The diagnostic values of procalcitonin and interleukin 6 in acute appendicitis

Abstract

Objective: Despite the recent use of computed tomography scan and diagnostic laparoscopy, acute appendicitis is still highly misdiagnosed. Timely diagnosis of acute appendicitis is more crucial in children and elderly patients because of vague symptoms and rapid progression to perforation in these age groups, which may result in high rates of morbidity and mortality. The aim of the present study was to find the diagnostic values of procalcitonin and interleukin 6 (IL-6) for diagnosing acute appendicitis in our center. Material and Methods: Patients who were suspected of acute appendicitis and referred to the emergency department of a tertiary care urban hospital in 2016 were enrolled in the study. A 5 mL blood sample was obtained from each patient before appendectomy and was examined for procalcitonin and IL-6. Then the resected specimen of the appendix was studied by a pathologist, and a definite diagnosis was made. Results: Eighty patients including 53 (66.3%) men who underwent appendectomy were enrolled in the study. The diagnosis of acute appendicitis was histopathologically confirmed in 60 (75%) patients including 18, 20, and 22 patients with inflammatory, suppurative, and gangrenous/perforated appendicitis, respectively. The sensitivity and specificity of procalcitonin versus IL-6 for diagnosing acute appendicitis were 65% and 80% vs. 76% and 55%, respectively. The sensitivity and specificity of concurrent procalcitonin and IL-6 for diagnosing acute appendicitis were 95% and 55%, respectively. Conclusion: Our study suggests that parallel measurement of procalcitonin and IL-6 decreases unnecessary negative appendectomies.

IL-6 Serum Levels Can Enhance the Diagnostic Power of Standard Blood Tests for Acute Appendicitis

“…PCT showed an Sn and Sp of 65% and 80%, respectively, suggesting a possible role in AA diagnosis. Finally, the authors highlighted how simultaneous high levels of PCT and IL-6 achieve an Sn of 95% and Sp of 55% [ 30 ].…”

Diagnostic Value of Procalcitonin and Interleukin-6 on Early Postoperative Pneumonia after Adult Cardiac Surgery: A Prospective Observational Study

“…Haghi et al reported that combining PCT and IL-6 improved the diagnostic efficiency of infectious appendicitis and decreased unnecessary negative appendectomies [Haghi 2018]. Another study demonstrated that the combination of IL-6, CRP and PCT seems to be predictive in diagnosis of early onset neonatal sepsis [Abdollahi 2012].…”

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

“…IL-6 is a proinflammatory cytokine, mediator of acute phase reaction, and is secreted during inflammatory process and neutrophil recruitment following the invasion of bacteria to the appendix [14,15]. Some of the previous studies have shown its relatively high sensitivity (73-84%) and low specificity (46-72%) for diagnosing AA and even higher sensitivity (up to 91%) and lower specificity (37%) for diagnosing perforated appendicitis [16,17]. Elevated serum IL-6 levels were found in the majority of our patients (55, 82.09%, p < 0.001).…”