Pro-adrenomedullin: a novel diagnostic biomarker of acute appendicitis

The objective of this study was to evaluate the diagnostic value of serum pro-adrenomedullin (pro-ADM) levels in diagnosing acute appendicitis (AA) in patients presenting to the emergency department (ED) with abdominal pain.

This prospective clinical study included patients over the age of 18 who presented to the ED with abdominal pain and were initially suspected of having appendicitis. A venous blood sample was collected from each patient upon presentation, and serum pro-ADM levels were measured. Based on laboratory and radiological evaluations, patients were categorized into two groups: those diagnosed with AA and those without AA. The AA group was further subdivided into simple and complicated AA. All statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) for Windows, version 21.0 (SPSS Inc., Chicago, IL, USA). A p-value of <0.05 was considered statistically significant.

This study included 83 adult patients with abdominal pain, of whom 44 were male (53.0%) and 39 were female (47.0%). The mean age of the patients was 32.28+-16.10 years. Serum pro-ADM levels were higher in patients with appendicitis than in those without. Setting the cut-off value for pro-ADM at 3.375 pg/mL to identify patients with appendicitis revealed a statistically significant difference between patients with and without appendicitis (p=0.002). Additionally, there was a statistically significant difference in serum pro-ADM levels when comparing the duration of ED presentation among patients with appendicitis (p<0.001).

Serum pro-ADM levels are elevated in patients with appendicitis; however, pro-ADM is less effective in distinguishing between simple and complicated appendicitis. Serum pro-ADM levels in patients who present to the ED within the first 24 hours of abdominal pain onset may be useful for early diagnosis.