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Are neutrophil CD64 expression and interleukin-6 early useful markers for diagnosis of acute appendicitis?
İsmet F Ozguner1, Murat Kızılgun2, Ayse Karaman1
1Department of Pediatric Surgery, Dr Sami Ulus Maternity and Children's Training and Research Hospital, Ankara, Turkey.
Insights
Interleukin-6 (IL-6) levels effectively identified appendicitis, differentiating patients with the condition from those without. Neutrophil CD64 expression and CRP levels were higher in complicated appendicitis cases.
Area of Science:
- Pediatric Surgery
- Clinical Diagnostics
- Immunology
Background:
- Acute appendicitis (AA) diagnosis can be challenging, particularly in differentiating it from nonspecific abdominal pain.
- Biomarkers such as interleukin-6 (IL-6) and neutrophil CD64 expression are explored for improved diagnostic accuracy.
Purpose of the Study:
- To evaluate the diagnostic utility of serum IL-6 levels and leukocyte CD64 expression in children presenting with right lower quadrant pain.
- To differentiate between non-complicated appendicitis, complicated appendicitis, and nonspecific abdominal pain.
Main Methods:
- A prospective controlled trial involving 49 children hospitalized with right lower quadrant pain.
- Serum samples analyzed for white blood cell count, C-reactive protein (CRP), IL-6, and leukocyte CD64 expression.
- Patients were categorized into non-complicated appendicitis (Group 1), complicated appendicitis (Group 2), and nonspecific abdominal pain (Group 3).
Main Results:
- Leukocyte CD64 expression and CRP levels were significantly elevated in patients with complicated appendicitis (Group 2).
- IL-6 levels were significantly lower in patients with nonspecific abdominal pain (Group 3) compared to those with appendicitis (Groups 1 and 2).
Conclusions:
- Leukocyte CD64 expression and CRP effectively predicted complicated appendicitis but not non-complicated cases.
- IL-6 levels demonstrated significant diagnostic value, distinguishing appendicitis patients from those with nonspecific abdominal pain.
- Incorporating IL-6 measurements may aid in reducing false-positive diagnoses of acute appendicitis.
Background/Purpose:
The aim of the study is to evaluate the diagnostic value of interleukin-6 (IL-6) level and neutrophil cluster of differentiation 64 (CD64) expression in diagnosis of acute appendicitis (AA).
Methods:
A prospective controlled trail was performed. Children who were hospitalized with a diagnosis of right lower quadrant pain were our cohort. Serum samples for white blood cell, C-reactive protein (CRP), leukocyte CD64 expression, and IL-6 were obtained from the patients just after their admission. Operation was performed if appendicitis seemed probable, others were observed actively. Patients who had noncomplicated appendicitis were Group 1, patients who had complicated appendicitis were Group 2, and patients who had discharged after observation without operation with a diagnosis of nonspecific abdominal pain and had negative appendectomy without another surgical disease were Group 3.
Results:
In this study, 49 patients were enrolled. CRP and CD64 levels were found higher in Group 2. IL-6 levels were found to be lower in Group 3 than Groups 1 and 2.
Conclusions:
There was a difference between Group 2 and the other groups about CD64 levels. The CRP level and expression of leukocyte CD64 level did not effectively predict the diagnosis of noncomplicated appendicitis, but it predicted well the patients with complicated appendicitis. However, IL-6 levels are statistically significantly different between Group 3 and Groups 1 and 2. According to this result, IL-6 levels predicted well the patient with appendicitis. Applying additional diagnostic methods such as IL-6 levels seems to be helpful in reducing the numbers of false-positive diagnosis of AA.
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