Determining acute complicated and uncomplicated appendicitis using serum and urine biomarkers: interleukin-6 and neutrophil gelatinase-associated lipocalin

Mohit Kakar (Coresponding Author), Mathilde Delorme, Renars Broks, Lasma Asare, Marisa Butnere, Aigars Reinis, Arnis Engelis, Juta Kroica, Amulya Saxena, Aigars Petersons

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Purpose: The study aim is to determine whether serum and urine interleukin-6 (IL-6) and neutrophil gelatinase-associated lipocalin (NGAL) can be included in the early diagnostic algorithm for pediatric appendicitis. Methods: Prospective single-center cohort study included 92 children divided into control, acute complicated appendicitis (AcA) and acute uncomplicated appendicitis (AnA) groups. Serum and urine samples were assayed for IL-6 and NGAL preoperatively, and on the second and fifth postoperative days. Intraoperative and bacteriological findings divided the appendicitis patients. Results: Average serum biomarker levels were higher in appendicitis patients versus the control, and the following values were produced via receiver operating characteristic (ROC) analysis. NGAL and IL-6 cutoff values were 113.95 ng/ml and 24.64 pg/ml, respectively, NGAL had 68.3% sensitivity and 65.5% specificity, while IL-6 had 72.6% and 86.2%. Comparing AcA and AnA, IL-6 was the only biomarker of significance yielding 77.4% sensitivity and 58.1% specificity with a 26.43 pg/ml cutoff value. Urine biomarkers were non-specific in differentiation appendicitis severity and ultimately, between infectious and non-infectious disease. Conclusion: Although NGAL provided measurable useful diagnostic information in evaluating children for appendicitis, its values were not sufficient for appendicitis severity. Serum IL-6 remains a strong biomarker for suspected acute appendicitis and has promising results predicting its severity.

Original languageEnglish
Pages (from-to)629-636
Number of pages8
JournalPediatric Surgery International
Volume36
Issue number5
DOIs
Publication statusPublished - 26 Mar 2020

Keywords

  • Adolescent
  • Appendicitis/diagnosis
  • Biomarkers/blood
  • Child
  • Diagnosis, Differential
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Interleukin-6/metabolism
  • Lipocalin-2/metabolism
  • Male
  • Prospective Studies
  • ROC Curve

Field of Science

  • 3.2 Clinical medicine

Publication Type

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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