The Value of C-Reactive Protein in Enhancing Diagnosis of Acute Appendicitis

Raja, Mazhar; Elshaikh, Elamin; Williams, Lisa; Ahmed, Mohamed H.

doi:10.14740/jcs316w

Cited by 13 publications

(15 citation statements)

References 9 publications

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“…2014), in which more number of CRP positive patients were females as compared to males. [6,7,8,9] It has been reported by the previous studies that age group most effectively affected with inflammatory diseases was 40- [8, 10,11] In the present study the CRP titre 48mg/L was obtained in maximum number of patients. The study showed similar results which are comparable to the studies reported by [7,11,12] The findings of this study that most patients with rheumatoid arthritis showed highly raised titres of serum CRP were similar to the study reported by Shrivastava et al(2013) and Andveera et al(2014).…”

Section: Resultssupporting

confidence: 47%

“…[6,7,8,9] It has been reported by the previous studies that age group most effectively affected with inflammatory diseases was 40- [8, 10,11] In the present study the CRP titre 48mg/L was obtained in maximum number of patients. The study showed similar results which are comparable to the studies reported by [7,11,12] The findings of this study that most patients with rheumatoid arthritis showed highly raised titres of serum CRP were similar to the study reported by Shrivastava et al(2013) and Andveera et al(2014). [8,9] However, results of present study vary from other studies - [6,7,13] In the present study raised CRP levels obtained in 76% patients with chronic inflammatory diseases and 24% patients with acute inflammatory diseases.…”

Section: Resultsmentioning

confidence: 50%

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C-Reactive Protein Levels and its Association with Acute and Chronic Inflammatory Diseases- An Observational Study

Bharti¹

2021

ijmra

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Background: C-reactive protein is a nonspecific, acute-phase, inflammatory protein, whose expression is increased in response to tissue injury, inflammation and infection. The highest concentrations of CRP are found in an individual having some bacterial infections where CRP level increase up to 1,000-fold. The present study was undertaken to determine the C-reactive protein levels in clinically suspected OPD and IPD patient by Latex agglutination test (LAT). Material and Methods: Blood samples were collected from clinically suspected OPD and IPD patients with signs of inflammation in plain vacutainer tubes and received in Serology laboratory of Microbiology Department for CRP testing. All blood samples were screened by Qualitative CRP assay by using commercially available kit. Blood samples that were positive were further tested for CRP titre by semi-quantitative test using same kit (Beacon Diagnostics Pvt Ltd ). Results: A total of 450 serum samples were received for CRP testing during a period of six months. Higher CRP levels were obtained in patients with chronic inflammatory diseases (76%) and as compared to patients with acute inflammatory diseases (24%). Conclusion: CRP is an inexpensive and easily available serological test helpful in correlating severity and mortality of any disease. Early CRP testing can be a very helpful tool to improve the clinical outcomes of patients and decreased mortality.

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Section: Resultssupporting

confidence: 47%

Section: Resultsmentioning

confidence: 50%

C-Reactive Protein Levels and its Association with Acute and Chronic Inflammatory Diseases- An Observational Study

Bharti¹

2021

ijmra

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“…The utility of CRP in diagnosing appendicitis has been evaluated in many studies. Negative CRP levels would most likely be associated with normal appendix [ 7 ]. In contrary, Amalesh T et al showed that the sensitivity, specificity, PPV, and NPV for CRP in appendicitis was 91%, 42%, 88%, and 48%, respectively, and that it may not be a useful tool to surgeons [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Role of C-Reactive Protein, White Blood Cell Counts, Bilirubin Levels, and Imaging in the Diagnosis of Acute Appendicitis as a Cause of Right Iliac Fossa Pain

Shetty

Vijayakumar

Srinivasan

et al. 2018

Cureus

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BackgroundRight iliac fossa (RIF) pain is one of the most common modalities of presentation to surgical emergency. It remains a challenge to the treating clinicians to accurately diagnose or to rule out appendicitis.ObjectiveThe aim of the study was to compare the efficacy of clinical impression, biochemical markers, and imaging in the diagnosis of RIF pain with special reference to appendicitis and their implication in reducing the negative appendicectomy rates.MethodsAll patients presenting to casualty with RIF pain were included in the study. Blood investigations including C-reactive protein (CRP), serum bilirubin, white blood cell counts (WBC), and ultrasound (USG) were done. Based on the clinical impression, patients were either posted for appendicectomy or observed in equivocal cases. Patients who had recurrent pain on follow-up underwent appendicectomy or underwent contrast-enhanced computed tomography (CECT) in equivocal cases. Patients who only had a single self-limiting episode with no other alternative diagnosis or had a normal CECT report were included in a non-specific RIF pain group.ResultsThe negative appendicectomy rate was 8.2%. The mean value of WBC counts (9.57x109/L vs 7.88x109/L; p<0.05) and that of serum bilirubin (1.37 mg/dl vs 0.89mg/dl; p<0.05) in the appendicitis and non-appendicitis group, respectively, were statistically significant. The percentage of CRP positivity was higher in the appendicitis group (51.9% vs 15%; p<0.05). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for USG (84.2%, 77.17%, 85.4%, and 75.5%), for CRP (51.8%, 85%, 82%, and 57%), for WBC count (45.1%, 88%, 86.6%, and 48.3%), and for serum bilirubin (69.2%, 75%, 81.4%, and 60.5%) were statistically significant between the groups.ConclusionImaging and biochemical investigations including bilirubin can act as useful adjuncts to the clinical diagnosis of appendicitis.

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“…[6] Pada kelompok pasien yang hanya terdiri dari pasien dengan apendisitis terkomplikasi, CRP menunjukkan sensitivitas sebesar 97%, tetapi ketika digabungkan dengan kelompok apendisitis akut tanpa komplikasi, sensitivitas turun menjadi 66%. [18] Tabel 1. AUC Berbagai Biomarker Potensial pada Apendisitis Komplikasi [16] CRP diproduksi di dalam hepar sehingga tidak menggambarkan inflamasi yang terjadi pada apendiks maupun peritoneum.…”

Section: Ekspresi Mmp Pada Serumunclassified

“…[6,20] Tabel 2. Sensitivitas Pemeriksaan pada Apendisitis Akut [17,18,20] No Meto de [19] MMP-9 merupakan biomarker paling utama yang dapat dideteksi pada apendisitis perforasi. MMP-9 selalu dijumpai mengalami peningkatan yang signifikan pada pemeriksaan histopatologi, biopsi cairan pada area perforasi, pemeriksaan serum, dan cairan peritoneum.…”

Section: Ekspresi Mmp Pada Serumunclassified

Matriks Metalloproteinase (MMP) sebagai Biomarker Terjadinya Perforasi pada Apendisitis Akut

Alnaz¹,

Nasution²,

Abdillah³

2020

JIMKI

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Pendahuluan: Apendisitis akut merupakan salah satu penyebab operasi gawat darurat dalam bidang gastroenterohepatologi. Hanya apendisitis yang terkomplikasi seperti perforasi yang memerlukan tindakan operasi. Saat ini belum ditemukan cara untuk menegakkan apakah pasien apendisitis yang datang perlu dilakukan operasi atau hanya dengan terapi konservatif dengan antibiotik. Salah satu pemeriksaan yang dapat dikaitkan pada apendisitis adalah Matriks Metalloproteinase (MMP). Tinjauan pustaka ini bertujuan untuk mengetahui potensi dan sensitivitas MMP sebagai biomarker untuk menentukan kemungkinan terjadinya perforasi pada apendisitis akut. Metode: Artikel dibuat dengan metode literature review dengan menggunakan textbook dan 21 jurnal, dengan 10 jurnal utama. Jurnal diperoleh dari search engine Pubmed, Cochrane, dan Google Scholar. Pembahasan: MMP memiliki sifat proteolitik terhadap matriks ekstraseluler pada jaringan ikat yang meningkat pada reaksi inflamasi. Ketidakseimbangan MMP terhadap Tissue Inhibitor of Metalloproteinase (TIMP) pada apendisitis menyebabkan peningkatan aktvitias proteolisis yang merusak dinding apendiks yang menjadi patofisiologi perforasi. Ekspresi dan konsentrasi MMP dijumpai meningkat secara signifikan pada pemeriksaan biopsi, imunohistokimia, cairan peritoneum, dan serum pasien yang mengalami komplikasi apendisitis dibandingkan dengan apendisitis tanpa komplikasi. MMP mampu membedakan apendisitis terkomplikasi dengan tidak, namun membutuhkan pemeriksaan TIMP untuk menentukan jenis komplikasi apendisitis. Simpulan: Pemeriksaan MMP dan TIMP berpotensi menjadi biomarker terjadinya perforasi pada apendisitis. Saran: Diperlukan penelitian lebih lanjut untuk menentukan nilai cut-off pada apendisitis.

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The Value of C-Reactive Protein in Enhancing Diagnosis of Acute Appendicitis

Cited by 13 publications

References 9 publications

C-Reactive Protein Levels and its Association with Acute and Chronic Inflammatory Diseases- An Observational Study

C-Reactive Protein Levels and its Association with Acute and Chronic Inflammatory Diseases- An Observational Study

Role of C-Reactive Protein, White Blood Cell Counts, Bilirubin Levels, and Imaging in the Diagnosis of Acute Appendicitis as a Cause of Right Iliac Fossa Pain

Matriks Metalloproteinase (MMP) sebagai Biomarker Terjadinya Perforasi pada Apendisitis Akut

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