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Eosinophilia in pediatric uncomplicated appendicitis is a time stable pattern

Josephine Reismann1, D Schädlich2, M I Minderjahn2

  • 1Department of Pediatric Surgery, Charité, Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. Josephine.reismann@charite.de.

Pediatric Surgery International
|December 12, 2018
PubMed

Insights

Eosinophilia is a key indicator in diagnosing uncomplicated appendicitis in children. This study confirms eosinophilia as a distinct inflammatory pattern differentiating uncomplicated appendicitis from complicated cases over time.

Area of Science:

  • Pediatric Surgery
  • Inflammatory Diseases
  • Hematology

Background:

  • Uncomplicated phlegmonous appendicitis exhibits unique inflammatory patterns, notably eosinophilia, in children aged 7-17.
  • Clinical differentiation of appendicitis based on inflammatory markers is challenging due to dynamic changes over time.

Purpose of the Study:

  • To evaluate the distinguishability of inflammatory patterns in appendicitis using laboratory values over time.
  • To expand on previous findings by including a broader age range (0-17 years) and a larger patient cohort.

Main Methods:

  • Retrospective review of 1041 appendectomies in patients aged 0-17 years (January 2008 - June 2016).
  • Analysis of full blood count cellular subpopulations.
  • Categorization of blood sampling times relative to symptom onset (0-12h, >12-24h, >24-36h, >36-48h, >48-72h, >72h).

Main Results:

  • Complicated appendicitis (n=369) showed persistently elevated leukocytes, neutrophils, and monocytes compared to uncomplicated cases (n=489).
  • Uncomplicated appendicitis consistently demonstrated relative eosinophilia throughout the inflammatory process.
  • Negative appendectomies (n=183) exhibited distinct inflammatory patterns separate from complicated and uncomplicated appendicitis.

Conclusions:

  • Relative eosinophilia serves as a constant and independent inflammatory marker in children with uncomplicated appendicitis.
  • Eosinophilia allows for the distinction of uncomplicated appendicitis throughout its inflammatory course.
  • Distinct laboratory patterns aid in differentiating appendicitis types and negative appendectomies.
Abstract

Keywords:
AppendicitisChildrenEosinophiliaTime course

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