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

J M Grönroos1

  • 1Department of Surgery. University of Turku, Finland. juha.gronroos@tyks.fi

Acta Paediatrica (Oslo, Norway : 1992)
|July 7, 2001
PubMed

Insights

In children, a normal leucocyte count and C-reactive protein (CRP) level do not rule out acute appendicitis. This differs from adult patients, highlighting a key diagnostic challenge in pediatric cases.

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.
Abstract

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