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Is it possible to predict the spontaneous reduction of pediatric intussusception using biomarkers?
Emel Ulusoy1, Oktay Ulusoy2, Nazlı Sütçüoğlu2
1Division of Pediatric Emergency Care, Department of Pediatrics, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
Insights
Alpha-glutathione S-transferase (alpha-GST), neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (CRP) can predict spontaneous reduction in childhood intussusception. These markers may help avoid unnecessary interventions for pediatric abdominal pain.
Area of Science:
- Pediatric Gastroenterology
- Biomarker Discovery
- Emergency Medicine
Background:
- Intussusception is a frequent cause of acute abdominal pain in children.
- Predicting spontaneous reduction can prevent invasive procedures.
Purpose of the Study:
- To investigate if alpha-glutathione S-transferase (alpha-GST), intestinal fatty acid-binding protein (IFABP), and inflammatory markers predict spontaneous reduction in ileocolic intussusception.
- To identify biomarkers that may reduce the need for unnecessary interventions.
Main Methods:
- Prospective case-control study in a Pediatric Emergency Department.
- Patients with ileocolic intussusception classified into spontaneous reduction, hydrostatic reduction, or surgical groups.
- Measured alpha-GST, IFABP, C-reactive protein (CRP), white blood cell count, neutrophil count, and neutrophil-to-lymphocyte ratio (NLR) pre-intervention.
Main Results:
- Significant differences observed in alpha-GST, CRP, white blood cell count, neutrophil count, and NLR between intussusception and control groups.
- IFABP levels did not show statistical significance.
- Alpha-GST, NLR, and CRP were significantly higher in patients requiring intervention compared to those with spontaneous reduction.
Conclusions:
- Alpha-GST, NLR, and CRP are potential predictors of spontaneous reduction in intussusception.
- These biomarkers may help clinicians minimize unnecessary interventions for pediatric intussusception.
Background:
Intussusception is one of the most common causes of acute abdominal pain in childhood. In this study, we hypothesized that alpha-glutathione S-transferase (alpha-GST), intestinal fatty acid-binding protein (IFAB), and inflammatory markers may predict spontaneous reduction in ileocolic intussusceptions, thereby preventing unnecessary interventions.
Methods:
A single-center, prospective case-control study was conducted in the Pediatric Emergency Department. Patients with ileocolic intussusception were categorized into three subgroups: spontaneous reduction, hydrostatic reduction, and those requiring surgery. Levels of Alpha-GST, IFABP, and routine inflammatory markers were measured prior to intervention.
Results:
A total of 52 cases of intussusception and 26 control patients were included in the study. Spontaneous reduction occurred in seven patients, while 45 patients required intervention. A statistically significant difference was observed between the patient and control groups regarding Alpha-GST, C-reactive protein (CRP), white blood cell count, neutrophil count, and the neutrophil-to-lymphocyte ratio (NLR). However, IFABP did not show a statistically significant difference. Alpha-GST, NLR, and CRP levels were significantly higher in the group requiring intervention than in the spontaneous reduction group.
Conclusion:
This study demonstrates that Alpha-GST, NLR, and CRP may predict spontaneous reduction in cases of intussusception and thereby minimize the need for unnecessary interventions.
