Can Fetuin-A, CRP, and WBC Levels Be Predictive Values in the Diagnosis of Acute Appendicitis in Children with
1Department of Pediatric Surgery, Cumhuriyet University Medical Faculty, Sivas 58140, Turkey. cguney@cumhuriyet.edu.tr.
Insights
Plasma Fetuin-A (FA) levels are significantly lower in children with acute appendicitis (AA). Decreased FA levels indicate AA, while very low levels suggest a higher risk of perforation, aiding in early diagnosis.
Area of Science:
- Pediatric Surgery
- Biochemistry
- Emergency Medicine
Background:
- Acute appendicitis (AA) is a frequent surgical emergency, often leading to perforation.
- Early diagnosis and novel biomarkers are crucial for managing AA.
- Investigating plasma Fetuin-A (FA) levels offers potential for improved diagnostic strategies.
Purpose of the Study:
- To evaluate the association between plasma Fetuin-A (FA) levels and acute appendicitis (AA) in pediatric patients.
- To determine if FA levels can predict perforation risk in children with AA.
- To explore FA as a potential diagnostic marker in acute abdominal pain.
Main Methods:
- Prospective study of 107 pediatric patients (<16 years) with abdominal pain.
- Categorization into acute appendicitis (AA) and other causes (OC) groups.
- Subgroup analysis of AA based on location and perforation status; serum FA levels measured.
Main Results:
- Children with AA exhibited significantly lower plasma FA levels compared to other causes of acute abdomen (AB).
- Elevated C-reactive protein (CRP) and white blood cell (WBC) counts were observed in the AA group.
- Multivariate analysis identified FA, CRP, and WBC levels as prognostic indicators for AA and perforation risk.
Conclusions:
- Plasma FA levels, alongside CRP and WBC, show predictive value in diagnosing AA in children.
- Significantly decreased FA levels correlate with AA, and markedly low levels are associated with perforation.
- These biomarkers may assist in identifying high-risk pediatric patients with acute appendicitis.
Abstract:
Background: Acute appendicitis (AA) is the most common cause of emergency surgery. Therefore, perforation is common. Early diagnosis and new markers are needed. The aim of this study was to investigate the effects of plasma Fetuin-A (FA) levels in patients with an acute abdomen (AB). Material and Method: This prospective study included 107 patients younger than 16 years of age who were admitted to the emergency department for abdominal pain between January and December 2018. The patients who presented abdominal pain were divided into two groups as AA and other causes (OC) of AB. Patients with acute appendicitis; intraperitoneal, retrocolic/retrocecal, and appendicitis were divided into three groups. Additionally, the AA group was divided into two groups as perforated appendicitis and non-perforated appendicitis. Serum FA levels of the patients were evaluated in the emergency department. Results: In the AA group, C-reactive protein (CRP) and white blood cell (WBC) levels were higher, and FA levels were significantly lower than in the AB group. Intraperitoneal localization was 95.2% and perforation was frequent. When significant values in the univariate regression analysis for acute abdomen and perforation were compared in the multivariate regression analysis, CRP, WBC, and FA levels were found to be prognostic. Furthermore, decreased FA levels were associated with AA, while too greatly decreased FA levels were associated with the risk of perforation. Conclusion: Current diagnosis can be made by history, physical examination, laboratory, and imaging methods in appendicitis cases. While trying to diagnose AA in children, the FA, CRP, and WBC levels may be predictive values to identify risk factors.
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