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01-05-2020 | Appendicitis | Original Article

Determining acute complicated and uncomplicated appendicitis using serum and urine biomarkers: interleukin-6 and neutrophil gelatinase-associated lipocalin

Authors: Mohit Kakar, Mathilde Delorme, Renars Broks, Lasma Asare, Marisa Butnere, Aigars Reinis, Arnis Engelis, Juta Kroica, Amulya Saxena, Aigars Petersons

Published in: Pediatric Surgery International | Issue 5/2020

Abstract

Purpose

The study aim is to determine whether serum and urine interleukin-6 (IL-6) and neutrophil gelatinase-associated lipocalin (NGAL) can be included in the early diagnostic algorithm for pediatric appendicitis.

Methods

Prospective single-center cohort study included 92 children divided into control, acute complicated appendicitis (AcA) and acute uncomplicated appendicitis (AnA) groups. Serum and urine samples were assayed for IL-6 and NGAL preoperatively, and on the second and fifth postoperative days. Intraoperative and bacteriological findings divided the appendicitis patients.

Results

Average serum biomarker levels were higher in appendicitis patients versus the control, and the following values were produced via receiver operating characteristic (ROC) analysis. NGAL and IL-6 cutoff values were 113.95 ng/ml and 24.64 pg/ml, respectively, NGAL had 68.3% sensitivity and 65.5% specificity, while IL-6 had 72.6% and 86.2%. Comparing AcA and AnA, IL-6 was the only biomarker of significance yielding 77.4% sensitivity and 58.1% specificity with a 26.43 pg/ml cutoff value. Urine biomarkers were non-specific in differentiation appendicitis severity and ultimately, between infectious and non-infectious disease.

Conclusion

Although NGAL provided measurable useful diagnostic information in evaluating children for appendicitis, its values were not sufficient for appendicitis severity. Serum IL-6 remains a strong biomarker for suspected acute appendicitis and has promising results predicting its severity.

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Title: Determining acute complicated and uncomplicated appendicitis using serum and urine biomarkers: interleukin-6 and neutrophil gelatinase-associated lipocalin
Authors: Mohit Kakar
Mathilde Delorme
Renars Broks
Lasma Asare
Marisa Butnere
Aigars Reinis
Arnis Engelis
Juta Kroica
Amulya Saxena
Aigars Petersons
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keywords: Appendicitis
Appendicitis
Appendectomy
Biomarkers
Published in: Pediatric Surgery International / Issue 5/2020
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-020-04650-y

At a glance: The STEP trials

Springer Medicine

Determining acute complicated and uncomplicated appendicitis using serum and urine biomarkers: interleukin-6 and neutrophil gelatinase-associated lipocalin

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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