Urinary biomarkers in pediatric appendicitis

Salö, Martin; Roth, Bodil; Stenström, Pernilla; Arnbjörnsson, Einar; Ohlsson, Bodil

doi:10.1007/s00383-016-3918-x

Cited by 23 publications

(42 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The actual feasibility and logistic of analyzing urine biomarkers in a clinical setting may pose additional obstacles but as our samples were analyzed in a research context, we do not have experience in this aspect. However, the time taken for processing of urine LRG in a clinical care setting had been reported to be 2 hours and at a cost of 26 USD in the study by Salo et al [22]. This was made possible by the new generation 'Ultra-Fast ELISA' assay.…”

Section: Discussionmentioning

confidence: 99%

“…This was replicated in the study by Kharbanda et al [23], wherein despite achieving a 100% sensitivity and negative predictive value, the AUC was only 0.63 by ELISA. In another comparative study employing equal numbers of AA and non-AA cases, Salo et al showed improved performance when urine LRG was used in conjunction with the Pediatric Appendicitis score [22]. The combination demonstrated superior sensitivity of 95%, specificity of 90% and AUC of 0.94.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A novel noninvasive appendicitis score with a urine biomarker

Yap

Fan

Chen

et al. 2019

Journal of Pediatric Surgery

View full text Add to dashboard Cite

Purpose: The aim of our study was to develop an appendicitis score incorporating a urine biomarker, Leucine rich alpha-2-glycoprotein (LRG), for evaluation of children with abdominal pain. Methods: From January to August 2017 we prospectively enrolled children aged 4-16 years old admitted for suspected appendicitis. Urine samples for LRG analysis were obtained preoperatively and quantified by enzyme-linked immunosorbent assay (ELISA) after correction for patient hydration status. The diagnosis of appendicitis was based on operative findings and histology. Logistic regression was used to identify prospective predictors.Results: A total of 148 patients were recruited, of which 42(28.4%) were confirmed appendicitis. Our Appendicitis Urinary Biomarker (AuB) model incorporated urine LRG with 3 clinical predictors: 'constant pain', 'right iliac fossa tenderness', 'pain on percussion'. Area under the ROC curve for AuB was 0.82 versus 0.78 for the Pediatric Appendicitis Score (PAS) on the same cohort of patients. A model-calculated risk score of b 0.15 is interpreted as low risk of appendicitis. Sensitivity for the AuB at this cutoff was 97.6%, specificity 37.7%, negative predictive value 97.6%, positive predictive value 38.3%, and negative likelihood ratio 0.06. Conclusion: The noninvasive AuB score appears promising as a diagnostic tool for excluding appendicitis in children without the need for blood sampling. Type of study: Study of diagnostic test. Level of evidence: Level III.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A novel noninvasive appendicitis score with a urine biomarker

Yap

Fan

Chen

et al. 2019

Journal of Pediatric Surgery

View full text Add to dashboard Cite

show abstract

“…The precise function of LRG1 remains unknown, but accumulating evidences showed that LRG1 is closely correlated with various types of cancers, such as lung, oral, ovarian, gastrict, pancreatic and biliary tract cancers [14][15][16][17][18]. Moreover, LRG1 is identified as an inflammatory protein in human serum and highly expressed in various kinds of benign inflammatory and autoimmune diseases, including suspected acute appendicitis of children [19], activated ulcerative colitis [12], rheumatoid arthritis [20,21], adultonset Still's disease [22] and asthma [23]. Especially, Ahn et al found serum LRG, namely LRG1, is elevated in patients with SLE and correlates with disease activity [24].…”

Section: Introductionmentioning

confidence: 99%

Leucine-rich α2-glycoprotein-1 upregulation in plasma and kidney of patients with lupus nephritis

et al. 2020

View full text Add to dashboard Cite

Background: Increased leucine-rich α2-glycoprotein-1 (LRG1) has been observed in various inflammatory and autoimmune diseases. We aimed to explore the expression and role of LRG1 in lupus nephritis (LN). Methods: Plasma LRG1 (pLRG1) was measured by enzyme-linked immunosorbent assay in 101 patients with renal biopsy-proven LN and 21 healthy controls (HC). Relationships between pLRG1 and clinical and pathological characteristics were analyzed. The expression of LRG1 in peripheral blood leukocytes and kidney was detected by flow cytometry, immunohistochemistry and immunofluorescence, respectively. Further cell experiments were focused on the role of LRG1.Results: We found that LRG1 was expressed in plasma, some peripheral blood leukocytes, proximal tubule and several inflammatory cells. The levels of LRG1 in plasma, peripheral blood leukocytes and kidney were elevated in LN patients as compared to HC. Plasma expression levels of LRG1 correlated positively with renal function and renal disease activity, and reflect specific pathologic lesions in the kidneys of patients with LN. Interleukin-1β and interleukin-6, not tumor necrosis factor-α and interferon γ induced the LRG1 expression in human renal tubular epithelial cell line. Moreover, stimulation of recombinant human LRG1 could inhibit late apoptosis, promote proliferation and regulate expression of inflammatory factors and cytokines. Conclusions: Plasma expression levels of LRG1 were associated with renal function, disease activity, and pathology in LN. It might also be involved in renal inflammation, proliferation and apoptosis of endothelial cells. LRG1 might be a potential prognosis novel predictor in LN patients.

show abstract

“…Clinical appearance in the younger children is often atypical, and misdiagnosis in 3 this age group is not rare, which can lead to an increased rate of perforation [2] . Clinical presentation, Pediatric Appendicitis Score (PAS), ALVARADO score, Computed tomography, ultrasound and blood tests, may be helpful in diagnose of AA, but it is difficult to confirm the type of appendicitis (simple or complicated appendicitis) [3][4][5] . Been able to diagnose uncomplicated vs. complicated appendicitis allows the surgeon to choose the best surgical approach ranging from antibiotics and delayed appendectomy to laparotomy [6] .…”

Section: Introductionmentioning

confidence: 99%

C -reactive protein and albumin ratio for the diagnosis of complicated appendicitis in children

Feng

Yang

Xing

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: No reliably specific marker for complicated appendicitis has been identified. Serum C-reactive protein (CRP) and albumin (ALB) ratio (CRP/ALB ratio) has been a new inflammation-based prognostic score which is associated with the severity of inflammation. However, its value in the diagnosis of complicated appendicitis has not been studied. The aim of this study was to evaluate the predictive value of CRP/ALB ratio for complicated appendicitis in children. Methods: A retrospective study of 232 children with acute appendicitis was conducted with assessment of age, gender, symptom duration, albumin and blood routine indexes on admission. According to intraoperative findings and postoperative pathological results, patients were divided into the simple appendicitis group (127 cases) and complicated appendicitis group (105 cases). SPSS version 17 was used to analyse the data. Results: Of the 232 patients, 118 (50.9%) were male and 114 (49.1%) were female. The CRP/ALB ratio was higher in complicated appendicitis compared with simple appendicitis (p<0.05). Logistic regression analysis showed that the higher levels of mononuclear cell count (MC), CRP, procalcitonin (PCT) and CRP/ALB ratio were independent risk factors for complicated appendicitis in children. Receiver operating characteristic curve analysis showed that the area under the curve of CRP/ALB ratio (0.946) was was bigger than MC (0.619), CRP (0.906) and PCT (0.843). CRP/ALB ratio >1.43 was found to be a significant marker in predicting complicatedappendicitis with 91.4% sensitivity and 90.6% specificity. Compared with CRP/ALB ratio =<1.43, patients with CRP/ALB ratio >1.43 had a 102.22 times higher chance of complicated appendicitis (95% CI: 41.322 - 252.874). Conclusion: Admission CRP/ALB ratio was significantly higher in children with acute complicated appendicitis. It is a novel but promising hematological marker that aids the differentiation of acute complicated and simple appendicitis.

show abstract

Urinary biomarkers in pediatric appendicitis

Abstract: LRG, adjusted for dehydration, is a promising novel urinary biomarker for appendicitis in children. LRG in combination with PAS has a high diagnostic performance.

Cited by 23 publications

References 34 publications

A novel noninvasive appendicitis score with a urine biomarker

A novel noninvasive appendicitis score with a urine biomarker

Leucine-rich α2-glycoprotein-1 upregulation in plasma and kidney of patients with lupus nephritis

C -reactive protein and albumin ratio for the diagnosis of complicated appendicitis in children

Contact Info

Product

Resources

About