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Urinary biomarkers in pediatric appendicitis.

Martin Salö1,2, Bodil Roth3, Pernilla Stenström4,5

  • 1Department of Clinical Sciences, Lund University, Lund, Sweden. martin.salo@med.lu.se.

Pediatric Surgery International
|June 29, 2016
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Summary

Diagnosing pediatric appendicitis is improved by a novel urinary biomarker, leucine-rich α-2-glycoprotein (LRG). Combining LRG with the Pediatric Appendicitis Score (PAS) significantly enhances diagnostic accuracy for appendicitis in children.

Keywords:
Abdominal painAppendicitisBiomarkersChildren

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Area of Science:

  • Pediatric Gastroenterology
  • Clinical Diagnostics
  • Biomarker Discovery

Background:

  • Pediatric appendicitis diagnosis remains challenging, leading to high rates of perforation and unnecessary surgeries.
  • Current diagnostic methods, including the Pediatric Appendicitis Score (PAS) and routine blood tests, have limitations in accuracy.

Purpose of the Study:

  • To evaluate novel urinary biomarkers for diagnosing appendicitis in children.
  • To assess if combining promising biomarkers with the PAS can improve diagnostic accuracy.

Main Methods:

  • Prospective study involving children with suspected appendicitis.
  • Assessed PAS, routine blood tests, and urinary biomarkers: leucine-rich α-2-glycoprotein (LRG), calprotectin, IL-6, and substance P.
  • Histopathological analysis confirmed appendicitis diagnosis.

Main Results:

  • Urinary LRG was significantly elevated in children with appendicitis (p < 0.001).
  • LRG levels were higher in complicated appendicitis cases (gangrenous/perforated) than phlegmonous.
  • LRG combined with PAS achieved 95% sensitivity and 90% specificity.

Conclusions:

  • Dehydration-adjusted urinary LRG is a promising biomarker for pediatric appendicitis.
  • The combination of LRG and PAS demonstrates high diagnostic performance for appendicitis.