Do normal leucocyte count and C-reactive protein value exclude acute appendicitis in children?

Area of Science:

• Pediatric Surgery
• Clinical Diagnostics
• Inflammatory Markers

Background:

• Acute appendicitis is a common surgical emergency in children.
• Diagnostic accuracy for appendicitis in pediatric patients can be challenging.
• Leucocyte count and C-reactive protein (CRP) are commonly used inflammatory markers.

Purpose of the Study:

• To evaluate the diagnostic role of leucocyte count and CRP in pediatric acute appendicitis.
• To identify cases of acute appendicitis in children presenting with normal leucocyte count and CRP levels.
• To compare diagnostic marker utility in children versus adults.

Main Methods:

• A comparative study involving 100 children with acute appendicitis (group B) and 100 with uninflamed appendices (group A).
• Preoperative leucocyte count and CRP levels were measured and analyzed.
• The distribution of normal, elevated, and combined values was calculated for both groups.

Main Results:

• Leucocyte count significantly differentiated between inflamed and uninflamed appendices in children (p < 0.001).
• Mean leucocyte count was 10.2 x 10(9)/L in controls and 15.0 x 10(9)/L in appendicitis cases.
• C-reactive protein (CRP) levels did not effectively distinguish between the groups (p = 0.866).
• Notably, 7% of children with acute appendicitis had both normal leucocyte count and CRP levels.

Conclusions:

• Normal leucocyte count and CRP levels do not reliably exclude acute appendicitis in children.
• Diagnostic strategies for pediatric appendicitis may need to consider limitations of these inflammatory markers.
• Findings contrast with adult appendicitis diagnostics, emphasizing age-specific considerations.