Assessment of proadrenomedullin as diagnostic or prognostic biomarker of acute appendicitis in children with acute abdominal pain

Oikonomopoulou, Niki; Míguez-Navarro, Concepción; García, Arístides Rivas; Gamiz, Mercedes García; López-López, Rosario; Oliver-Sáez, Paloma; Riaño-Méndez, Bibiana; Farfan-Orte, Tamara; Lobato-Salinas, Zulema; Rúbies-Olives, Júlia; Llena-Isla, Priscila; Lancho-Monreal, Encarnación María

doi:10.1016/j.ajem.2018.09.038

Cited by 6 publications

(9 citation statements)

References 19 publications

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“…As prospective cohorts with abdominal pain in the ED tend to suffer from inclusion bias, because of a tendency to both focus on "acute abdomen" [25,26] and assess the performance of AP biomarkers [27], there are no comparable data on all-comer populations. Therefore, the question on the prevalence of extra abdominal causes of abdominal pain needs to be highlighted.…”

Section: Discussionmentioning

confidence: 99%

Acute Abdominal Pain: Missed Diagnoses, Extra-Abdominal Conditions, and Outcomes

Osterwalder

Özkan

Malinovska

et al. 2020

JCM

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Abdominal pain (AP) is a common reason for presentation to an emergency department (ED). With this prospective, observational all-comer study, we aimed to answer three questions: Which diagnoses are most often missed? What is the incidence of extra-abdominal causes? What is the prognosis of abdominal pain in a tertiary urban European ED? Participants were systematically interviewed for the presence of 35 predefined symptoms. For all patients with abdominal pain, the index visit diagnoses were recorded. Related representation was defined as any representation, investigation, or surgery related to the index visit (open time frame). If a diagnosis changed between index visit and representation, it was classified as missed diagnosis. Among 3960 screened presentations, 480 (12.1%) were due to AP. Among 63 (13.1%) related representations, the most prevalent causes were cholelithiasis, gastroenteritis, and urinary retention. A missed diagnosis was attributed to 27 (5.6%) presentations. Extra-abdominal causes were identified in 162 (43%) presentations. Thirty-day mortality was comparable to that of all other ED patients (2.2% vs. 2.1%). Patients with abdominal pain had a low risk of representation, and the majority of representations due to missed diagnoses were of benign origin. The high incidence of extra-abdominal causes is noteworthy, as this may induce change to differential diagnosis of abdominal pain.

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Section: Discussionmentioning

confidence: 99%

Acute Abdominal Pain: Missed Diagnoses, Extra-Abdominal Conditions, and Outcomes

Osterwalder

Özkan

Malinovska

et al. 2020

JCM

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“…According to articles published on this topic, MR-proADM concentrations are higher in children with acute appendicitis than in children with non-specific abdominal pain [ 17 , 18 ]. Greater differences in the levels of this biomarker were seen in complicated cases than in uncomplicated cases of appendicitis, in the first study being not significant ( p = 0.159), probably due to the smaller number of patients, and being significant in the other ( p = 0.005).…”

Section: Resultsmentioning

confidence: 99%

A Review of Adrenomedullin in Pediatric Patients: A Useful Biomarker

2022

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Adrenomedullin has several properties. It acts as a potent vasodilator, has natriuretic effects, and reduces endothelial permeability. It also plays a role in initiating the early hyperdynamic phase of sepsis. Since its discovery, many articles have been published studying the uses and benefits of this biomarker. The aim of this review is to determine the usefulness of adrenomedullin in pediatric patients. Relevant studies covering adrenomedullin in pediatrics (<18 years) and published up until August 2021 were identified through a search of MEDLINE, PubMed, Embase, Web of Science, Scopus, and Cochrane. Seventy studies were included in the present review, most of them with a low level of evidence (IV to VI). Research on adrenomedullin has primarily been related to infection and the cardiovascular field. The performance of adrenomedullin to quantify infection in children seems satisfactory, especially in sepsis. In congenital heart disease, this biomarker seems to be a useful indicator before, during, and after cardiopulmonary bypass. Adrenomedullin seems to be useful in the pediatric population for a large variety of pathologies, especially regarding infection and cardiovascular conditions. However, it should be used in combination with other biomarkers and clinical or analytical variables, rather than as a single tool.

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“…A number of studies have taken nonspecific abdominal pain (NSAP) patients as CG into consideration. For instance, Oikonomopoulou et al [ 24 ] selected 185 non-AA cases as CG. The CG included NSAP (151, 81.6%), followed by mesenteric lymphadenitis (16, 8.6%), ileitis (4, 2.2%), acute gastroenteritis (5, 2.7%), pneumonia (2, 1.1%), streptococcal pharyngitis (1, 0.5%), influenza type B virus (1, 0.5%), constipation (1, 0.5%), and intussusception (1, 0.5%).…”

Section: Discussionmentioning

confidence: 99%

sB7H3 in Children with Acute Appendicitis: Its Diagnostic Value and Association with Histological Findings

Chen

Zhu

et al. 2020

Journal of Immunology Research

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Background. Several efforts have been made to find out a valuable marker to assist the diagnosis and differentiation of gangrenous/perforated appendicitis. We aimed to determine the diagnostic capacity of soluble B7H3 (sB7H3) in acute appendicitis (AA) and its accuracy as a predictor of the severity of appendicitis. Methods. 182 children were allocated into four groups as follows: control group (CG, 90), simple appendicitis (SA, 12), purulent appendicitis (PA, 49), and gangrenous appendicitis (GA, 31). Prior to appendectomy, blood was collected and sent for analysis of routine examination and cytokines (sB7H3 and TNF-α). We compared values of all measured parameters according to histological findings. Furthermore, we assigned AA patients into the nonperforated appendicitis group and the perforated appendicitis group. The diagnostic effects of significant markers were assessed by ROC curves. Results. Only the levels of CRP, FIB, and sB7H3 had a remarkable rising trend in AA-based groups, while differences in the levels of CRP and FIB between simple appendicitis and purulent appendicitis were not statistically significant. In addition, sB7H3 was found as the only marker in children with AA, which was markedly associated with the degree of histological findings of the appendix. Furthermore, sB7H3 had a high diagnostic value in predicting AA and complex appendicitis (PA+GA) in children. However, the diagnostic performance of sB7H3 for distinguishing PA from GA was not remarkable. Additionally, only the levels of CRP and sB7H3 were statistically different between the nonperforated appendicitis group and the perforated appendicitis group. The diagnostic performance of CRP and sB7H3 could not merely predict perforation of AA in children; however, the diagnostic performance was improved after combination. Conclusions. sB7H3 could be used as a valuable marker to predict the presence of AA and complex AA in children. However, the diagnostic value of sB7H3 to predict gangrenous/perforated appendicitis was not found to be remarkable. The combination of sB7H3 and CRP might improve the prediction of perforated appendicitis.

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Assessment of proadrenomedullin as diagnostic or prognostic biomarker of acute appendicitis in children with acute abdominal pain

Cited by 6 publications

References 19 publications

Acute Abdominal Pain: Missed Diagnoses, Extra-Abdominal Conditions, and Outcomes

Acute Abdominal Pain: Missed Diagnoses, Extra-Abdominal Conditions, and Outcomes

A Review of Adrenomedullin in Pediatric Patients: A Useful Biomarker

sB7H3 in Children with Acute Appendicitis: Its Diagnostic Value and Association with Histological Findings

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