Eosinophilia in pediatric uncomplicated appendicitis is a time stable pattern

We have recently shown that uncomplicated phlegmonous appendicitis is characterized by independent inflammatory patterns based on significant eosinophilia in children aged 7-17 years. However, clinical decision-making based on inflammatory values is not easy, especially due to the dynamics of inflammation over time. The present study was performed to evaluate the basic distinguishability of the inflammatory entities by laboratory values over time based on an extended patient number with children aged 0-17 years.

All patients aged 0-17 years, who underwent appendectomy from January 2008 until June 2016, were retrospectively reviewed. Special attention was paid to cellular subpopulations within full blood counts within compartments of time (onset of symptoms - blood sampling): 0-12 , > 12-24 , > 24-36 , > 36-48 , > 48-72 , > 72 h.

1041 appendectomies were included in the study. The inflammatory course in patients with complicated appendicitis (n = 369) was characterized by continuously increased mean leukocytes, neutrophil and monocyte counts compared with patients with phlegmonous appendicitis (n = 489). In contrast, continuous relative eosinophilia was found in uncomplicated appendicitis within the inflammatory process. In cases of negative appendectomies (n = 183), again, distinct independent inflammatory patterns were found.

Eosinophilia is a constant and independent pattern in children with uncomplicated appendicitis, which, thus, can be distinguished throughout the inflammatory process.