Does elevated urinary 5-hydroxyindole acetic acid level predict acute appendicitis in children?

Veršić, Ana Bosak; Glavan, Nedeljka; Bukvić, Nado; Tomašić, Zlatko; Nikolić, Harry

doi:10.1136/emermed-2015-205559

Cited by 10 publications

(40 citation statements)

References 20 publications

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“…Delayed diagnosis and treatment of these conditions may lead to a significant morbidity that may outweigh the harm caused by COVID-19 infection [ 3 ]. Acute appendicitis is one of the most common abdominal surgical emergencies in general with a 7% lifetime risk [ 4 – 7 ]. Eventhough antibiotics have been described as a type of therapy for uncomplicated appendicitis, surgery still remains the preferable treatment modality [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Acute Appendicitis before and during the COVID-19 Pandemic: Single Center Experience

Veršić

Šestan

Cepić

et al. 2022

Emergency Medicine International

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The aim of the study was to investigate whether the COVID-19 pandemic caused an increased incidence of complicated appendicitis due to the late presentation when compared to the pre-COVID-19 period. Summary Background Data. Acute appendicitis is one of the most common surgical emergencies. During the coronavirus-19 (COVID-19) pandemic, there has been a reported delay in the presentation of some urgencies to the emergency hospital departments. Methods. A total of 427 patients who underwent surgical treatment due to suspected acute appendicitis from June 2019 to November 2020 were retrospectively included in this study. The patients were divided into two groups: the first (pre-COVID-19) group consisted of patients who had surgery before the onset of COVID-19 pandemic (n = 240), while the second (COVID-19) group consisted of those who were operated during the COVID-19 pandemic (n = 187). The primary outcome of the study was to compare the incidence of perforated appendicitis before and during the onset of COVID-19. Results. Overall, 84 patients (19.67%) were diagnosed with perforated appendicitis. We found a weak significance ( p = 0.085 ) in the rate of perforated appendicitis between the pre-COVID-19 (17.08%) and the COVID-19 era (22.99%). Conclusions. We did not observe any significant difference in the complications of acute appendicitis before and during the COVID-19 pandemic in a university hospital in Rijeka. An emergent medical care should always be accessible.

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Section: Introductionmentioning

confidence: 99%

Characteristics of Acute Appendicitis before and during the COVID-19 Pandemic: Single Center Experience

Veršić

Šestan

Cepić

et al. 2022

Emergency Medicine International

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“…A number of studies on adult patients which introduce new markers in the diagnosis of acute appendicitis have been conducted recently [5][6][7]. Some studies have also been conducted in the pediatric population [8][9][10][11]. Numerous parameters have been examined to support the diagnosis of acute appendicitis until today.…”

Section: Introductionmentioning

confidence: 99%

“…Enterochromaffin cells that contain large amounts of serotonin are mostly located in the distal appendix. Serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) could therefore be a marker for acute appendicitis, but it has been shown that it is not a reliable method for diagnosing acute appendicitis in children [10].…”

Section: Introductionmentioning

confidence: 99%

Predictive Value of Red Blood Cell Distribution Width, Mean Platelet Volume and Platelet Distribution Width in Children with Acute Appendicitis

et al. 2021

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Background and Objectives: Acute appendicitis in pediatric patients is one of the most common surgical emergencies, but the early diagnosis still remains challenging. The aim of this study was to determine the predictive value of Red blood cell distribution width (RDW), Mean platelet volume (MPV) and Platelet distribution width (PDW) in children with acute appendicitis. Materials and Methods: This study was a retrospective assessment of laboratory findings (RDW, MPV, PDW) of patients who underwent surgical treatment for acute appendicitis from January 2019 to December 2020. Result: During this period, 223 appendectomies were performed at our Institute. In 107 (43%) cases appendicitis was uncomplicated, while in 116 (46.6%) it was complicated. WBC and RDW/MPV ratio were significant parameters for the diagnosis of acute appendicitis with cut-off values of 12.86 (susceptibility: 66.3%; specificity: 73.2%) and 1.64 (susceptibility: 59.8%; specificity: 71.9%), respectively. WBC and RDW/RBC ratio were independent variables for the diagnosis of complicated appendicitis. The cut-off values were 15.05 for WBC (sensitivity: 60.5%; specificity: 70.7%) and 2.5 for RDW/RBC ratio (sensitivity: 72%; specificity: 52.8%). Conclusions: WBC is an important predictor of appendicitis and complicated appendicitis. RDW, MPV and PDW alone have no diagnostic value in pediatric acute appendicitis or predicting the degree of appendix inflammation. However, the RDW/MPV ratio can be an important predictor of appendix inflammation, with higher values in patients with more severe appendix inflammation. RDW/RBC ratio may be an important predictor of complicated appendicitis.

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“…Besides, the difficulty of obtaining a stool sample in the emergency department should also be considered. Urine 5-hydroxyindole acetic acid [ 6 ] and cortisol in hair [ 7 ] have also been evaluated. Considering that capillary sample processing requires specific equipment and trained personnel, the applicability in daily clinical practice of cortisol in hair is unfeasible.…”

Section: Introductionmentioning

confidence: 99%

Leucine-Rich Alpha-2-Glycoprotein as a non-invasive biomarker for pediatric acute appendicitis: a systematic review and meta-analysis

et al. 2023

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The aim of this study was to analyze the diagnostic performance of Leucine-Rich Alpha-2-Glycoprotein (LRG1) in pediatric acute appendicitis (PAA). We conducted a systematic review of the literature in the main databases of medical bibliography. Two independent reviewers selected the articles and extracted relevant data. Methodological quality was assessed using the QUADAS2 index. A synthesis of the results, standardization of the metrics and 4 random-effect meta-analyses were performed. Eight studies with data from 712 participants (305 patients with confirmed diagnosis of PAA and 407 controls) were included in this review. The random-effect meta-analysis of serum LRG1 (PAA vs control) resulted in a significant mean difference (95% CI) of 46.76 μg/mL (29.26–64.26). The random-effect meta-analysis for unadjusted urinary LRG1 (PAA vs control) resulted in a significant mean difference (95% CI) of 0.61 μg/mL (0.30–0.93). The random-effect meta-analysis (PAA vs control) for urinary LRG1 adjusted for urinary creatinine resulted in a significant mean difference (95% CI) of 0.89 g/mol (0.11–1.66). Conlusion: Urinary LRG1 emerges as a potential non-invasive biomarker for the diagnosis of PAA. On the other hand, due to the high between-study heterogeneity, the results on serum LRG1 should be interpreted with caution. The only study that analyzed salivary LRG1 showed promising results. Further prospective studies are needed to confirm these findings. What is Known:• Pediatric acute appendicitis continues to be a pathology with a high rate of diagnostic error.• Invasive tests, although useful, are a source of stress for patients and their parents. What is New:• LRG1 emerges as a promising urinary and salivary biomarker for the noninvasive diagnosis of pediatric acute appendicitis.

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Does elevated urinary 5-hydroxyindole acetic acid level predict acute appendicitis in children?

Abstract: Urine 5-HIAA concentration measured in spot samples is not a reliable method for diagnosing acute appendicitis in children.

Cited by 10 publications

References 20 publications

Characteristics of Acute Appendicitis before and during the COVID-19 Pandemic: Single Center Experience

Characteristics of Acute Appendicitis before and during the COVID-19 Pandemic: Single Center Experience

Predictive Value of Red Blood Cell Distribution Width, Mean Platelet Volume and Platelet Distribution Width in Children with Acute Appendicitis

Leucine-Rich Alpha-2-Glycoprotein as a non-invasive biomarker for pediatric acute appendicitis: a systematic review and meta-analysis

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