The Role of Serum C - reactive protein, White Blood Cell Count and Neutrophils Percentage in the Diagnosis of Childhood Acute Appendicitis

Abstract

Objective: To determine the role of CRP, white cell count, and granulocytosis in accurately diagnosing acute appendicitis. The sensitivity, specificity, positive predictive value negative predictive values of these tests was calculated. Methodology: This cross-sectional study was conducted in the immunology department of the Children’s Hospital and University of Child Health Sciences, Lahore over a period of six months from July 2019 to December 2019. A total of 91 suspected patients with acute appendicitis were included. The blood samples were collected from the patients and immediately sent to the lab for estimating serum CRP, WBC count and Neutrophil Percentage (Nu %). The sensitivity, specificity, positive predictive value, and accuracy were calculated for each test, and then the combined sensitivity, specificity, positive predictive value, and accuracy were calculated. Results: The mean values of CRP, WBC, and Nu % were 59.44 mg/L, 15.30 uL, and 76% respectively, among the 71 patients with acute appendicitis. The mean values of CRP, WBC, and Nu % in another group of patients with non-specific abdominal pain were 29.13mg/L, 9.05/uL, and 62.93 percent, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive values of these 3 tests 93.87%, 83.63%, 88.5%, 92% and 63.63% respectively. Conclusion: The combination of clinical indications and symptoms, as well as tests of serum CRP, WBC count, and neutrophils percentage, can improve pre-surgical decision-making and rescue children from both negative surgery and appendix complications if left untreated.