Role of serum cytokines in acute appendicitis and acute mesenteric lymphadenitis among children

Zviedre, Astra; Eņģelis, Arnis; Tretjakovs, Pēteris; Jurka, Antra; Zîle, Irisa; Pētersons, Aigars

doi:10.1016/j.medici.2016.10.002

Cited by 18 publications

(16 citation statements)

References 19 publications

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“…In a study performed for AA and AML differential diagnosis, the monocyte chemoattractant protein-1 (MCP 1) ratio was found not to be different between these two groups. In this study, although the MCP 1 ratio was high in AA, there was no statistically significant difference between the two groups [11]. This result was compatible with our work regarding the M percentage in the discrimination of both groups (p = 0.15).…”

Section: Discussionsupporting

confidence: 92%

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Acute mesenteric lymphadenitis in children: findings related to differential diagnosis and hospitalization

Özdamar¹,

Karavaş²

2020

aoms

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Introduction: Diagnostic discrimination between acute appendicitis (AA) and mesenteric lymphadenitis (AML) may require more diagnostic tests or great skill after excluding other diagnoses. This study aimed to make a differential diagnosis between AA and AML patients with previous and new parameters and to examine which parameters should be taken into account regarding whether the AML patient should be hospitalized or discharged. Material and methods: One hundred and twenty-three AML and 134 AA patients, randomly selected, were included in the study. Demographic, clinical, and laboratory data of all subjects were analyzed. Ultrasonographic and rarely computed tomography examinations evaluating for the enlarged lymph nodes with the shortest diameter in the right lower quadrant of the AML patients were performed. Also, the erect abdominal radiographs (EAR) of AML and AA patients were evaluated. Results: While there was no statistically significant difference in age or gender, C-reactive protein, white blood cell count, monocyte percentage as well as symptoms between the AA and AML groups (p > 0.05), neutrophil and lymphocyte percentage, appearance of EAR and L/M ratio were significantly different between the two groups (p < 0.05). There was no correlation between the short-axis diameter of the mesenteric lymph node and clinical and laboratory findings in the AML group (p > 0.05). Conclusions: Based on the results with ROC curve analysis, we propose to take into account the L/M ratio and the EAR from the parameters in the differential diagnosis between AA and AML in addition to previously reported parameters. Also, we recommend that the same features may be used to decide whether AML patients under observation are hospitalized or not.

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Section: Discussionsupporting

confidence: 92%

“…When looking at the literature, there was generally no significant difference in age (range: 9-13) or gender in studies comparing AML and AA patients [8,11]. Conversely, there was a study that found significant differences in age between AA and AML patients (male vs. female: 10.3 vs. 7.9 years) [7].…”

Section: Discussionmentioning

confidence: 99%

Acute mesenteric lymphadenitis in children: findings related to differential diagnosis and hospitalization

Özdamar¹,

Karavaş²

2020

aoms

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“…As IL-6 has been reported to induce the acute phase response caused by bacterial endotoxemia. Zviedre et al reported that IL-6 can provide more sensitivity in acute appendicitis when used in parallel with a white blood count (WBC) to improve the sensitivity of a diagnosis of appendicitis [ 13 ]. However, PTX3 has been linked to various cytokines as an inflammatory response related to IL-6.…”

Section: Reviewmentioning

confidence: 99%

Pentraxin-3, Interleukin-6, and Acute Appendicitis: Biomarkers That Need Further Exploration

Abouhamda¹

2020

Cureus

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Acute appendicitis is one of the most common abdominal emergencies that present in the hospital. With acute appendicitis, there is always a possibility of complications of perforation and peritonitis. Even though medicine has advanced substantially in different investigational modalities, appendicitis is confirmed clinically with the aid of a clinical approach (i.e., Alvarado Score), laboratory, and investigational modalities. However, biomarkers such as pentraxin-3 and interleukin-6 have been recently researched to assess the possibility of confirming the diagnosis of acute appendicitis in both adults and the pediatric age group. This article breaks down the previous research on pentraxin-3 and interleukin-6 biomarkers in relation to appendicitis and proposes a new hypothetical way of confirming the diagnosis.

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“…Laboratory data show that serum levels of the white blood cell (WBC), C-reactive protein (CRP), and interleukin-6 are related to AA[ 44 - 46 ]. The most reliable marker is neither the neutrophil count nor CRP, but the WBC count[ 1 , 44 ].…”

Section: Diagnostic Valuementioning

confidence: 99%

“…The WBC count and CT findings equally provide surgeons with complementary information in discerning the necessity for an urgent operation[ 36 , 44 , 47 ]. With development of WBC measurement and enhanced CT imaging, the rate of negative appendectomy has decreased to as low as < 5%[ 1 , 36 , 40 , 48 ].…”

Section: Diagnostic Valuementioning

confidence: 99%

Laparoscopic appendectomy for acute appendicitis: How to discourage surgeons using inadequate therapy

Hori¹,

Machimoto²,

Kadokawa³

et al. 2017

WJG

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Acute appendicitis (AA) develops in a progressive and irreversible manner, even if the clinical course of AA can be temporarily modified by intentional medications. Reliable and real-time diagnosis of AA can be made based on findings of the white blood cell count and enhanced computed tomography. Emergent laparoscopic appendectomy (LA) is considered as the first therapeutic choice for AA. Interval/delayed appendectomy at 6-12 wk after disease onset is considered as unsafe with a high recurrent rate during the waiting time. However, this technique may have some advantages for avoiding unnecessary extended resection in patients with an appendiceal mass. Non-operative management of AA may be tolerated only in children. Postoperative complications increase according to the patient’s factors, and temporal avoidance of emergent general anesthesia may be beneficial for high-risk patients. The surgeon’s skill and cooperation of the hospital are important for successful LA. Delaying appendectomy for less than 24 h from diagnosis is safe. Additionally, a semi-elective manner (i.e., LA within 24 h after onset of symptoms) may be paradoxically acceptable, according to the factors of the patient, physician, and institution. Prompt LA is mandatory for AA. Fortunately, the Japanese government uses a universal health insurance system, which covers LA.

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Role of serum cytokines in acute appendicitis and acute mesenteric lymphadenitis among children

Abstract: Serum IL-6 with a cut-off value of 4.3pg/mL and WBC with a cut-off value of 10.7×10/μL assessed together will yield more sensitivity for AA.

Cited by 18 publications

References 19 publications

Acute mesenteric lymphadenitis in children: findings related to differential diagnosis and hospitalization

Acute mesenteric lymphadenitis in children: findings related to differential diagnosis and hospitalization

Pentraxin-3, Interleukin-6, and Acute Appendicitis: Biomarkers That Need Further Exploration

Laparoscopic appendectomy for acute appendicitis: How to discourage surgeons using inadequate therapy

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