Diagnostic Value of Interleukin-6 and C-Reactive Protein in Acute Appendicitis

Abstract

The aim of this study is prospectively to evaluate the serum C-reactive protein (CRP) and interleukin-6 (IL-6) levels in detection of acute appendicitis in patients with right iliac fossa pain. Data were collected in prospective manner on 102 consecutive patients with right iliac fossa pain. Laparotomy was performed for suspected acute appendicitis for 55 of the 102 patients, of whom 49 patients had appendicitis, 6 patients non-appendicitis (NA), and the other 47 patients had nonspecific abdominal pain (NSAP) and they did not undergo operation. Among those with appendicitis 31 had acute appendix (AA), 8 had gangrenous appendix (GA), and 10 had perforated appendix (PA). The WBC and CRP the mean (SEM) values were significantly different in AA, GA, and PA groups compared with NSAP and NA groups (P < 0.05). Although the mean IL-6 levels were significantly different only in PA group than the others groups (P < 0.05). The sensitivity and specificity of serum CRP measurements were calculated as 96% and 87%, respectively whereas these were 33% and 83% for IL-6 levels for the diagnosis of the acute appendicitis. As a result, measurement of the CRP levels and WBC have an additional diagnostic value on the diagnosis of the acute appendicitis but determination of IL-6 levels which added to the test combination of WBC and CRP, the sensitivity for the diagnosis of the acute appendicitis was not changed whereas the specificity was decreased to 66%.

How To Avoid Negative Appendectomies: Can Us Achieve This?

“…Many studies have confirmed accuracy and effectiveness of these tests. [14][15][16] Nevertheless, none of these tests is sufficient or suitably specific to decrease negative appendectomy rate by itself.…”

White Cell Count and C-Reactive Protein Measurement in Patients with Possible Appendicitis

“…[4][5][6] Some groups have reported more specific findings: raised CRP values have been shown to correlate with complications such as perforation or appendix abscess. [7][8][9] These studies have, however, all been retrospective, focusing on blood tests done on patients who have had appendicectomy. More limited data are available from prospective analyses in patients presenting with right iliac fossa pain.…”

Patients with Clinical Acute Appendicitis Should have Pre-operative Full Blood Count and C-Reactive Protein Assays

“…9 Though novel inflammatory markers including interleukin-6 have been assessed with little additional merit, [10][11][12] the most commonly used are total white cell count (WCC), neutrophil count (NC) and C-reactive protein (CRP).…”