Abstract
Acute appendicitis (AA) is the first cause of emergency surgery. Leucine-Rich Alpha-2-Glycoprotein 1 (LRG1) has been shown to be a potential biomarker in cases of AA in children, but there are conflicting results for its use in adults. The objective of this study is to compare the median plasma values of LRG1 in patients with acute abdomen with and without appendicitis. This case–control study was conducted prospectively at the emergency room (ER) of a tertiary teaching hospital, between March 1st, 2011 and December 31st, 2012. Patients with recent abdominal pain, aged 18–70 years who attended at the ER were included in the study. Blood samples were drawn at the first presentation. Those who were submitted to surgery and had a pathology report of AA were considered as cases. Those without a need for surgery and treated for other conditions, e.g., pelvic inflammatory disease, were considered as controls. Follow-up in controls was made up to 30 days. LRG1 plasma median values were measured using an ELISA kit and compared between groups. A total of 28 participants, 14 cases with acute appendicitis and 14 controls, were included. The median (range) values of leucine-rich alpha-2-glycoprotein-1 level in the group with appendicitis and control group were 8.8 ng/ml (5.5–31) and 11 (4.6–108) ng/ml, respectively (Mann–Whitney test P = 0.26). Median plasma leucine-rich alpha-2-glycoprotein-1 levels were not useful in diagnosing Acute Appendicitis in patients with acute abdominal pain.
Highlights
Acute appendicitis (AA) is the first cause of emergency surgery in the United States, with about 250,000 cases per year[1] and has a peak incidence in the 10–24-years-old age group; the incidence in men is higher than in women[2]
Dermici et al reported that plasma levels of leucine-rich alpha-2-glycoprotein 1 (LRG1) were not useful to differentiate between acute appendicitis and pelvic inflammatory disease in women with acute abdominal pain in right lower-quadrant[16]
Between March 1st, 2011 and December 31st, 2012, 28 cases who presented at the emergency room at HCPA with a hypothesis of appendicitis and with inclusion criteria were enrolled
Summary
Acute appendicitis (AA) is the first cause of emergency surgery in the United States, with about 250,000 cases per year[1] and has a peak incidence in the 10–24-years-old age group; the incidence in men is higher than in women[2]. Patients with appendicitis continue to display a complex and atypical range of clinical manifestations, providing a subsequent high risk for emergency physicians to miss acute abdominal pathology on a patient’s initial visits[7]. In 2017, using an adult population (> 18 years-old) and a commercial ELISA kit for LRG1, Rainer et al found a significant difference in plasma median levels of LRG1 between patients with and without appendicitis. Due to the great variability of kits and to the scant data on the accuracy of LRG1 in an adult population with acute abdominal pain, it is necessary to investigate with different ELISA kits to evaluate the accuracy of LRG1 in the differential diagnosis of acute appendicitis. The objective of this study is to compare the plasma levels of LRG1 in an adult population with and without the diagnosis of appendicitis, using a commercial ELISA kit
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