Abstract
Objectives: Appendicitis is a common abdominal emergency in children. It is difficult for clinicians to distinguish between simple appendicitis (SA), gangrenous appendicitis (GA), and ruptured appendicitis (RA) in children based on physical and current laboratory tests. Abdominal computed tomography with the disadvantage of excess radiation exposure is usually used in the emergency room for appendicitis surveys. Serum soluble CD40 ligand (sCD40L) is an inflammatory biomarker. This study aimed to use sCD40L to distinguish SA, GA, and RA.Methods: All patients aged <18 years old with suspected appendicitis were tested once for serum sCD40L within 72 h of appendicitis symptoms. We compared sCD40L levels of SA, GA, and RA individually on days 1, 2, and 3 in patients with normal appendix (NA), a total of nine subgroups. Thereafter, the diagnostic performance of sCD40L in predicting appendicitis and the receiver operating characteristic curves were carried out.Results: Of 116 patients, 42 patients had SA, 20 GA, 44 RA, and 10 NA. We found six subgroups with significant p-values of sCD40L predicting appendicitis as follows: SA on day 2, GA on days 2 and 3, and RA on days 1–3. The sensitivity and specificity of sCD40L at the best cutoff point with 178 pg/mL in these six subgroups range from 0.75 to 1.00 and 0.90, respectively.Conclusions: SCD40L is a good predictor of pediatric appendicitis. Clinicians can use sCD40L to distinguish from SA, GA, and RA in children with suspected appendicitis.
Highlights
Appendicitis is one of the most common abdominal emergencies in pediatric patients [1, 2]
Symptoms and signs which patient first felt ill commonly included migration of abdominal pain, anorexia, nausea and right lower quadrant (RLQ) tenderness in cases with simple appendicitis (SA) and gangrenous appendicitis (GA), but fever, RLQ tenderness, nausea/vomiting, and rebounded pain over RLQ were common in cases with ruptured appendicitis (RA)
The mean soluble CD40 ligand (sCD40L) levels in patients with GA and RA increased from days 1 to 3
Summary
Appendicitis is one of the most common abdominal emergencies in pediatric patients [1, 2]. Appendicitis can be classified as simple appendicitis (SA) and complicated appendicitis including gangrenous appendicitis (GA) and ruptured appendicitis (RA). Soluble CD40 Ligand Predicting Appendicitis [4, 5]. SA is defined as non-perforated appendicitis without necrotic tissue. GA is an inflamed appendix with grossly necrotic tissue without perforation or abscess. RA is called perforated appendicitis [6]. Diagnosis and treatment of SA, including antibiotics and operation, can avoid the occurrence of GA and RA. Delayed treatment may lead to many complications including severe peritonitis and septic shock [7]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have