Clinic for Children's Diseases, University Clinical Centre Tuzla, Bosnia and Herzegovina
Clinic for Children's Diseases, University Clinical Centre Tuzla, Bosnia and Herzegovina
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Cantonal Hospital ''Dr. Irfan Ljubijankić'' Bihać, Bosnia and Herzegovina
Clinic for Children's Diseases, University Clinical Centre Tuzla, Bosnia and Herzegovina
Aim To evaluate diagnostic reliability of accessible laboratory findings in recognition of acute appendicitis (AA).
Methods A retrospective study included children aged 0-15 years with abdominal pain that lasted less than 5 days with at least two of the signs/symptoms - abdominal pain, tenderness of the lower right quadrant of the abdomen, "return" sensitivity of the abdomen to palpation, loss of appetite, nausea, vomiting, body temperature>37.2°C. Values of procalcitonin (PCT), C-reactive protein (CRP) and the leukocyte count were analyzed in the peripheral blood.
Results Among 114 children, 63 (58.2%) were boys and 50 (41.8%) girls; median age of 9.5 years. Elevated values of PCT were found in 74 (65.5%), CRP in 94 (83.1%), and leukocytes in 78 (69%) (65%) children. Almost uniform significance in the recognition of AA was found for pathological values of PCT and CRP with sensitivity of 65% and 83% and diagnostic accuracy of 63% and 59%, respectively, but somewhat lower sensitivity for leukocytes, 61%. A very high predictive value of 98% for PCT and CRP, and PCT with leukocytes was found; CRP with leukocytes had a negative predictive value of 100%.
Conclusion PCT values have significant sensitivity, specificity and diagnostic accuracy in recognizing AA, while CRP and leukocytes, with high sensitivity, as non-specific markers can be a significant support for clinical assessment in the timely diagnosis of AA.
No specific funding was received for this study.
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