Novel Molecular Biomarkers and Diagnosis of Acute Appendicitis in Children

Hodge, Sarah; Mickiewicz, Beata; Lau, Matthew; Jenne, Craig N.; Thompson, Graham C.

doi:10.2217/bmm-2021-0108

Cited by 11 publications

(15 citation statements)

References 79 publications

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“…As suggested in a recent review, the management in the ED would be improved, and the efficiency of AA diagnosis would be increased with a diagnostic tool developed with the biomarker technology. [10] The elevated levels of CRP, WBC were consistently demonstrated to be a significant indicator for AA diagnosis. The researchers indicated that WBC and Neu had higher sensitivity early in the disease, while the sensitivity of CRP increased with the progression and reached its highest sensitivity at day four.…”

Section: Discussionmentioning

confidence: 93%

“…[16] On the other hand, the low specificity of CRP for AA was recently underlined, and its limited utility as a diagnostic biomarker was emphasized. [10,17] Plasma levels of IL-6, CRP, and PCT were significantly different in children with AA compared to children with non-AA causes of abdominal pain. [18] The overall performance of IL-6 has been reported to be superior to PCT, especially regarding cost, sensitivity, and prediction of perforation.…”

Section: Introductionmentioning

confidence: 95%

“…[7][8][9] Difficulties in diagnosing AA have led to increased search for biomarkers for a timely and accurate diagnosis. [10] Considering its etiopathogenesis as a vicious cycle of an immune response, comprising of infection, obstruction, and inflammation, researchers focused on investigating the immuno-inflammatory system components, i.e., white blood cells, interleukins. [11][12][13] Procalcitonin (PCT), known for its rapid response against bacterial infections, has been studied for its potential as a biomarker.…”

Section: Introductionmentioning

confidence: 99%

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Akut Apandisitte Presepsin Performansı Üzerine Bir Pilot Çalışma: Prospektif Bir Vaka Kontrol Çalışması

TAŞAR>¹,

Fidancı²,

Bulut³

et al. 2022

Journal of Contemporary Medicine

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Aim: Diagnostic biomarkers are needed for pediatric acute appendicitis (AA). We hypothesized that presepsin (soluble CD14 subtype), a biomarker for sepsis, can also be used in pediatric AA and aimed to investigate its diagnostic value in those patients. Materials and Methods: This prospective case-control study was conducted on children admitted to the Pediatric Emergency Department with suspected acute appendicitis. Serum levels of interleukin-6, and presepsin were statistically analyzed for their diagnostic values. Results: No remarkable demographic differences were present between the 41 cases and 47 controls. Clinical and routine laboratory findings were significantly positive for acute appendicitis in the cases compared to controls. ROC analysis indicated an AUC for presepsin as 0.999 (CI 95%: 0.890-0.993) and for interleukin-6 as 0.963 (CI 95%:0.949-1.000). The best cut-off point value for presepsin was at 739 pg/ml, corresponding to a sensitivity of 97.56% and a specificity of 100%. The best cut-off point value for interleukin-6 was at 19 pg/ml, corresponding to a sensitivity of 97.56% and a specificity of 90.32%. Conclusions: Our study results indicate that presepsin can be considered a biomarker for diagnosing appendicitis in pediatric cases. Future studies might better include the combination with other biomarkers in pediatric cases.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Akut Apandisitte Presepsin Performansı Üzerine Bir Pilot Çalışma: Prospektif Bir Vaka Kontrol Çalışması

TAŞAR>¹,

Fidancı²,

Bulut³

et al. 2022

Journal of Contemporary Medicine

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“…More research is needed when it comes to biomarkers; it is probably more likely than one or more biomarkers should be incorporated into the clinical scoring systems rather than be used independently. Precision medicine techniques also have the potential to add to the strength of the diagnostics [ 17 ].…”

Section: Resultsmentioning

confidence: 99%

The Diagnostic Differentiation Challenge in Acute Appendicitis: How to Distinguish between Uncomplicated and Complicated Appendicitis in Adults

Skjold-Ødegaard

Søreide

2022

Diagnostics

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(1) Background: How to best define, diagnose and differentiate uncomplicated from complicated acute appendicitis remains debated. Hence, the aim of this review was to present an overview of the current knowledge and emerging field of acute appendicitis with a focus on the diagnostic differentiation of severity currently subject to ongoing investigations. (2) Methods: We conducted a PubMed search using the MeSH terms “appendicitis AND severity” and “appendicitis AND classification”, with a focus on studies calling appendicitis as ‘uncomplicated’ or ‘complicated’. An emphasis on the last 5 years was stressed, with further studies selected for their contribution to the theme. Further studies were retrieved from identified full-text articles and included per the authors’ discretion. (3) Results: The assumption that appendicitis invariably will proceed to perforation has been outdated. Both uncomplicated and complicated appendicitis exist with likely different pathophysiology. Hence, this makes it important to differentiate disease severity. Clinicians must diagnose appendicitis, but, in the next step, also differentiate between uncomplicated and complicated appendicitis in order to allow for management decisions. Diagnostic accuracy without supportive imaging is around 75–80% and, based on clinical judgement and blood tests alone, the negative appendectomy rate has been described as high as 36%. More research is needed on available biomarkers, and the routine use of imaging still remains debated. Scoring systems have the potential to improve diagnostic accuracy, but no scoring system has yet been validated for differentiating disease severity. Currently, no universally agreed definition exists on what constitutes a complicated appendicitis. (4) Conclusions: Uncomplicated and complicated appendicitis appear to have different pathophysiology and should be treated differently. The differentiation between uncomplicated and complicated appendicitis remains a diagnostic challenge.

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“…However, despite its high incidence the accurate preoperative diagnosis of AA is still challenging. The negative appendectomy rate is 20.6% [2] with peaks in certain categories of patients such as women in childbearing age (30-50%) or young children (30-46%) [3,4]. The diagnosis of AA is still predominantly clinical with 80% diagnostic accuracy of the initial algorithm consisting of suggestive history,pain at Mc-Burney's point and leukocytosis [5].…”

Section: Introductionmentioning

confidence: 99%

The potential role of interleukin-6, endotoxin and C-reactive protein as standard biomarkers for acute appendicitis in adults

Dimić¹,

Dimic²,

Elek³

et al. 2022

Srp Arh Celok Lek

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Introduction/Objective. Acute appendicitis (AA) is by far the most frequent urgent condition in abdominal surgery and numerous biomarkers may help the physician to diagnose and even predict the severity of the disease. The objective of the paper was to determine the accuracy of C-reactive protein (CRP), interleukin-6 (IL-6) and endotoxin and compare it with the diagnostic value of Alvarado score (AS) in adults surgically treated for AA. Methods. Sixty-seven patients were diagnosed with AA using AS. Prior to surgery serum levels of inflammatory biomarkers were determined and together with AS were respectively compared to the results of histopathological analysis of specimens. The patients were divided into three group according to the histopathological assessment. Results. The univariate analysis revealed that the increase of CRP level by one unit increases the probability of complicated AA (CoAA) occurence by 1% (1.00 to 1.02, p < 0.05). ROC curve analysis has revealed that CRP has better capacity to predict supurative AA (SAAs)/CoAAs than catarrhal AA (CAA), with the cut-of value 19.45. Increase of AS value by one unit produced 2.98 fold increase of the probability of CoAA occurrence (1.60 to 5.57, p < 0.001), while positive AS value increases the probability of CoAA occurrence 24.67 times (4.94 to 123.12; p < 0.001). ROC curve analysis was demonstrated that AS may better predict CoAAs than CAAs/SAAs, with the cut-off value 8.50. Conclusion. AS and CRP should be routinely used combined as powerful tools for diagnosis and prediction of complicated AA.

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Novel Molecular Biomarkers and Diagnosis of Acute Appendicitis in Children

Cited by 11 publications

References 79 publications

Akut Apandisitte Presepsin Performansı Üzerine Bir Pilot Çalışma: Prospektif Bir Vaka Kontrol Çalışması

Akut Apandisitte Presepsin Performansı Üzerine Bir Pilot Çalışma: Prospektif Bir Vaka Kontrol Çalışması

The Diagnostic Differentiation Challenge in Acute Appendicitis: How to Distinguish between Uncomplicated and Complicated Appendicitis in Adults

The potential role of interleukin-6, endotoxin and C-reactive protein as standard biomarkers for acute appendicitis in adults

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