<abstract xmlns="http://www.w3.org/1999/xhtml"><p>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.</p></abstract>

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.

Laboratory Tests in Addition to the Alvarado Score in the Management of Acute Appendicitis in School-Age Children

Department of Physiology and Biochemistry

Department of Research, Statistics and Health Promotion

Department of Public Health and Epidemiology

Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

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...

Laboratory Tests in Addition to the Alvarado Score in the Management of Acute Appendicitis in School-Age Children

Publié en ligne: 12 juil. 2019

Pages: 379 - 386

Reçu: 18 oct. 2018

Accepté: 28 mai 2019

DOI: https://doi.org/10.2478/prolas-2019-0059

Mots clés
appendicitis, mesenteric lymphadenitis, Alvarado score, serum cytokines

© 2019 Astra Zviedre et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Laboratory Tests in Addition to the Alvarado Score in the Management of Acute Appendicitis in School-Age Children

Publié en ligne: 12 juil. 2019

Pages: 379 - 386

Reçu: 18 oct. 2018

Accepté: 28 mai 2019

DOI: https://doi.org/10.2478/prolas-2019-0059

Mots clésappendicitis, mesenteric lymphadenitis, Alvarado score, serum cytokines

© 2019 Astra Zviedre et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Mots clés
appendicitis, mesenteric lymphadenitis, Alvarado score, serum cytokines