Biomarker of urinary 5-HIAA as a valuable predictor of acute appendicitis

Abstract

Background Serotonin-containing cells are abundantly found in the appendix. Studies have shown that acute appendicitis is likely to be characterized by altered urinary 5-hydroxyindole acetic acid (5-HIAA), an active serotonin metabolite. The aim of this study is to investigate the diagnostic potential of 5-HIAA as a biomarker for acute appendicitis. Method This cross-sectional study enrolled patients referred at the Madani Hospital, with right iliac fossa pain, suspected to having the acute appendicitis. Before the initiation of the basic treatment and surgery, urine samples were obtained from the patients. Enzyme-linked immunosorbent assay (ELISA) was used for the analysis of 5-HIAA urinary levels. The obtained data were statistically analyzed using SPSS v18. Results Of 129 patients included in the study with the mean age of 29 years, 62 (48.1%) were men and 67 (51.9%) were women. Appendectomy was performed in 96 patients, where 81 cases were that of acute appendicitis. The mean levels of 5-HIAA in acute appendicitis group and in the negative appendectomy group was not statistically significant. The sensitivity of the test was 54.3% based on 7.4 ​μmol/L as cut-off %-HIAA value. Conclusion Our study reports that 5-HIAA urine concentration is not a reliable diagnostic marker for the diagnosis of acute appendicitis.

Hyperbilirubinemia as a new predictor of appendicular perforation in acute appendicitis.

“…Application of various clinical, hematological, and radiological tests to confirm diagnosis might delay decision to proceed for surgery. 8,9 Risk of perforation warrants to proceed for appendectomy in order to avoid perforation related morbidity and mortality but has contributed to unnecessary appendectomies as well. None of the method seems specific, and a clinical assessment in addition to tests is supportive.…”

“…None of the method seems specific, and a clinical assessment in addition to tests is supportive. 9 Impaired excretion of bile due to bacteremia and or endotoxemia is reported in many literature. 10 Complicated appendicitis lead to hyperbilirubinemia might be used as an indicator to diagnose this condition accurately.…”

Comparison of the prevalence of perforated appendicitis during and before COVID19 pandemic

“…Following the increase in COVID19 cases, patients with acute illness such as myocardial infarctions, those requiring cardiac catheterization laboratory activations, and stroke have also reduced their visits to the hospital [ 16 , 17 ]. Due to reduction in non-emergent surgical procedures in COVID19 period, patients with acute appendicitis may have poor postoperative outcomes such as abscesses, prolonged hospitalization, and increased reoperations and readmissions [ 18 , 19 ]. Our study did not report any significant difference in the demographic variables of appendectomy patients before and during pandemic.…”

Diagnostic accuracy of random 5-Hydroxyindole acetic acid (5-HIAA) in early diagnosis of appendicitis

“…However, the results of these studies have, in many cases, been limited to children. On the other hand, due to the limitations stated in studies, such as low sample size, contradictory results have been obtained regarding the diagnostic accuracy of 5hydroxyindole acetic acid in appendicitis diagnosis (10,11). The present study aimed to evaluate the diagnostic accuracy of 5-hydroxyindole acetic acid in the early detection of appendicitis.…”