Mean Platelet Volume and Platelet Distribution Width as Diagnosis Markers of Acute Perforated Appendicitis in Pediatric Patients

Rahmi Noorhayati,Wahyu Wardhana Wardhana

doi:10.20527/jbk.v16i2.9224

Abstract

Abstract: Symptoms and findings in acute perforated appendicitis (APA) may not always typical in children, becomes difficult to establish the diagnosis preoperatively. Rapid and accurate diagnosis is important to reduce the risk of sepsis and even death. Another biomarkers for diagnosis are needed. This study investigated the diagnostic accuracy of indicators of platelet activation, namely mean platelet volume and platelet distribution width, in children with non perforated acute appendicitis (NPAA) and APA. This retrospective study compared 15 patients with APA (Group I), 15 patients with NPAA (Group II) between January 2016 to December 2018. Patient white blood cell (WBC) count, platelet (PLT) count, MPV, PDW, and hematocrit (HCT) were analyzed. Receiver operating characteristic (ROC) curves were used to evaluate the sensitivity and specificity of these indices in AP. Positive correlation was found between MPV and the degree of AP; as well as negative correlation between PDW and degree of AP. This is the first study to assess the MPV and PDW in pediatric patients with AP. This study showed the MPV is reduced and the PDW is normal in patients with AP. A decreased MPV value could serve as a marker to diagnose AP preoperatively. More studies are needed to establish relationship between PDW and MPV with AP. Keywords: Appendicitis perforations; Mean Platelet Volume; Platelet distribution width

Highlights

Appendicitis is the most common surgical condition that causes acute abdominal pain in children population, but its diagnosis can be difficult due to its vague signs and symptoms and in preverbal children and its symptoms vary widely.[1,2] Delay in its diagnosis is associated with increased morbidity and mortality
The aim of this study is to research whether mean platelet volume and other platelet indices had diagnostic value to distinguish non perforated acute appendicitis (NPAA) and perforated appendicitis (PAA) on pediatric gruop.[12,13]
Groups were comprised of 53% boy and 47% girl in group I (NPAA), 47% girl and 53% boy in group II (PAA)

Summary

Introduction

Appendicitis is the most common surgical condition that causes acute abdominal pain in children population, but its diagnosis can be difficult due to its vague signs and symptoms and in preverbal children and its symptoms vary widely.[1,2] Delay in its diagnosis is associated with increased morbidity and mortality. It is necessery to use more biomarkers are needed to clarify the diagnosis of patients with suspected appendicitis.[3,4]. Recent studies have investigated the diagnostic accuracy of inflammatory markers.[5,6] During inflammatory diseases such as appendicitis, there is a rapid recruitment of platelets to the site of inflammation where large active platelets decrease due to its consumption and sequestration.[7,8]. Recent studies have investigated the diagnostic accuracy of inflammatory markers.[9,10] Mean platelet volume (MPV) and platelet distribution width (PDW) are markers of the platelet activation that have relation with inflamation and can be helpful in diagnosis of acute appendicitis.[11]

Objectives

Methods

Results