TY - JOUR
T1 - Laboratory Tests in Addition to the Alvarado Score in the Management of Acute Appendicitis in School-Age Children
AU - Zviedre, Astra
AU - Eņgelis, Arnis
AU - Tretjakovs, Peteris
AU - Zile, Irisa
AU - Petersons, Aigars
N1 - Funding Information:
The study was financially supported by a Grant No. 2010.10-4/VPP-4 of the framework of the Latvian National Programme and Grant No. 2009/0147/1DP/1.1.2.1.2/09/ IPIA/VIAA/009 from the project Support for Doctoral and Post-doctoral Investigations Rîga Stradiòð University fellowship.
Publisher Copyright:
© 2019 Astra Zviedre et al., published by Sciendo 2019.
PY - 2019/8/1
Y1 - 2019/8/1
N2 - The aim of the study was to determine whether the Alvarado score (AS) together with laboratory tests could be used to distinguish patients with acute appendicitis (AA) from acute mesenteric lymphadenitis (AML). Fifty-seven patients (7-18 years) with suspected AA were included in the prospective study (October 2010 - October 2013). Thirty-one patients underwent surgery for AA and 26 were not treated surgically and were diagnosed AML on ultrasonography. AS, white blood cell count (WBC), C - reactive protein (CRP) and serum cytokines (EGF, IL-10, IL-12(p70), IL-1β, IL-4, IL-6, IL-8, IL-17, MCP-1, TNF-α) were obtained on admission and were compared between groups. Mean age of the 57 patients was 12.9 (SD 3.2). Accuracy (AR) for AS ≥ 7 alone was 73.7% for AA. Modified AS with certain serum cytokines seemed to be a reliable tool for initial differential diagnosis between AA and AML in school-age children. Based on these results, AS ≥ 7, WBC ≥ 10.7 × 103/μL and serum IL-6 ≥ 4.3 pg/mL assessed altogether will yield more sensitivity for AA. Also for further advanced diagnostics, we propose to take into account the serum IL-6, IL-8, MCP-1, CRP cut-off levels in the differential diagnosis between complicated and uncomplicated AA to decide whether the treatment should be conservative or surgical.
AB - The aim of the study was to determine whether the Alvarado score (AS) together with laboratory tests could be used to distinguish patients with acute appendicitis (AA) from acute mesenteric lymphadenitis (AML). Fifty-seven patients (7-18 years) with suspected AA were included in the prospective study (October 2010 - October 2013). Thirty-one patients underwent surgery for AA and 26 were not treated surgically and were diagnosed AML on ultrasonography. AS, white blood cell count (WBC), C - reactive protein (CRP) and serum cytokines (EGF, IL-10, IL-12(p70), IL-1β, IL-4, IL-6, IL-8, IL-17, MCP-1, TNF-α) were obtained on admission and were compared between groups. Mean age of the 57 patients was 12.9 (SD 3.2). Accuracy (AR) for AS ≥ 7 alone was 73.7% for AA. Modified AS with certain serum cytokines seemed to be a reliable tool for initial differential diagnosis between AA and AML in school-age children. Based on these results, AS ≥ 7, WBC ≥ 10.7 × 103/μL and serum IL-6 ≥ 4.3 pg/mL assessed altogether will yield more sensitivity for AA. Also for further advanced diagnostics, we propose to take into account the serum IL-6, IL-8, MCP-1, CRP cut-off levels in the differential diagnosis between complicated and uncomplicated AA to decide whether the treatment should be conservative or surgical.
KW - Alvarado score
KW - appendicitis
KW - mesenteric lymphadenitis
KW - serum cytokines
UR - http://www.scopus.com/inward/record.url?scp=85069684925&partnerID=8YFLogxK
U2 - 10.2478/prolas-2019-0059
DO - 10.2478/prolas-2019-0059
M3 - Article
AN - SCOPUS:85069684925
SN - 1407-009X
VL - 73
SP - 379
EP - 386
JO - Proceedings of the Latvian Academy of Sciences, Section B: Natural, Exact, and Applied Sciences
JF - Proceedings of the Latvian Academy of Sciences, Section B: Natural, Exact, and Applied Sciences
IS - 4
ER -