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Erschienen in: Wiener Medizinische Wochenschrift 13-14/2022

10.01.2022 | Original research

Diagnostic accuracy of laboratory markers for diagnosis of acute appendicitis in children

verfasst von: Mohammadreza Esmaeili Dooki, Masoud nezhadan, Sanaz Mehrabani, Soheil Osia, Abbas Hadipoor, Mahmoud Hajiahmadi, Mohsen Mohammadi

Erschienen in: Wiener Medizinische Wochenschrift | Ausgabe 13-14/2022

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Summary

Background

Acute appendicitis (AA), the most common abdominal emergency disease, is one of the most important causes of hospitalization of children. Studies have shown that white blood cell (WBC) count, mean platelet volume (MPV), C‑reactive protein (CRP), and erythrocyte sedimentation rate (ESR) can play an important role in the diagnostic prediction of appendicitis. Therefore, the aim of this study was to evaluate the diagnostic value of WBC count, polymorphonuclear leukocytes (PMNs) percentage, MPV, CRP, and ESR for the diagnosis of AA.

Methods

In this study, 100 medical records were reviewed for children referred to the hospital complaining of abdominal pain and who underwent operation with a provisional diagnosis of acute appendicitis based on clinical and laboratory findings. Patients were divided into two groups according to the pathology gold standard method: AA and the other group with acute abdominal pain without appendicitis (AAP). The diagnostic accuracy of WBC, PMNs%, MPV, ESR, and CRP were compared for patients with AA and AAP.

Results

A total of 100 patients (50 with AA and 50 with AAP) were identified. The sensitivity and specificity of WBC and PMNs% were 78 and 66%, and 76 and 54%, respectively; ESR was 80 and 48%, respectively; and CRP was 82 and 62% (30–89%), respectively. A low specificity (8%) and 70% sensitivity was calculated using the cutoff point of 8.1 fl for MPV.

Conclusion

Our data suggest that children with AA often present with significantly higher WBC count, ESR level, CRP level, PMNs%, and lower MPV level. The results of the study showed that WBC, CRP, and ESR, along with other diagnostic methods, can be useful in diagnosing AA in children. MPV is not effective in the diagnosis of AA due to its specificity; however, a significantly lower level was found in children with AA.
Literatur
1.
Zurück zum Zitat Almaramhy HH. Acute appendicitis in young children less than 5 years. Ital J Pediatr. 2017;43(1):1–9.CrossRef Almaramhy HH. Acute appendicitis in young children less than 5 years. Ital J Pediatr. 2017;43(1):1–9.CrossRef
2.
Zurück zum Zitat López JJ, Deans KJ, Minneci PC. Nonoperative management of appendicitis in children. Curr Opin Pediatr. 2017;29(3):358–62.CrossRef López JJ, Deans KJ, Minneci PC. Nonoperative management of appendicitis in children. Curr Opin Pediatr. 2017;29(3):358–62.CrossRef
4.
Zurück zum Zitat Howell EC, Dubina ED, Lee SL. Perforation risk in pediatric appendicitis: assessment and management. Pediatric Health Med Ther. 2018;9:135.CrossRef Howell EC, Dubina ED, Lee SL. Perforation risk in pediatric appendicitis: assessment and management. Pediatric Health Med Ther. 2018;9:135.CrossRef
5.
Zurück zum Zitat Richardsen I, et al. Etiology of appendicitis in children: the role of bacterial and viral pathogens. J Invest Surg. 2016;29(2):74–9.CrossRef Richardsen I, et al. Etiology of appendicitis in children: the role of bacterial and viral pathogens. J Invest Surg. 2016;29(2):74–9.CrossRef
6.
Zurück zum Zitat Chang Y‑J, et al. Misdiagnosed acute appendicitis in children in the emergency department. Chang Gung Med J. 2010;33(5):551–7.PubMed Chang Y‑J, et al. Misdiagnosed acute appendicitis in children in the emergency department. Chang Gung Med J. 2010;33(5):551–7.PubMed
7.
Zurück zum Zitat Zavras N, Vaos G. Management of complicated acute appendicitis in children: still an existing controversy. World J Gastrointest Surg. 2020;12(4):129.CrossRef Zavras N, Vaos G. Management of complicated acute appendicitis in children: still an existing controversy. World J Gastrointest Surg. 2020;12(4):129.CrossRef
9.
Zurück zum Zitat Beltrán MA, et al. Predictive value of white blood cell count and C‑reactive protein in children with appendicitis. J Pediatr Surg. 2007;42(7):1208–14.CrossRef Beltrán MA, et al. Predictive value of white blood cell count and C‑reactive protein in children with appendicitis. J Pediatr Surg. 2007;42(7):1208–14.CrossRef
10.
Zurück zum Zitat Siddique K, et al. Diagnostic accuracy of white cell count and C‑reactive protein for assessing the severity of paediatric appendicitis. JRSM Short Rep. 2011;2(7):59.CrossRef Siddique K, et al. Diagnostic accuracy of white cell count and C‑reactive protein for assessing the severity of paediatric appendicitis. JRSM Short Rep. 2011;2(7):59.CrossRef
11.
Zurück zum Zitat Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986;15(5):557–64.CrossRef Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986;15(5):557–64.CrossRef
12.
Zurück zum Zitat Monajemzadeh M, et al. Pathologic evaluation of appendectomy specimens in children: is routine histopatholgic examination indicated? Iran J Pediatr. 2011;21(4):485.PubMedPubMedCentral Monajemzadeh M, et al. Pathologic evaluation of appendectomy specimens in children: is routine histopatholgic examination indicated? Iran J Pediatr. 2011;21(4):485.PubMedPubMedCentral
13.
Zurück zum Zitat Pogorelić Z, et al. Acute appendicitis in children younger than five years of age: diagnostic challenge for pediatric surgeons. Surg Infect. 2020;21(3):239–45.CrossRef Pogorelić Z, et al. Acute appendicitis in children younger than five years of age: diagnostic challenge for pediatric surgeons. Surg Infect. 2020;21(3):239–45.CrossRef
14.
Zurück zum Zitat Lounis Y, et al. Influence of age on clinical presentation, diagnosis delay and outcome in pre-school children with acute appendicitis. BMC Pediatr. 2020;20(1):1–9.CrossRef Lounis Y, et al. Influence of age on clinical presentation, diagnosis delay and outcome in pre-school children with acute appendicitis. BMC Pediatr. 2020;20(1):1–9.CrossRef
15.
Zurück zum Zitat Martin C, Marayati R. The role and efficacy of laboratories in the diagnosis of pediatric appendicitis. Controversies in pediatric appendicitis. : Springer; 2019. pp. 23–7. Martin C, Marayati R. The role and efficacy of laboratories in the diagnosis of pediatric appendicitis. Controversies in pediatric appendicitis. : Springer; 2019. pp. 23–7.
16.
Zurück zum Zitat Barreto S, et al. Acute perforated appendicitis: an analysis of risk factors to guide surgical decision making. Indian J Med Sci. 2010;64(2):58.CrossRef Barreto S, et al. Acute perforated appendicitis: an analysis of risk factors to guide surgical decision making. Indian J Med Sci. 2010;64(2):58.CrossRef
17.
Zurück zum Zitat Akay MA, et al. The most useful marker for the diagnosis of acute appendicitis: serum amyloid‑A. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi. 2021;7(1):27–31. Akay MA, et al. The most useful marker for the diagnosis of acute appendicitis: serum amyloid‑A. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi. 2021;7(1):27–31.
18.
Zurück zum Zitat Yo C‑H, et al. Comparison of the test characteristics of procalcitonin to C‑reactive protein and leukocytosis for the detection of serious bacterial infections in children presenting with fever without source: a systematic review and meta-analysis. Ann Emerg Med. 2012;60(5):591–600.CrossRef Yo C‑H, et al. Comparison of the test characteristics of procalcitonin to C‑reactive protein and leukocytosis for the detection of serious bacterial infections in children presenting with fever without source: a systematic review and meta-analysis. Ann Emerg Med. 2012;60(5):591–600.CrossRef
19.
Zurück zum Zitat Morandi A, et al. The coagulation profile as a marker for acute appendicitis in the paediatric population: retrospective study. Afr J Paediatr Surg. 2020;17(3):59.CrossRef Morandi A, et al. The coagulation profile as a marker for acute appendicitis in the paediatric population: retrospective study. Afr J Paediatr Surg. 2020;17(3):59.CrossRef
20.
Zurück zum Zitat Erdem H, et al. Evaluation of mean platelet volume as a diagnostic biomarker in acute appendicitis. Int J Clin Exp Med. 2015;8(1):1291.PubMedPubMedCentral Erdem H, et al. Evaluation of mean platelet volume as a diagnostic biomarker in acute appendicitis. Int J Clin Exp Med. 2015;8(1):1291.PubMedPubMedCentral
21.
Zurück zum Zitat Bilici S, et al. Mean platelet volume in diagnosis of acute appendicitis in children. Afr H Sci. 2011;11(3):427–32. Bilici S, et al. Mean platelet volume in diagnosis of acute appendicitis in children. Afr H Sci. 2011;11(3):427–32.
22.
Zurück zum Zitat Nia AA, Zareifar P. Mean platelet volume (MPV) in children with acute appendicitis. JPMS. 2018;8(1):6. Nia AA, Zareifar P. Mean platelet volume (MPV) in children with acute appendicitis. JPMS. 2018;8(1):6.
Metadaten
Titel
Diagnostic accuracy of laboratory markers for diagnosis of acute appendicitis in children
verfasst von
Mohammadreza Esmaeili Dooki
Masoud nezhadan
Sanaz Mehrabani
Soheil Osia
Abbas Hadipoor
Mahmoud Hajiahmadi
Mohsen Mohammadi
Publikationsdatum
10.01.2022
Verlag
Springer Vienna
Erschienen in
Wiener Medizinische Wochenschrift / Ausgabe 13-14/2022
Print ISSN: 0043-5341
Elektronische ISSN: 1563-258X
DOI
https://doi.org/10.1007/s10354-021-00898-8

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