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[Acute-phase proteins in appendicitis in childhood: new findings]
1Cattedra di Chirurgia Pediatrica, Università degli Studi di Siena, Italia.
Insights
Monitoring acute phase proteins aids in diagnosing acute appendicitis in children. Elevated white blood cell (G.B.) count and C-reactive protein (P.C.R.) levels are early indicators, improving diagnostic accuracy.
Area of Science:
- Pediatric Surgery
- Clinical Chemistry
- Immunology
Background:
- Acute appendicitis diagnosis in children presents challenges.
- Acute phase protein (APP) response is a potential diagnostic marker.
- APPs are hepatic proteins released due to inflammation, infection, or trauma.
Purpose of the Study:
- To evaluate the utility of preoperative acute phase protein values in pediatric appendicitis.
- To assess the diagnostic and prognostic value of APPs in pediatric appendicitis.
Main Methods:
- Analysis of preoperative acute phase protein levels in pediatric patients with appendicitis.
- Statistical evaluation of various APP markers, including white blood cell (G.B.) count and C-reactive protein (P.C.R.).
Main Results:
- Preoperative APP evaluation is beneficial for diagnosing pediatric appendicitis.
- G.B. count and P.C.R. show early and statistically significant changes.
- Other APP values exhibit later and less interpretable alterations.
Conclusions:
- Acute phase protein monitoring, particularly G.B. count and P.C.R., is a valuable tool for preoperative diagnosis of acute appendicitis in children.
- Early detection of changes in specific APPs can aid in timely surgical intervention and patient management.
Abstract:
The diagnosis of acute appendicitis in children can be sometimes difficult. The monitoring of acute phase protein response has been suggested as an accurate diagnostic procedure in these patients. This response is an aspecific event caused by phlogosis, infections and traumatisms; it is accomplished by the hepatic release of "endogenous leukocytic mediators" (L.E.M.) among which can be remembered IL-6 and IL-7. The acute phase proteins can be distinguished into positive and negative factors. Many authors used the acute phase protein response in order to stratify the severity of disease, to evaluate the efficacy of therapy and to find out any complication. They actually think that this response is useful to draw up a prognostic index in each patient. This second part of a study started in 1994 is based on the evaluation of the preoperative acute phase proteins values in pediatric patients affected by acute appendicitis underwent to surgery. The results of the statistic analysis show the utility of the evaluation of these parameters in the preoperative period; in particular G.B. count and P.C.R. rates very early with significant statistics, while the other values change later and are more difficult to interpret.