of admission. The diagnostic performance was analyzed using receiver operating characteristic (ROC) curves.Results: WBC count, CRP and IL-6 correlated significantly with the severity of appendiceal inflammation. Identification of children with severe appendicitis was supported by IL-6 or CRP but not WBC. Between IL-6 and CRP, there were no significant differences in diagnostic use. Conclusion:Laboratory results should be considered to be integrated within the clinical assessment. If used critically, CRP and IL-6 equally provide surgeons with complementary information in discerning the necessity for urgent operation.

Ischemia modified albumin and other inflammatory markers in the diagnosis of appendicitis in children

“…However, when WBC of group with early appendicitis (mucosal ulceration and focal appendicitis) was compared that of group with abdominal pain who did not require surgery, no statistically significant difference was found (p>0.05). [14] In the present study, results were similar to those reported in the literature.…”

“…They found that CRP was significantly higher in group with PA (p<0.001). [14] In the same study, ESR level was also higher in group with appendicitis. In the current study, CRP and ESR values were also statistically significantly higher in patients with appendicitis, compared with control subjects.…”

Evaluation of the open and laparoscopic appendectomy operations with respect to their effect on serum IL-6 levels

“…In particular, increased neutrophil count may be accepted as a useful marker to indicate level of inflammation in diagnosis of acute appendicitis. [10][11][12] As in the literature, the present study also found that the difference in serum IL-6 levels tested preoperatively between Group 1 patients (65.7±6.3 pg/mL), who had laparoscopic appendectomy, and Group 2 patients (65.2±4.7 pg/mL), who underwent conventional appendectomy, was low and statistically insignificant (p=0.752). The serum IL-6 levels tested at postoperative 24 th hour in both groups (76.1±16.1 pg/mL in Group 1 and 105.2±16.1 pg/mL in Group 2) were remarkably high, especially in the conventional surgery patients, and the finding was statistically extremely significant (p<0.001).…”

Akurasi Total Hitung Leukosit dan Durasi Simtom sebagai Prediktor Perforasi Apendisitis pada Penderita Apendisitis Akut

“…Adanya perubahan sintesis protein ini dapat menimbulkan respon tubuh berupa tingginya kadar leukosit darah serta peningkatan aktivitas imun dan suhu tubuh. [19,20,21] Penelitian ini juga menunjukkan bahwa SD memiliki hubungan yang bermakna dengan kejadian apendisitis perforasi.…”